1
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Cipu RI, Stănişteanu ML, Andrei MA, Banciu DD, Banciu A. Theoretical Model for In Vivo Induction of Chemotherapy Sensitization Using miRNA Packaged in Distinct Layered Liposomes. J Funct Biomater 2024; 15:298. [PMID: 39452596 DOI: 10.3390/jfb15100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 10/01/2024] [Accepted: 10/03/2024] [Indexed: 10/26/2024] Open
Abstract
Resistance to chemotherapy is a problem of major social and economic importance, when looking at factors like the decrease in life expectancy, the associated therapeutic costs, and a significant number of cancers that resist current chemotherapy. The development of chemotherapeutics for all theoretically possible tumor variants is an approach that requires unreasonable resources. We propose a theoretical model that serves the purpose of overcoming resistance to chemotherapeutic agents used in cancer therapy. The model describes a gene delivery system based on liposomes, which are optically guided to the tumor's location. The main aim of the gene delivery system is inhibiting the activity of enzymes involved in drug metabolism, hence offering the opportunity to use inexpensive chemotherapeutics that are already on the market. This model will reduce the costs of chemotherapy and will assure a positive outcome for patients.
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Affiliation(s)
- Ruxandra-Ioana Cipu
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, National University of Science and Technology Politehnica Bucharest, 1-7 Gh. Polizu Street, 011061 Bucharest, Romania
| | - Mihai-Laurențiu Stănişteanu
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, National University of Science and Technology Politehnica Bucharest, 1-7 Gh. Polizu Street, 011061 Bucharest, Romania
| | - Mihaela-Aurelia Andrei
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, National University of Science and Technology Politehnica Bucharest, 1-7 Gh. Polizu Street, 011061 Bucharest, Romania
| | - Daniel Dumitru Banciu
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, National University of Science and Technology Politehnica Bucharest, 1-7 Gh. Polizu Street, 011061 Bucharest, Romania
| | - Adela Banciu
- Department of Biomaterials and Medical Devices, Faculty of Medical Engineering, National University of Science and Technology Politehnica Bucharest, 1-7 Gh. Polizu Street, 011061 Bucharest, Romania
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2
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Vecchie' D, Wolter JM, Perry J, Jumbo-Lucioni P, De Luca M. The Impact of the Angiotensin-Converting Enzyme Inhibitor Lisinopril on Metabolic Rate in Drosophila melanogaster. Int J Mol Sci 2024; 25:10103. [PMID: 39337588 PMCID: PMC11432024 DOI: 10.3390/ijms251810103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 09/16/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
Evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) may increase metabolic rate by promoting thermogenesis, potentially through enhanced fat oxidation and improved insulin. More research is, however, needed to understand this intricate process. In this study, we used 22 lines from the Drosophila Genetic Reference Panel to assess the metabolic rate of virgin female and male flies that were either fed a standard medium or received lisinopril for one week or five weeks. We demonstrated that lisinopril affects the whole-body metabolic rate in Drosophila melanogaster in a genotype-dependent manner. However, the effects of genotypes are highly context-dependent, being influenced by sex and age. Our findings also suggest that lisinopril may increase the Drosophila metabolic rate via the accumulation of a bradykinin-like peptide, which, in turn, enhances cold tolerance by upregulating Ucp4b and Ucp4c genes. Finally, we showed that knocking down Ance, the ortholog of mammalian ACE in Malpighian/renal tubules and the nervous system, leads to opposite changes in metabolic rate, and that the effect of lisinopril depends on Ance in these systems, but in a sex- and age-specific manner. In conclusion, our results regarding D. melanogaster support existing evidence of a connection between ACEI drugs and metabolic rate while offering new insights into this relationship.
