The application of videodermoscopic examination in assessing the skin and its products in pure Arabian horses in the summer and winter seasons.

Videodermoscopic examinations have only recently started to be used in veterinary medicine and usually involve a small group of animals. The aim of this study was to compare specific dermoscopic parameters in selected areas of the body of Arabian horses in the summer and winter seasons. The research was conducted between 2018-2019. The procedure was performed on the left side of the horse's body in seven areas: head, neck, chest, flank, rump, mane, and tail. 42 purebred Arabian horses aged 1-25 (median), 39 mares and 3 stallions were qualified for the study. An Italian Video-Dermascope 7 (Medici Medical SRL with the 3 VIDIX 5Mpx camera and the VX1 overlay - Contact type cap Ø 3.5 cm) was used in the dermatoscopic evaluation. Specialist Cellsens Olympus software for analysing microscopic images was used to perform the measurements. Regardless of the area assessed, the skin in the summer months is darker than in the winter months. Hair thickness ranged from 44.82 (chest in summer) to 87.45 um (mane in winter). Regarding hair density, the number of hairs in the field of view of the dermatoscope ranged from 990 (summer mane) to 3680 (head in winter). Our research showed that the season of the year influences the amount of hair without significantly affecting its thickness.

Evaluation of a hydrolysed salmon and pea hypoallergenic diet application in dogs and cats with cutaneous adverse food reaction.

Cutaneous adverse food reaction (CAFR) is a common disease, affecting about 1-2% of dogs and cats. Diagnosis of the CAFR is made through elimination diet coupled with diet challenge, as methods like skin tests, patch tests, basophil degranulation tests and assessment of IgG and IgE serum levels are not sensitive enough. A partially hydrolysed salmon and pea hypoallergenic diet was evaluated in the diagnosis and treatment of CAFR in dogs and cats. The diet was used in the treatment of 13 dogs and 12 cats for 10 weeks. The Pruritus Visual Analog Scale (PVAS; dogs and cats), Canine Atopic Dermatitis Extent and Severity Index (CADESI-04; dogs) and the Scoring Feline Allergic Dermatitis (SCORFAD; cats) were used for effectiveness evaluation. In dogs, a significant decrease was reported in both CADESI-04 (from 17.3±7.5 to 10.15±7.4; p=0.028) and PVAS (from 7±1.3 to 4.76±1.8; p=0.003) after four weeks of treatment. Also in cats, both the PVAS (from 6.75±1.8 to 4±2.3; p=0.006) and SCORFAD (from 4.16±1.9 to 2.58±1.2; p=0.029) decreased significantly after four weeks. After eight weeks, a significant improvement was observed in almost all the animals. Evaluated diet was useful in the treatment of the CAFR in dogs and cats.

Serum tT4, fT4 and TSH concentrations in German Shepherd dogs depending on age and type of work.

Serum concentration of thyroid hormones in healthy dogs varies according to age, sex, breed or professional activity. The aim of this study was to determine the influence of both age and dogs' work involvement on TSH and thyroid hormones values. Thyroid-stimulating hormone (TSH), total thyroxine (tT4) and free thyroxine (fT4) were tested in the serum of 57 healthy, German Shepherd dogs. The dogs were divided into study groups according to age: dogs aged 3 to 6 years (A), dogs over the age of 6 years (B) and involvement: police-working dogs (C) and accompanying animals (D). Mean values of TSH, tT4 and fT4 ranged from 0.19 to 0.31 ng/ml, 15.58 to 17.25 nmol/L and 11.83 to 17.89 pmol/L, respectively. The highest values of TSH were in group B and the lowest were in group A, while there was an inverse dependence in case of fT4 concentration. The highest mean values of tT4 were in dogs in group C and the lowest in group B. There were statistically significant differences in TSH (p=0.007) and fT4 (p=0.003) concentrations between the age groups. The results indicate that a dog's age is an important factor in the case of thyroid profile results interpretation.

The role of the superior parietal lobule in lexical processing of sign language: Insights from fMRI and TMS.

