The research, led by Pedro Fernández-Cabán, assistant professor of civil engineering at the FAMU-FSU College of Engineering, together with associate professor Qian Zhang, doctoral student Arezoo Bakhshizadeh and alumnus Peter Tsouroukdissian, set out to answer a question that has long intrigued wind engineers: can macro-scale corrugation of a building envelope meaningfully disrupt the aerodynamic mechanisms that tear roofs off houses and peel cladding from walls? The answer, according to their wind tunnel experiments, is a resounding yes. Models with the deepest wave patterns tested reduced peak wind pressures by 40 to 60 percent near roof and wall corners—the very zones where destructive forces concentrate—across multiple wind directions.

“Changing a building’s shape can significantly reduce the intensity of wind forces it has to withstand,” said Fernández-Cabán. “These nonconventional building shapes reduce the damage from worst-case severe weather scenarios. It’s another tool for engineers and designers to protect against wind damage.” That statement captures a shift in thinking that has been gathering momentum in structural engineering for years. Rather than simply building thicker walls or specifying stronger materials to resist wind loads, engineers can instead reshape the building so that the loads never fully develop in the first place.

To test the concept, the team fabricated 3D-printed scale models of low-rise buildings equipped with wave-shaped exterior roof and wall systems in place of traditional flat surfaces. Three-dimensional printing allowed the researchers to produce precise, repeatable geometries that would have been difficult or impossible to construct by hand. They then systematically varied the depth of the waves, evaluating amplitudes between 5 and 10 percent of the building height, and compared each configuration against a conventional flat-walled control model. Pressure taps embedded in the model surfaces recorded the fluctuating wind pressures at high resolution as the models were subjected to controlled airflow in the college’s wind tunnel.

The physics behind the improvement lies in the behavior of vortices—rotating masses of air that form when wind flows over sharp edges and corners. When wind sweeps smoothly across a flat wall or a pitched roof, the flow separates abruptly at the leading edge, curling back on itself and creating powerful conical vortices that cling to roof corners and wall edges. These vortices generate regions of intense suction, where the local air pressure drops far below the ambient atmospheric pressure. The higher pressure inside the building then pushes outward on the roof or wall surface toward that low-pressure zone, and it is this differential—often acting suddenly and in gusts—that lifts roofing membranes, rips off shingles and tears siding loose. The strongest forces reliably develop at the corners and edges of the roof, where the vortices congregate and pose the greatest threat to structural integrity.

Wave-shaped surfaces attack this mechanism at its root. Instead of presenting a sharp, straight edge where flow can separate cleanly and organize into a coherent vortex, the undulating envelope presents a series of rounded hills and valleys that continuously disrupt the airflow. The wind skips across these contours like a stone bouncing across the surface of a lake, unable to settle into the steady separation patterns that produce concentrated suction loads. Each successive crest and trough breaks up the pressure zones and redirects the flow away from the building envelope, preventing the pockets of high suction from forming in the first place. In effect, the geometry converts one large, coherent, destructive aerodynamic structure into many small, weak, rapidly mixing ones.

The wind tunnel data confirmed this picture quantitatively. Among the configurations tested, the model with the greatest wave depth proved the most effective at alleviating wind load effects, delivering peak pressure reductions of 40 to 60 percent near roof and wall corners across multiple wind directions. That range matters enormously in practice, because hurricanes do not arrive from a single predictable heading, and a mitigation strategy that only works when the wind blows from one quarter would be of limited value. The consistency of the benefit across directions suggests that corrugated envelopes could provide robust, all-around protection rather than a narrow, orientation-dependent advantage.

The economic logic of the approach is equally compelling. Battling wind pressure has long been an ongoing challenge in structural design, and the conventional toolkit reflects that struggle. Exterior architectural features such as rounded corners, sloped walls and stepped setbacks are known to alleviate wind loads, and another common strategy is to make walls thicker or sturdier by adding more or tougher material. These techniques can be effective, but they are expensive. Design and site constraints rule out some features entirely, and retrofitting them onto existing structures can be impractical or prohibitively costly. A corrugated facade, by contrast, modifies the geometry of the envelope itself, potentially adding aerodynamic resilience without demanding dramatic increases in material quantity or fundamentally altering the building’s footprint. The research demonstrates the possibility of adopting building facades with nontraditional shapes as a practical route to wind protection.