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Affiliation(s)
- Denise Vecchie'
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Julia M Wolter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jesse Perry
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Patricia Jumbo-Lucioni
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University, Birmingham, AL 35229, USA
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Maria De Luca
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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3
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Ferreira-Santos R, Pinto JP, Pinho JP, Ribeiro AC, da Costa M, Vieira V, Ferreira C, Manso F, Pereira JC. Continuous monitoring after laparoscopic Roux-En-Y gastric bypass: a pathway to ambulatory care surgery - a pilot study. J Clin Monit Comput 2024:10.1007/s10877-024-01216-4. [PMID: 39249567 DOI: 10.1007/s10877-024-01216-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/28/2024] [Indexed: 09/10/2024]
Abstract
Same-day discharge (SDD) after Laparoscopic Roux-En-Y Gastric Bypass (LRYGB) faces resistance due to possible undetected postoperative complications. These present with changes in vital signs, which continuous remote monitoring devices can detect. This study compared continuous vital signs monitoring using the Isansys Patient Status Engine™ with standard nursing vital signs measurements to assess the device's reliability in postoperative surveillance of patients undergoing LRYGB. We conducted a pilot study including patients who underwent LRYGB. During their hospital stay, patients were continuously monitored using the Isansys Patient Status Engine™ with Lifetouch™, Lifetemp™, and Nonin Pulse Oximeter™ sensors. The heart rate (HR), body temperature, and oxygen saturation (SpO2) collected by the device were compared with standard nursing assessments. Thirteen patients with a mean body mass index of 41.5 ± 4.4 kg/m2 were included. No major complications occurred. The median HR assessed by standard and continuous monitoring did not significantly differ (75.5 [69-88] vs. 77 [66-91] bpm, p = 0.995), nor did the mean values of SpO2 (94.7 ± 2.0 vs. 93.7 ± 1.8%, p = 0,057). A significant difference was observed in median body temperature between the nursing staff and the monitoring device (36.3 [36.1-36.7] vs. 36.1 [34.5-36.6] degrees Celsius, p = 0.012), with a tendency for lower temperature measurements by the device. In conclusion, this is the first study on continuous postoperative surveillance using the Isansys Patient Status Engine™ monitoring device for LRYGB patients. Our results introduce a novel tool for more efficient surgery. Prospective randomized experimental studies are warranted to evaluate this method's efficacy and safety.
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Affiliation(s)
| | - José Pedro Pinto
- Department of Surgery, Unidade Local de Saúde de Braga, Braga, Portugal
| | - João Pedro Pinho
- Department of Surgery, Unidade Local de Saúde de Braga, Braga, Portugal
| | | | - Maia da Costa
- Department of Surgery, Unidade Local de Saúde de Braga, Braga, Portugal
| | - Vicente Vieira
- Department of Anesthesiology, Unidade Local de Saúde de Braga, Braga, Portugal
| | - Carmélia Ferreira
- Department of Anesthesiology, Unidade Local de Saúde de Braga, Braga, Portugal
| | - Fernando Manso
- Department of Surgery, Unidade Local de Saúde de Braga, Braga, Portugal
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4
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Rafnsdottir S, Jang K, Halldorsdottir ST, Vinod M, Tomasdottir A, Möller K, Halldorsdottir K, Reynisdottir T, Atladottir LH, Allison KE, Ostacolo K, He J, Zhang L, Northington FJ, Magnusdottir E, Chavez-Valdez R, Anderson KJ, Bjornsson HT. SMYD5 is a regulator of the mild hypothermia response. Cell Rep 2024; 43:114554. [PMID: 39083378 PMCID: PMC11401508 DOI: 10.1016/j.celrep.2024.114554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/24/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024] Open
Abstract
The mild hypothermia response (MHR) maintains organismal homeostasis during cold exposure and is thought to be critical for the neuroprotection documented with therapeutic hypothermia. To date, little is known about the transcriptional regulation of the MHR. We utilize a forward CRISPR-Cas9 mutagenesis screen to identify the histone lysine methyltransferase SMYD5 as a regulator of the MHR. SMYD5 represses the key MHR gene SP1 at euthermia. This repression correlates with temperature-dependent levels of histone H3 lysine 26 trimethylation (H3K36me3) at the SP1 locus and globally, indicating that the mammalian MHR is regulated at the level of histone modifications. We have identified 37 additional SMYD5-regulated temperature-dependent genes, suggesting a broader MHR-related role for SMYD5. Our study provides an example of how histone modifications integrate environmental cues into the genetic circuitry of mammalian cells and provides insights that may yield therapeutic avenues for neuroprotection after catastrophic events.