There is strong evidence that neuronal bases for language processing are remarkably similar for sign and spoken languages. However, as meanings and linguistic structures of sign languages are coded in movement and space and decoded through vision, differences are also present, predominantly in occipitotemporal and parietal areas, such as superior parietal lobule (SPL). Whether the involvement of SPL reflects domain-general visuospatial attention or processes specific to sign language comprehension remains an open question. Here we conducted two experiments to investigate the role of SPL and the laterality of its engagement in sign language lexical processing. First, using unique longitudinal and between-group designs we mapped brain responses to sign language in hearing late learners and deaf signers. Second, using transcranial magnetic stimulation (TMS) in both groups we tested the behavioural relevance of SPL's engagement and its lateralisation during sign language comprehension. SPL activation in hearing participants was observed in the right hemisphere before and bilaterally after the sign language course. Additionally, after the course hearing learners exhibited greater activation in the occipital cortex and left SPL than deaf signers. TMS applied to the right SPL decreased accuracy in both hearing learners and deaf signers. Stimulation of the left SPL decreased accuracy only in hearing learners. Our results suggest that right SPL might be involved in visuospatial attention while left SPL might support phonological decoding of signs in non-proficient signers.

Energy-restricted Central-European diet stimulates liver microsomal function in obese postmenopausal women - a randomized nutritional trial with a comparison to energy-restricted Mediterranean diet.

OBJECTIVE: Obesity and metabolic syndrome are risk factors for liver diseases like non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. A healthy food pattern is vital for managing these health problems, therefore, this study investigated how two calorie-restricted diets, the Central European diet (CED) and Mediterranean diet (MED), altered microsomal liver function in obese postmenopausal women with a risk of metabolic syndrome. PATIENTS AND METHODS: One-hundred-forty-four subjects were randomly assigned to the CED (n=72) or the MED (n=72) groups. A 13C-methacetin breath test was performed, before and after the intervention to assess CPDR (Cumulative Percentage Dose Recovery at 120 minutes of the test), TTP (Time to Peak - maximal momentary recovery of 13C) and Vmax (the maximum momentary 13C recovery). RESULTS: There was a statistically significant increase in TTP and Vmax in the CED group only (p=0.0159 and p=0.0498, respectively). Changes in CPDR and TTP due to intervention were significantly higher in the CED group than in the MED group (p=0.0440 and p=0.0115, respectively). CONCLUSIONS: This is the first study to document a stimulatory effect of the energy-restricted CED on liver microsomal function as compared to MED. The relatively short dietary intervention led to a significant difference in the CYP1A2 activity between groups. The trial was registered in the German Clinical Trials Register (DRKS-ID: DRKS00012958; URL: https://www.germanctr.de/).

Evaluation of the clinical efficiency of lokivetmab in client privately owned atopic dogs - multicenter study.

Atopic dermatitis (AD) is the most frequent allergic disease in dogs. AD can be treated using allergenspecific immunotherapy as well as symptomatic antipruritic treatment including the use of lokivetmab - caninized anti-interleukine-31 antibody.The aim of the study was to evaluate the effectiveness of lokivetmab over 12 weeks of treat-ment. Studies have been carried out in 89 dogs. In all affected animals, the severity of lesions was assessed using the CADESI 04 and the pruritus was assessed using the VAS.After the first dose of lokivetmab, both CADESI 04 and VAS statistical decreased by 4 weeks from 40.48 to 20.31, and from 7.42 to 2.48, respectively (p = 0.0000001) maintained significantly decresed values during the whole treatment period (CADESI 04 15.64, 15.07 after 8 and 12 weeks, respectively, PVAS 2.03, 1.95 after 8 and 12 weeks, respectively).Lokivetmab leads to a significant reduction of CADESI 04 and pruritus, within four weeks and maximum effect is achived after the second dose.

Evaluation of Copeptin during Pulmonary Exacerbation in Cystic Fibrosis.