The implications of the work extend well beyond the structural engineering community. The underlying fluid dynamics—the behavior of turbulent boundary layers, flow separation and vortex shedding over curved and corrugated surfaces—carry broad relevance for any field that investigates how fluids move around obstacles. “We’re dealing with air, and other engineers and scientists might be dealing with waves and water, but the understanding of fluid dynamics can inform design and engineering across fields,” Fernández-Cabán said. “Aerodynamic optimization requires a multidisciplinary approach that balances structural safety, resilience, material efficiency and performance.” Researchers in aeronautics, environmental science and fundamental physics all grapple with versions of the same problem: how geometry shapes the turbulent flows that determine forces, heat transfer and mixing. Insights from building aerodynamics could inform everything from the design of more efficient aircraft components to models of how wind transports particles and pollutants over rough terrain.

Much work remains before wave-shaped envelopes appear on real construction sites. The current study measured the wind pressures acting on the surfaces of the models, which is the critical first step, but the research team is already conducting additional experiments to better understand the detailed wind flows around these envelope systems—how the air actually moves, separates and reattaches as it travels over the corrugations. The researchers also plan to deploy computational fluid dynamics modeling to further optimize the wave patterns and to explore other surface geometries that were not physically tested in the wind tunnel. Together, these efforts could yield design guidelines that architects and engineers can apply directly, turning an elegant laboratory result into a standard strategy for hurricane resilience. For communities on the front lines of increasingly severe storms, the message from Tallahassee is striking: sometimes the best defense against the wind is not more material, but a better shape.

Subject of Research: Aerodynamic mitigation of hurricane wind loads on low-rise buildings using wave-shaped corrugated wall and roof surfaces

Article Title: FAMU-FSU College of Engineering researchers develop wave-shaped wall and roof designs that protect against hurricane-force winds

Article References: FAMU-FSU College of Engineering researchers develop wave-shaped wall and roof designs that protect against hurricane-force winds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: wind engineering, hurricane resilience, building aerodynamics, wind tunnel testing, vortex dynamics, low-rise buildings, corrugated envelopes, structural engineering, fluid dynamics, wind loads, 3D-printed models, Engineering Structures

The methodology behind the review was rigorous. The authors followed PRISMA guidelines, searching PubMed from database inception through August 2025 with terms combining Mohs micrographic surgery and patient satisfaction. Two independent reviewers screened the initial 183 records against predefined criteria, with disagreements resolved by consensus or a third reviewer. Eligible studies had to be peer-reviewed, published in English, conducted within the context of Mohs surgery, and designed to evaluate the effect of a perioperative intervention on patient satisfaction. The final set comprised fifteen randomized controlled trials, three retrospective observational studies, and one comparative study, with sample sizes ranging from just 24 participants to 1,250. Risk of bias was assessed independently by two reviewers using the National Institutes of Health Quality Assessment Tool, an important quality check given the heterogeneity of the underlying literature.

Measuring satisfaction proved to be a challenge in itself. The included studies employed a patchwork of instruments: twelve used Likert scales, two used patient satisfaction questionnaires, two used visual analog scales, two used investigator-developed surveys, and one used the FACE-Q Skin Cancer module. This instrument heterogeneity meant the authors could not pool results statistically and instead performed a qualitative synthesis. Perhaps the most striking finding, however, was not about any single intervention at all. Patient satisfaction was uniformly high across the board, regardless of what treatment patients received. The authors attribute this to a ceiling effect arising from the exceptionally high baseline satisfaction already observed in Mohs populations, where cure rates for primary basal cell carcinoma reach as high as 99 percent and 92 to 99 percent for squamous cell carcinoma.

Against that ceiling, four interventions broke through with statistically significant improvements in satisfaction. The first emerged in the preoperative phase: education using three-dimensional printed anatomical models. In a randomized trial by Biro and colleagues, 42 patients who received education via a 3D printed model of their own surgical anatomy showed improved procedural understanding, reduced preoperative anxiety, and significantly higher satisfaction on a Likert-type scale compared with 40 controls who received verbal education alone, a difference that reached statistical significance at p less than 0.03. The tactile and visual engagement of holding a physical replica of the surgical site appears to address multiple dimensions of the preoperative experience simultaneously, a quality that videos and pamphlets have struggled to replicate.

The second significant intervention was remarkably simple: letting patients look at their own surgical defect in a mirror before reconstruction begins. In a multicenter prospective cohort study, Veldhuizen and colleagues found that patients who viewed their facial skin cancer defect prior to closure reported dramatically higher satisfaction with their appearance, with an odds ratio of 8.66, and the effect persisted at twelve-month follow-up. This finding challenges the intuition that seeing a wound might be distressing. Instead, it appears that confronting the reality of the defect before it is repaired helps patients calibrate their expectations and appreciate the reconstruction, a form of psychological inoculation against the shock of the immediate postoperative appearance.