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Affiliation(s)
- Salvor Rafnsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Kijin Jang
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sara Tholl Halldorsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Meghna Vinod
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Arnhildur Tomasdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Katrin Möller
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Katrin Halldorsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tinna Reynisdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Laufey Halla Atladottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Kevin Ostacolo
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Genetics and Molecular Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Jin He
- Department of Biochemistry and Molecular Biology, College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - Li Zhang
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frances J Northington
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuroscience Intensive Care Nursery Program, Johns Hopkins University, Baltimore, MD, USA
| | - Erna Magnusdottir
- Department of Biomedical Science and Department of Anatomy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Raul Chavez-Valdez
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuroscience Intensive Care Nursery Program, Johns Hopkins University, Baltimore, MD, USA
| | - Kimberley Jade Anderson
- Department of Genetics and Molecular Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Hans Tomas Bjornsson
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland, Reykjavik, Iceland; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA; Department of Genetics and Molecular Medicine, Landspitali University Hospital, Reykjavik, Iceland.
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5
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Li K, Deng C, Sun D, Wang Y, Li G, Jiang L, Wang T. Predictive value of neutrophil-to-lymphocyte ratio on admission for intrapartum maternal fever in parturients undergoing epidural analgesia: A retrospective cohort study using propensity score-matched analysis. Int J Gynaecol Obstet 2024. [PMID: 39092575 DOI: 10.1002/ijgo.15820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/30/2024] [Accepted: 07/16/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE To identify the predictive value of the neutrophil-to-lymphocyte ratio (NLR) on admission for intrapartum maternal fever in parturients undergoing epidural analgesia (EA). METHODS In this retrospective cohort study, propensity score matching (PSM) was applied to address covariates. Univariate and multivariate regression analyses were implemented in sequence to find out the factors influencing intrapartum fever. The receiver operating characteristics curve was applied to determine the area under the curve (AUC) of NLR for intrapartum fever. RESULTS NLR and duration of EA were independent risk factors for intrapartum fever. The AUC of the combined indicator (NLR + duration of EA) was higher than that of NLR (AUC = 0.583, 95% confidence interval [CI] 0.53-0.64) and duration of EA (AUC = 0.702, 95% CI 0.66-0.75), reaching 0.715 (95% CI 0.67-0.76; p < 0.001). NLR increased predictive performance for intrapartum fever when added to the duration of EA (net reclassification index 0.076, p = 0.022; integrated discrimination improvement 0.020, p = 0.002). CONCLUSION NLR has limited predictive power for intrapartum fever. The combination of NLR and duration of epidural analgesia may be considered a promising predictor for intrapartum maternal fever in parturients undergoing epidural analgesia. SYNOPSIS The neutrophil-to-lymphocyte ratio is an accessible predictor for the early identification of parturients at risk of intrapartum fever.
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Affiliation(s)
- Kunyue Li
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chunyun Deng
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Daqi Sun
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuxia Wang
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Genxia Li
- Department of Obstetrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lihua Jiang
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Tao Wang
- Department of Anesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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6
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Roberts NJ, Sarria JC. Recognizing the roles of fever in host survival and in medical intervention in infectious diseases. Am J Med Sci 2024; 368:85-89. [PMID: 38795968 DOI: 10.1016/j.amjms.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/10/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
Fever has roles both in host defense against infectious challenges and in guidance of medical intervention. These roles remain insufficiently acknowledged and considered by both health care providers and patients and their families. This review cites reports in support of both roles and provides recommendations regarding the clinician's approach to fever, as well as points relevant for education of patients and their families.
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Affiliation(s)
- Norbert J Roberts
- Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA; Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Juan C Sarria
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
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7
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Yasuda I, Sando E. Combined treatment of Japanese spotted fever with tetracycline and fluoroquinolone requires careful evaluation using robust outcomes both in terms of its advantages and disadvantages. Int J Antimicrob Agents 2024; 64:107201. [PMID: 38768739 DOI: 10.1016/j.ijantimicag.2024.107201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/13/2024] [Accepted: 02/23/2024] [Indexed: 05/22/2024]
Affiliation(s)
- Ikkoh Yasuda
- Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan; Department of General Internal Medicine and Infectious Diseases, Kita-Fukushima Medical Centre, Fukushima, Japan
| | - Eiichiro Sando
- Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan; Department of General Internal Medicine and Infectious Diseases, Kita-Fukushima Medical Centre, Fukushima, Japan.