Copeptin was found to be a stable biomarker of inflammation and stress response in cardiac, renal, metabolic, and respiratory conditions such as pneumonia. The aim of this study was to investigate the copeptin levels in biological fluids (serum and sputum supernatant) of cystic fibrosis pediatric patients during pulmonary exacerbation and remission and to investigate the possible influence of copeptin levels on disease severity and quality of life. Copeptin serum concentrations were measured in 28 pediatric cystic fibrosis (CF) patients: 13 in stable condition and 15 during pulmonary exacerbation. In 10 CF patients, copeptin was also measured in the sputum. In all the patients, we assessed complete blood count, BMI, sputum culture, lung function, and chest imaging (with Brasfield score). The severity of symptoms was assessed using the Shwachman-Kulczycki (SK) score, and the quality of life was assessed with the Cystic Fibrosis Quality of Life Questionnaire-Revised (CFQ-R). Copeptin concentrations in serum and sputum supernatant was measured using an ELISA kit. Statistical analysis was done in Statistica v.12. Serum and sputum copeptin levels were higher in CF patients during pulmonary exacerbation than in a stable period, but the differences were not significant (p = 0.58 and p = 0.13, respectively). Copeptin did not correlate significantly with any clinical, laboratory, or spirometry markers of exacerbation. There was, however, a significant inverse correlation between the serum copeptin level and symptoms severity (r = -0.77, p = 0.008) and radiological changes (r = -0.5626, p = 0.036) during pulmonary exacerbation in pediatric CF patients. Copeptin also inversely correlated with the quality of life domains in CF patients: vitality and eating habits, mostly loss of appetite (p = 0.031 and p = 0.016, respectively). Copeptin may be useful to identify patients with a higher risk of deterioration to improve their outcomes.

Transepidermal water loss and skin hydration in healthy cats and cats with non-flea non-food hypersensitivity dermatitis (NFNFHD).

Allergic skin diseases in cats are amongst the most prevalent dermatological conditions in this species. The objectives of this study were to evaluate different types of skin barrier measurements in healthy cats and cats with non-flea non-food hypersensitivity dermatitis (NFNFHD). 24 clinically healthy and 19 NFNFHD cats were included in this clinical trial. In each animal, the transepidermal water loss (TEWL) and skin hydration (SH) were assessed on six clipped body sites by VapoMeter SWL 4605 and Corneometer ®CM 825, respectively. Results of TEWL measurement were , significantly higher in one of the six examined body sites, namely on the lumbar area (p=0.0049). Furthermore, a statistically significant difference was found between the average TEWL values (p=0.019). Statistically notable differences were measured at least in one certain body site for SH: in the groin (p=0.02), where the values in the affected cats were lower than in the healthy individuals. These results may suggest that in NFNFHD cats transepidermal water loss is higher than in healthy cats. Skin hydration is, at least, in certain body sites, lower in atopic feline patients than in healthy individuals.

Influence of hair clipping on transepidermal water loss values in horses: a pilot study.

The measurement of transepidermal water loss (TEWL) is one of the biophysical skin parameters used to assess skin barrier function. Assessment of transepidermal water loss, may depend on such factors as body region, age, sex or breed and the hair coat has been considered as one of the factors that may cause variation of TEWL values. The aim of our research was an examination of the influence of clipping on the amount of TEWL. The examination was performed with 12 Wielkopolska horses with Courage Khazaka Multi Probe Adapter 5 and a TEWL TM 300 probe. The TEWL values were statistically constant in the clipped site, while the values in the unclipped sites were not. Hair clipping of examined sites is recommended for TEWL measurement in horses.

Epidemiological Study of Canine Mast Cell Tumours According to the Histological Malignancy Grade.

The aim of the study was to identify significant relationships between the tumour malignancy grade and dogs' age, breed, sex, size, and location of mast cell tumours (MCTs). MCTs accounted for 13.27% of all diagnosed canine skin tumours. The highest incidence was recorded among Boxers, Labrador Retrievers, American Staffordshire Terriers, and Golden Retrievers. Statistical analysis revealed significantly higher probability of occurrence of the grade I mast cell tumour in the French Bulldog in the head, neck, torso, and limb regions, the grade-II mast cell tumour in Boxer, Doberman, Dachshund, shepherds, and setters in the scrotal region, and the grade III mast cell tumour in Shar-Pei in the axilla region. In the group of the oldest dogs aged 11-16, there was higher risk of development of MCTs grade II and III. Young dogs (aged 2-3 and 4-6) were found to be more prone to development of MCTs grade I. There was no correlation between MCTs grade and dogs' sex and size. To the authors' knowledge this is the first report on statistical relationships between the degree of mast cell tumour malignancy and dogs' phenotypic traits, age and tumour location. This analysis indicate predilections for development of the particular mast cell tumour malignancy degrees in certain dog breeds, age, and anatomical location.

Relationship between Total Homocysteine, Folic Acid, and Thyroid Hormones in Hypothyroid Dogs.