The third winning intervention targeted a sensory detail most surgeons never consider: smell. Because Mohs patients are awake, the acrid burning odor of electrocautery can be an unpleasant and memorable part of the procedure. In a cleverly designed comparative study, researchers attached a smoke evacuator to the electrocautery pen and activated it only during the closure stage, while maintaining the vacuum sound throughout all stages of the operation to preserve blinding. The results were dramatic. All patients perceived a burning odor during excision compared with only 40 percent during closure, patients were far less likely to report an unpleasant smell when the evacuator was active, 66.6 percent versus 16.6 percent at p less than 0.0001, and 76.7 percent rated the closure stage as more pleasant. Sometimes the difference between a good and bad surgical memory is literally the air in the room.

The fourth significant intervention came after the operation was over. Asilian and colleagues tested an oral wound-healing supplement containing bromelain, Centella asiatica, hyaluronan, vitamin C, zinc, and copper in a randomized, double-blinded, placebo-controlled trial. Patients receiving the supplementation showed significantly improved wound healing on the Early Healing Score and, critically, significantly higher satisfaction at two weeks on a visual analog scale, 9.08 versus 7.42 at p less than 0.001, the largest direct satisfaction effect in the entire review. The authors urge caution, however, noting that the small sample size and short follow-up duration mean this result requires confirmation in larger trials before it changes clinical practice.

Just as instructive are the interventions that failed to lift satisfaction scores but proved valuable in other ways. Educational videos, whether watched at home or integrated into the informed consent process, did not improve satisfaction across three randomized trials, yet patients consistently rated the content as informative and recommended it for future patients, suggesting value in preparedness even when the metric being tracked remained flat. Preoperative phone calls similarly showed no satisfaction benefit in two trials. Intraoperative anxiolytics told an interesting story: in a seven-armed randomized trial comparing lorazepam, diazepam, alprazolam, gabapentin, pregabalin, melatonin, and placebo, single-dose benzodiazepines and GABA-agonist medications proved safe and effective for reducing perioperative anxiety, even though satisfaction scores were uniformly high in every arm. A separate trial found significant within-group anxiety reduction with midazolam at p equal to 0.002, an effect absent in the placebo arm. Anxiety and satisfaction, the review makes clear, are related but distinct constructs that warrant independent measurement.

Other null results carried their own lessons. Handholding and stress balls made no difference to satisfaction or anxiety. Intravenous anesthesia was associated with significantly higher postoperative anxiety than local anesthesia, though possibly confounded by larger defect sizes. Postoperative telephone follow-up did not raise satisfaction, but same-night calls proved most effective at identifying active pain, offering a practical surveillance tool for early complication detection. A film-forming silicone gel dressing improved objective wound healing significantly without increasing contact dermatitis rates compared with triple antibiotic ointment, yet produced no corresponding satisfaction gain, a striking dissociation between clinical outcomes and what patients actually report feeling. Even surgical technique mattered less than expected for overall satisfaction, though melolabial island flap reconstruction yielded better donor site scar satisfaction than the paramedian forehead flap at p equal to 0.026.

The review’s authors are candid about the limitations constraining their conclusions. The analysis relied on a single database, PubMed, and was not prospectively registered, limiting methodological transparency. Only English-language publications were included, introducing language bias, and publication and outcome reporting biases may have underrepresented null results. The predominance of small, single-center randomized trials with heterogeneous instruments and bundled intervention designs makes it difficult to attribute effects to individual components. Their prescription for the field is clear: adequately powered, multicenter trials that isolate individual interventions, incorporate anxiety and preparedness as co-primary outcomes, employ standardized validated instruments, and account for demographic risk factors such as female sex, age of 65 or younger, and smoking, which are associated with worse scar-related outcomes. For now, the message for surgeons is refreshingly practical: hand patients a printed model of their own anatomy, let them look at the defect before you fix it, clear the smoke from the air, and the awake patient on your table may remember the operation far more fondly.

Subject of Research: Perioperative interventions and patient satisfaction in Mohs micrographic surgery for skin cancer

Article Title: Patient-centered perioperative interventions for mohs micrographic surgery: a systematic review

Article References: Patient-centered perioperative interventions for mohs micrographic surgery: a systematic review. (n.d.). https://doi.org/10.1007/s00403-026-04972-2

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04972-2

Keywords: Mohs micrographic surgery, patient satisfaction, systematic review, skin cancer, perioperative care, 3D printed models, smoke evacuation, wound healing, patient-reported outcomes, dermatologic surgery, anxiety reduction, surgical education