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8
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Rafnsdottir S, Jang K, Halldorsdottir ST, Vinod M, Tomasdottir A, Möller K, Halldorsdottir K, Reynisdottir T, Atladottir LH, Allison KE, Ostacolo K, He J, Zhang L, Northington FJ, Magnusdottir E, Chavez-Valdez R, Anderson KJ, Bjornsson HT. SMYD5 is a regulator of the mild hypothermia response. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.05.11.540170. [PMID: 37333301 PMCID: PMC10274674 DOI: 10.1101/2023.05.11.540170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The mild hypothermia response (MHR) maintains organismal homeostasis during cold exposure and is thought to be critical for the neuroprotection documented with therapeutic hypothermia. To date, little is known about the transcriptional regulation of the MHR. We utilize a forward CRISPR-Cas9 mutagenesis screen to identify the histone lysine methyltransferase SMYD5 as a regulator of the MHR. SMYD5 represses the key MHR gene SP1 at euthermia. This repression correlates with temperature-dependent levels of H3K36me3 at the SP1-locus and globally, indicating that the mammalian MHR is regulated at the level of histone modifications. We have identified 37 additional SMYD5 regulated temperature-dependent genes, suggesting a broader MHR-related role for SMYD5. Our study provides an example of how histone modifications integrate environmental cues into the genetic circuitry of mammalian cells and provides insights that may yield therapeutic avenues for neuroprotection after catastrophic events.
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Affiliation(s)
- Salvor Rafnsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Kijin Jang
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Sara Tholl Halldorsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Meghna Vinod
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Arnhildur Tomasdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Katrin Möller
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Katrin Halldorsdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Tinna Reynisdottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | - Laufey Halla Atladottir
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
| | | | - Kevin Ostacolo
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
- Department of Genetics and Molecular Medicine, Landspitali University Hospital; Reykjavik, Iceland
| | - Jin He
- Department of Biochemistry and Molecular Biology, College of Natural Science, Michigan State University; MI, USA
| | - Li Zhang
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine; Baltimore, MD, USA
| | - Frances J Northington
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine; Baltimore, MD, USA
- Neuroscience Intensive Care Nursery Program, Johns Hopkins University; Baltimore, MD, USA
| | - Erna Magnusdottir
- Department of Biomedical Science and Department of Anatomy, Faculty of Medicine, University of Iceland; Reykjavík, Iceland
| | - Raul Chavez-Valdez
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine; Baltimore, MD, USA
- Neuroscience Intensive Care Nursery Program, Johns Hopkins University; Baltimore, MD, USA
| | - Kimberley Jade Anderson
- Department of Genetics and Molecular Medicine, Landspitali University Hospital; Reykjavik, Iceland
| | - Hans Tomas Bjornsson
- Louma G. Laboratory of Epigenetic Research, Faculty of Medicine, University of Iceland; Reykjavik, Iceland
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine; Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University; Baltimore, MD, USA
- Department of Genetics and Molecular Medicine, Landspitali University Hospital; Reykjavik, Iceland
- Lead contact
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9
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Nies JF, Krusche M. [Fever in rheumatological diseases]. Z Rheumatol 2024; 83:341-353. [PMID: 38634905 DOI: 10.1007/s00393-024-01505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
Fever is a frequent and important symptom in patients with rheumatological diseases and can be an expression of activity of the underlying rheumatological disease. There is great variability in the incidence of fever as a symptom of the disease between individual diseases. The growing understanding of the molecular signatures of the diseases can help to explain these discrepancies: A genetic overactivation of potently pyrogenic cytokines is the reason why fever is nearly always present in autoinflammatory syndromes. In contrast, fever is less common in polyarthritis and myositis and mostly limited to severe courses of disease. In the diagnostic work-up of fever, frequent differential diagnoses, such as infections, malignancies, side effects of drugs and hypersensitivity reactions should be considered. This article provides an overview of the physiology of the development of fever, describes the relevance of fever in individual rheumatological diseases and proposes a workflow for the clinical clarification of rheumatological patients who present with fever.