BACKGROUND: Both elevated homocysteine and decreased folic acid concentrations are observed in human patients with hypothyroidism and can influence the development of numerous secondary disorders. OBJECTIVES: The aim of the study was to assess total homocysteine concentration in serum and to examine its relationship with the concentration of folic acid and thyroid hormones (tT4 and fT4). ANIMALS: Ten healthy and 19 hypothyroid client-owned dogs. METHODS: Dogs with clinical signs of hypothyroidism had the diagnosis confirmed by additional tests. Total homocysteine, folic acid, total thyroxine, and free thyroxine concentrations in serum were evaluated. RESULTS: Hypothyroid dogs were diagnosed with increased homocysteine (median 22.20 µmol/L; range, 16.50-37.75) and decreased folic acid (median 20.62 nmol/L; range, 10.54-26.35) concentrations, as compared to healthy dogs (11.52 µmol/L; range, 10.00-16.65 and 30.68 nmol/L; range, 22.84-38.52, respectively). In sick dogs, total homocysteine was inversely correlated with folic acid (ρ = -0.47, P < 0.001), total thyroxine (ρ = -0.69, P = 0.0092), and free thyroxine (ρ = -0.56, P = 0.0302). CONCLUSIONS: Hypothyroidism in dogs causes hyperhomocysteinemia. Concomitant mild folic acid decrease in hypothyroid dogs might be as a result of hyperhomocysteinemia.

Comparison of serum concentrations of environmental allergen-specific IgE in atopic and healthy (nonatopic) horses.

Allergic responses in humans, horses and other species are mediated by immunoglobulin E (IgE) antibodies. Serum testing to detect allergen-specific IgE antibodies has been developed for dogs, cats and horses; this allows for the identification of allergens and determination of appropriate allergen- specific immunotherapies. This study compared serum allergen-specific IgE concentrations in atopic and healthy horses. The study was performed on Malopolski breed atopic (n=21) and nonatopic (n=21) clinically healthy horses. Allergen-specific IgE serum concentrations were measured in summer seasons of 2008-2015 using a monoclonal anti-IgE antibody. A Northern and Central European allergen panel containing mite, insect, mould and plant pollen allergens, including 15 tests of individual allergens and 5 tests of allergen mixtures was used. The mean allergen-specific IgE concentrations in the atopic and normal horse populations were compared. Among the atopic horses, the strongest positive reactions occurred against the storage mites Tyrophagus putrescentiae and the domestic mite Dermatophagoides farinae. The atopic horses also demonstrated high IgE concentrations against insects, particularly Tabanus sp., the plant pollens colza, cultivated rye and the mould pollen mixture Aspergillus/Penicillium. No horses in the atopic group were IgE-negative. Among all mite, insect, mould and some plant allergen groups the differences in mean specific IgE concentrations between allergic and healthy horses were significant. The mean IgE concentrations for most allergen groups were significantly higher in the atopic horses than in the healthy animals. However, a high incidence of positive reactions was observed in both healthy and allergic horses. Our results showed a high frequency of polysensitization in atopic horses.

Influence of horse breed on transepidermal water loss.

Non-invasive methods of skin condition assessment include, among others, the evaluation of transepidermal water loss (TEWL). The aim of the study was to examine whether TEWL values depend on horse breed. The study was conducted on four breeds: "Felin" ponies (FP) (n=16), Polish koniks (PK) (n=15), Polish cold-blooded horses (PcbH) (n=11) and Wielkopolska horses (WH) (n=12). It was found that horse breed influences TEWL values. In the neck region, statistically significant differences were found between PK and FP (p=0.006), and PK and WH (p=0.0005). In the lumbar region, there were statistically significant differences between FP and PK (p=0.0009), FP and PcbH (p=0.0016) as well as between PK and WH (p=0.000037), and PcbH and WH (p=0.0006). In the inguinal region statistically significant differences were found between FP and PK (p=0.0003), FP and PcbH (p=0.0005), PK and WH (p=0.009) and PcbH and WH (p=0.006). In the lip region statistically significant differences were observed between FP and PK (p=0.013) as well as between PK and PcbH (p=0.029) and PK and WH (p=0.009). In the examination of TEWL animal breed should be taken into consideration. The non-significant differences found in three of the examined body regions may suggest that these regions are the most adequate for TEWL assessment.