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Affiliation(s)
- Jasper F Nies
- Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Martin Krusche
- III. Medizinische Klinik und Poliklinik für Nephrologie, Rheumatologie und Endokrinologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland
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10
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Zanfaño L, Carro-Huerga G, Rodríguez-González Á, Mayo-Prieto S, Cardoza RE, Gutiérrez S, Casquero PA. Trichoderma carraovejensis: a new species from vineyard ecosystem with biocontrol abilities against grapevine trunk disease pathogens and ecological adaptation. FRONTIERS IN PLANT SCIENCE 2024; 15:1388841. [PMID: 38835860 PMCID: PMC11148300 DOI: 10.3389/fpls.2024.1388841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/16/2024] [Indexed: 06/06/2024]
Abstract
Trichoderma strains used in vineyards for the control of grapevine trunk diseases (GTDs) present a promising alternative to chemical products. Therefore, the isolation and characterization of new indigenous Trichoderma strains for these purposes is a valuable strategy to favor the adaptation of these strains to the environment, thus improving their efficacy in the field. In this research, a new Trichoderma species, Trichoderma carraovejensis, isolated from vineyards in Ribera de Duero (Spain) area, has been identified and phylogenetically analyzed using 20 housekeeping genes isolated from the genome of 24 Trichoderma species. A morphological description and comparison of the new species has also been carried out. In order to corroborate the potential of T. carraovejensis as a biological control agent (BCA), confrontation tests against pathogenic fungi, causing various GTDs, have been performed in the laboratory. The compatibility of T. carraovejensis with different pesticides and biostimulants has also been assessed. This new Trichoderma species demonstrates the ability to control pathogens such as Diplodia seriata, as well as high compatibility with powdered sulfur-based pesticides. In conclusion, the autochthonous species T. carraovejensis can be an effective alternative to complement the currently used strategies for the control of wood diseases in its region of origin.
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Affiliation(s)
- Laura Zanfaño
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
| | - Guzmán Carro-Huerga
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
| | - Álvaro Rodríguez-González
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
| | - Sara Mayo-Prieto
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
| | - Rosa E Cardoza
- Area of Microbiology, University School of Agricultural Engineers, Universidad de León, Ponferrada, Spain
| | - Santiago Gutiérrez
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
- Area of Microbiology, University School of Agricultural Engineers, Universidad de León, Ponferrada, Spain
| | - Pedro A Casquero
- Research Group of Engineering and Sustainable Agriculture, Natural Resources Institute, Universidad de León, León, Spain
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11
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Solomon D, Arumugam V, Sakthirajan R, Lamech TM, Dineshkumar T, Vathsalyan P, Senthilkumaran G, Krishna R, Shaji S, Gopalakrishnan N. A Pilot Study on the Safety and Adequacy of a Novel Ecofriendly Hemodialysis Prescription-Green Nephrology. Kidney Int Rep 2024; 9:1496-1503. [PMID: 38707836 PMCID: PMC11069008 DOI: 10.1016/j.ekir.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Hemodialysis (HD) units require large quantities of water. To reduce water consumption without compromising the adequacy and safety of dialysis, we studied a novel HD prescription with high temperature and low flow dialysate. Methods This was a single-center nonrandomized open-label cross-over pilot trial in patients with end-stage kidney disease on maintenance HD. Each participant was subjected to 3 different dialysis prescriptions for 1 month each as follows: (i) normal temperature with normal flow dialysate (NTNF prescription), (ii) high temperature with normal flow dialysate (HTNF prescription), and (iii) high temperature with low flow dialysate (HTLF prescription). The primary outcome, assessed at the end of each dialysis session, was the delivery of "adequate" dialysis, as defined by a single-pool Kt/V (spKt/V) ≥1.2. Outcomes were evaluated by comparing the NTNF and HTLF prescriptions. Results A total of 863 sessions of HD were performed in 30 patients over 3 months, with 287 to 288 sessions in each of the 3 dialysis prescriptions. The primary outcome was not significantly different between the NTNF prescription (202 sessions [70.14%]) and the HTLF prescription (198 sessions [68.75%]) (odds ratio, 1.07; 95% confidence interval, 0.75 to 1.52; P = 0.45). The mean spKt/V and urea reduction ratio (URR) were not significantly different. Clinically evident hemodynamic instability occurred in only 1 dialysis session in the HTNF prescription. Conclusion Increasing dialysate temperature while reducing dialysate flow rate (QD) can be used as a water conservation strategy without compromising the adequacy and safety of dialysis in young and hemodynamically stable patients. Reducing the QD from 500 ml/min to 300 ml/min reduces water consumption by 40%.