The influence of non-specific anti-pruritus treatment with cyclosporine A on transepidermal water loss (TEWL) in natural atopic dermatitis in dogs.

Atopic dermatitis is a common allergic skin disease in dogs. Monitoring the progress of treatment and the assessment of the severity of disease symptoms are crucial elements of the treatment procedure. One of the common means of assessing the severity of the clinical signs of the disease is the CADESI 03. Research studies have pointed to a possibility of assessing the severity of skin lesions by means of measuring biophysical skin parameters such as TEWL, skin hydration and erythema intensity. The aim of the study was the assessment of changes in TEWL and CADESI values measured in ten different body regions during non-specific anti-pruritus treatment. The examination was performed on ten dogs with atopic dermatitis (age from 2.5 years to 7 years, mean age 3.8 years). The measurements were performed in the following body regions: the lumbar region, the right axillary fossa, the right inguinal region, the ventral abdominal region, the right lateral thorax region, the internal surface of the auricle, interdigital region of the right forelimb, cheek, bridge of nose and the lateral site of antebrachum. A statistically significant decrease in CADESI values was reported starting from the second week of treatment. In the case of the mean TEWL values, a fall was observed after one week of treatment in the ventral abdominal region and the interdigital region, after two weeks of treatment in the axillary fossa and the inguinal region, and after three weeks in the cheek and the lateral thorax region. There was no statistically significant decrease in TEWL values in the course of treatment in four other regions.

Systemic and local effects of intragastric administration of the habanero fruit (Capsicum chinense Jacquin c.v.) in rats.

The fruits of the habanero plant (Capsicum chinense Jacq.) are commonly used as spices. Their exceptionally hot flavour is the result of the substantial content of capsaicin that has among others the anticancer action. The experiments assess the impact of intragastric administration of a suspension of dried matter (dm) habanero fruit in peanut oil on the state of the digestive tract and parenchymal organs of rats. Habanero fruit with three different doses (0.08, 0.05 and 0.025 g of dry matter (d.m.) habanero fruit/kg b.w.) in 2 equal doses every 12 hours during 28 days was administered intragastrically in male rats. In day 8, 15 and 29 blood proofs were obtained to measure hematological parameters and alanine aminotransferase (ALT), aspartate aminotransferase (AST) activity, total bilirubin (BIL), total cholesterol (CHOL), glucose (GLUC), urea (U), and creatinine (CREA) content. Internal organs of rats were examined anatomopathologically. Between the study groups and control group there were no statistically significant differences in studied parameters. Post-mortem examinations as well as histological findings showed no pathological changes in the organs of rats. The study demonstrated a high level safety of the fruit habanero (Capsicum chinense Jacq.) administration in rats. There were no hematological, biochemical or post-mortem changes at doses that due to the amount of capsaicin can exhibit antitumor properties.

Non-invasive detection of Helicobacter pylori in cystic fibrosis--the fecal test vs. the urea breath test.

OBJECTIVES: Only recently it has been proven that cystic fibrosis (CF) patients have the same prevalence of Helicobacter pylori (HP infection) as the general population, as well as the same spectrum of changes caused by this pathogen. The aim of this study was to assess the reliability of the two most popular noninvasive tests--the urea breath test (UBT) and the fecal test (FT) in diagnosing HP infection in CF patients. PATIENTS AND METHODS: The study was conducted on 79 CF patients and 49 healthy subjects (HS). The presence of HP infection was evaluated using the 13C isotope-labeled urea breath test and the fecal test (ELISA). RESULTS: Fifteen (19.0%) CF patients and eight (16.3%) HS were found to be HP positive using the UBT. The HP stool antigen was detected in twelve (15.2%) CF patients and seven (14.3%) HS. Discordant results for the two tests were obtained in 9 out of 18 (50.0%) CF patients and 3 out of 9 (33.3%) HS. Although the differences were not statistically significant, the risk of potentially false negative and false positive results in CF subjects seems to be high. Similarly, no statistical differences in the basic clinical parameters were documented between the CF subgroups with concordant and divergent HP results. CONCLUSIONS: Since there is convincing evidence of divergent UBT and FT results in the CF patients, we suggest that UBT is kept as the standard method for HP detection in this population, at least until obtaining reliable and valid results allows for a change in such an approach.