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Affiliation(s)
- Dolphin Solomon
- Institute of Nephrology, Madras Medical College, Chennai, India
| | | | | | | | | | | | | | | | - Sajmi Shaji
- Institute of Nephrology, Madras Medical College, Chennai, India
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12
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Javaid W. 'Redefining normal: a fresh perspective on oral temperature'. Evid Based Nurs 2024:ebnurs-2023-103847. [PMID: 38631875 DOI: 10.1136/ebnurs-2023-103847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Waleed Javaid
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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13
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Muhamad SN, Lim FL, Md Akim A, Karuppiah K, Mohd Shabri NSA, How V. Association between physiological responses and heat shock protein 70 (HSP70) expressions in the vulnerable populations of Kuala Lumpur. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-11. [PMID: 38616509 DOI: 10.1080/09603123.2024.2340125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
Continued heat exposure can cause physiological and cellular responses. This study investigated the association between physiological responses and heat shock protein 70 (HSP70) expressions in Kuala Lumpur's urban vulnerable population. We conducted a cross-sectional study involving 54 participants from four areas classified as experiencing moderate to strong heat stress. Physiological measurements included core body temperature, heart rate, and diastolic and systolic blood pressure. RT-qPCR and ELISA were also performed on blood samples to assess HSP70 gene and protein expressions. Despite indoor heat stress, participants maintained normal physiological parameters while there were significant indications of HSP70 expression at both the gene and protein levels. However, our study found no significant correlation (p > 0.05) between physiological responses and HSP70 expressions. This study shows no interaction between physiological responses and HSP70 expressions in the study population, revealing the complex mechanisms of indoor heat stress in vulnerable individuals.
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Affiliation(s)
- Siti Nurfahirah Muhamad
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fang Lee Lim
- Department of Environmental Engineering, Universiti Tunku Abdul Rahman, Faculty of Engineering and Green Technology, Kampar, Perak, Malaysia
| | - Abdah Md Akim
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Karmegam Karuppiah
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nur Shabrina Azreen Mohd Shabri
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Vivien How
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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14
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Woolfe Loftus N, Navales V, Bowden T. Using the NEWS2 and ABCDE assessment to identify early signs of clinical deterioration. Nurs Stand 2024; 39:40-45. [PMID: 38523526 DOI: 10.7748/ns.2024.e12188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 03/26/2024]
Abstract
Nurses may encounter deteriorating patients in their clinical practice, so they require an understanding of the early physiological signs of deterioration and a structured approach to patient assessment. This enables appropriate management and a timely response to the most life-threatening issues identified, such as a compromised airway. This article describes how nurses can use early warning scores and a structured patient assessment, using the ABCDE (airway, breathing, circulation, disability, exposure) framework, to identify early signs of deterioration and facilitate the timely escalation of patient care where necessary.
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Affiliation(s)
- Nicholas Woolfe Loftus
- Adult Critical Care Unit, St Bartholomew's Hospital, London, and NIHR predoctoral clinical academic fellow, City, University of London, London, England
| | - Vanna Navales
- Adult Critical Care Unit, St Bartholomew's Hospital, London, England
| | - Tracey Bowden
- School of Health and Psychosocial Sciences, City, University of London, London, England
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15
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Eifling KP, Gaudio FG, Dumke C, Lipman GS, Otten EM, Martin AD, Grissom CK. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wilderness Environ Med 2024; 35:112S-127S. [PMID: 38425235 DOI: 10.1177/10806032241227924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The Wilderness Medical Society (WMS) convened an expert panel in 2011 to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. The current panel retained 5 original members and welcomed 2 new members, all of whom collaborated remotely to provide an updated review of the classifications, pathophysiology, evidence-based guidelines for planning and preventive measures, and recommendations for field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. This is an updated version of the WMS clinical practice guidelines for the prevention and treatment of heat illness published in Wilderness & Environmental Medicine. 2019;30(4):S33-S46.