Assessment of serum levels of allergen-specific immunoglobulin E in different seasons and breeds in healthy horses.

The present study was designed to asses specific IgE towards environment allergens in 42 healthy horses. Determination of this immunoglobulin in serum serve as diagnostic tools in allergic diseases to improve efficacy of the treatment and proper allergen selection to specific immunotherapy. Serum levels of allergen specific IgE were measured with equine monoclonal antibody, using 15 individual and 5 mix allergens in North European Panel. The study revealed season dependent increased levels of allergen specific IgE in normal horses. It is noteworthy that healthy horses show high percentage of positive reactions, most commonly towards to domestic mites D. farinae (80%), D. pteronyssinus (35.71%) and storage mites T. putrenscentiae (42.86%), Acarus siro (40.48%). These allergens play an important role in equine, canine and feline atopic dermatitis. We also demonstrated high IgE levels in the group of horse specific insect allergens. Tabanus sp. (35.71%), Culicoides sp. (28.57%) and Simulium sp. (26.19%) were the most frequent insect positive reaction allergens. No positive reactions in all groups of allergens were found in winter season, low and merely detectable levels of antibodies have been found relating to D. farianae and T. putrescentiae allergen. We observed elevated mould-IgE levels in horses that live in stables, while outdoor living horses showed very low levels. Amongst all positive reactions we observed only weak and moderate reactions but no strong positive reactions were found. No significant differences were observed between three breeds of horses with the exception of moulds and D. pteronyssinus allergens.

Parenteral nutrition in patients with inborn errors of metabolism - a therapeutic problem.

BACKGROUND: Parenteral nutrition is now a standard part of supportive treatment in pediatric departments. We describe four cases in which parenteral nutrition was extremely difficult due to coincidence with inborn errors of metabolism. The first two cases was fatty acid beta-oxidation disorders associated with necrotizing enterocolitis and congenital heart disease. Thus, limitations of intravenous lipid intake made it difficult to maintain a good nutritional status. The third case was phenylketonuria associated with a facial region tumour (rhabdomyosarcoma), in which parenteral nutrition was complicated because of a high phenylalanine content in the amino acid formulas for parenteral nutrition. The fourth patient was a child with late-diagnosed tyrosinemia type 1, complicated with encephalopathy - during intensive care treatment the patient needed nutritional support, including parenteral nutrition - we observed amino acid formula problems similar to those in the phenylketonuria patient. Parenteral nutrition in children with inborn errors of metabolism is a rare, but very important therapeutic problem. Total parenteral nutrition formulas are not prepared for this group of diseases.

The examination of biophysical skin parameters (transepidermal water loss, skin hydration and pH value) in different body regions in Polish ponies.

The purpose of this study was to evaluate transepidermal water loss, skin hydration and skin pH in normal polish ponies. Twelve ponies of both sexes were examined in the study. Measurements were taken from seven different sites: the neck region, the shoulder, thorax, lumbar, inguinal, lip region and the pinna. In each of the regions transepidermal water loss (TEWL), skin hydration and skin pH were measured. For transepidermal water loss, the lowest values were observed in the pinna (10.54 g/hm(2)), while the highest values were observed in the lip region (30.98 g/hm(2)). In the case of skin hydration the lowest values were observed for the thorax region (1.96 CU), and the highest for the lip region (48.28 CU). For skin pH, the lowest results were obtained in the pinna (7.03), and the highest in the lumbar region (8.05).

The examination of biophysical parameters of skin (transepidermal water loss, skin hydration and pH value) in different body regions of ponies.

The purpose of this study was to evaluate transepidermal water loss, skin hydration and skin pH in normal ponies. Sixteen ponies of both sexes were examined in the study. Measurements were taken from seven different sites: the neck region, the shoulder, thorax, lumbar, inguinal, lip region and the auricle. In each of the regions transepidermal water loss (TEWL), skin hydration and skin pH were measured. For transepidermal water loss, the lowest values were observed in the lumbar region (9.71g/hm2), while the highest values were observed in the lip region (22.35 g/hm2). In the case of skin hydration the lowest values were observed for the thorax region (2.13 CU), and the highest for the lip region (41.81 CU). For skin pH, the lowest results were obtained in the lumbar region (6.93), and the highest in the lip region (7.96).