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Affiliation(s)
- Kurt P Eifling
- Department of Emergency Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR
| | - Flavio G Gaudio
- Department of Emergency Medicine, New York-Presbyterian Hospital / Weill Cornell Medical College, New York, NY
| | - Charles Dumke
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | | | - Edward M Otten
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH
| | - August D Martin
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR
| | - Colin K Grissom
- Pulmonary and Critical Care Division, Intermountain Medical Center and the University of Utah, Salt Lake City, UT
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16
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Mason AE, Kasl P, Soltani S, Green A, Hartogensis W, Dilchert S, Chowdhary A, Pandya LS, Siwik CJ, Foster SL, Nyer M, Lowry CA, Raison CL, Hecht FM, Smarr BL. Elevated body temperature is associated with depressive symptoms: results from the TemPredict Study. Sci Rep 2024; 14:1884. [PMID: 38316806 PMCID: PMC10844227 DOI: 10.1038/s41598-024-51567-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
Correlations between altered body temperature and depression have been reported in small samples; greater confidence in these associations would provide a rationale for further examining potential mechanisms of depression related to body temperature regulation. We sought to test the hypotheses that greater depression symptom severity is associated with (1) higher body temperature, (2) smaller differences between body temperature when awake versus asleep, and (3) lower diurnal body temperature amplitude. Data collected included both self-reported body temperature (using standard thermometers), wearable sensor-assessed distal body temperature (using an off-the-shelf wearable sensor that collected minute-level physiological data), and self-reported depressive symptoms from > 20,000 participants over the course of ~ 7 months as part of the TemPredict Study. Higher self-reported and wearable sensor-assessed body temperatures when awake were associated with greater depression symptom severity. Lower diurnal body temperature amplitude, computed using wearable sensor-assessed distal body temperature data, tended to be associated with greater depression symptom severity, though this association did not achieve statistical significance. These findings, drawn from a large sample, replicate and expand upon prior data pointing to body temperature alterations as potentially relevant factors in depression etiology and may hold implications for development of novel approaches to the treatment of major depressive disorder.
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Affiliation(s)
- Ashley E Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA.
| | - Patrick Kasl
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, San Diego, CA, USA
| | - Severine Soltani
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, San Diego, CA, USA
| | - Abigail Green
- Neurosciences Graduate Program, University of California San Diego, San Diego, CA, USA
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY, USA
| | | | - Leena S Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Chelsea J Siwik
- Department of Wellness and Preventative Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Simmie L Foster
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maren Nyer
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Charles L Raison
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Frederick M Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Benjamin L Smarr
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, San Diego, CA, USA
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
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17
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Maloney E, Duffy D. Deciphering the relationship between temperature and immunity. DISCOVERY IMMUNOLOGY 2024; 3:kyae001. [PMID: 38567294 PMCID: PMC10917241 DOI: 10.1093/discim/kyae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/01/2023] [Accepted: 01/29/2024] [Indexed: 04/04/2024]
Abstract
Fever is a hallmark symptom of disease across the animal kingdom. Yet, despite the evidence linking temperature fluctuation and immune response, much remains to be discovered about the molecular mechanisms governing these interactions. In patients with rheumatoid arthritis, for instance, it is clinically accepted that joint temperature can predict disease progression. But it was only recently demonstrated that the mitochondria of stimulated T cells can rise to an extreme 50°C, potentially indicating a cellular source of these localized 'fevers'. A challenge to dissecting these mechanisms is a bidirectional interplay between temperature and immunity. Heat shock response is found in virtually all organisms, activating protective pathways when cells are exposed to elevated temperatures. However, the temperature threshold that activates these pathways can vary within the same organism, with human immune cells, in particular, demonstrating differential sensitivity to heat. Such inter-cellular variation may be clinically relevant given the small but significant temperature differences seen between tissues, ages, and sexes. Greater understanding of how such small temperature perturbations mediate immune responses may provide new explanations for persistent questions in disease such as sex disparity in disease prevalence. Notably, the prevalence and severity of many maladies are rising with climate change, suggesting temperature fluctuations can interact with disease on multiple levels. As global temperatures are rising, and our body temperatures are falling, questions regarding temperature-immune interactions are increasingly critical. Here, we review this aspect of environmental interplay to better understand temperature's role in immune variation and subsequent risk of disease.
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Affiliation(s)
- Elizabeth Maloney
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Frontiers of Innovation in Research and Education PhD Program, LPI Doctoral School, Paris, France
| | - Darragh Duffy
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
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18
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Li T, Tian J, Wu M, Tian Y, Li Z. Electroacupuncture stimulation improves cognitive ability and regulates metabolic disorders in Alzheimer's disease model mice: new insights from brown adipose tissue thermogenesis. Front Endocrinol (Lausanne) 2024; 14:1330565. [PMID: 38283741 PMCID: PMC10811084 DOI: 10.3389/fendo.2023.1330565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Background Metabolic defects play a crucial role in Alzheimer's disease (AD) development. Brown adipose tissue (BAT) has been identified as a novel potential therapeutic target for AD due to its unique role in energy metabolism. Electroacupuncture (EA) shows promise in improving cognitive ability and brain glucose metabolism in AD, but its effects on peripheral and central metabolism are unclear. Methods In this study, SAMP8 mice (AD model) received EA stimulation at specific acupoints. Cognitive abilities were evaluated using the Morris water maze test, while neuronal morphology and tau pathology were assessed through Nissl staining and immunofluorescence staining, respectively. Metabolic variations and BAT thermogenesis were measured using ELISA, HE staining, Western blotting, and infrared thermal imaging. Results Compared to SAMR1 mice, SAMP8 mice showed impaired cognitive ability, neuronal damage, disrupted thermoregulation, and metabolic disorders with low BAT activity. Both the EA and DD groups improved cognitive ability and decreased tau phosphorylation (p<0.01 or p<0.05). However, only the EA group had a significant effect on metabolic disorders and BAT thermogenesis (p<0.01 or p<0.05), while the DD group did not. Conclusion These findings indicate that EA not only improves the cognitive ability of SAMP8 mice, but also effectively regulates peripheral and central metabolic disorders, with this effect being significantly related to the activation of BAT thermogenesis.
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Affiliation(s)
- Ting Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Junjian Tian
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Meng Wu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanshuo Tian
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhigang Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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19
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Okabe K, Sotoma S, Harada Y. Cellular Thermal Biology Using Fluorescent Nanothermometers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1461:97-108. [PMID: 39289276 DOI: 10.1007/978-981-97-4584-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
It has been known that cells have mechanisms to sense and respond to environmental noxiousness and mild temperature changes, such as heat shock response and thermosensitive TRP channels. Meanwhile, new methods of measuring temperature at the cellular level has recently been developed using fluorescent nanothermometers. Among these thermometers, fluorescent polymeric thermometers and fluorescent nanodiamonds excel in the properties required for intracellular thermometry. By using these novel methods to measure the temperature of single cells in cultures and tissues, it was revealed that spontaneous spatiotemporal temperature fluctuations occur within cells. Furthermore, the temperature fluctuations were related to organelles such as mitochondria and cellular and physiological functions, revealing a close relationship between intracellular temperature and cellular functions.
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Affiliation(s)
- Kohki Okabe
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
- JST, PRESTO, Saitama, Japan.
| | - Shingo Sotoma
- Faculty of Molecular Chemistry and Engineering, Kyoto Institute of Technology, Kyoto, Japan.
| | - Yoshie Harada
- Institute for Protein Research, Osaka University, Osaka, Japan
- Center for Quantum Information and Quantum Biology, Osaka, Japan
- Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Osaka University, Osaka, Japan
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20
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Rony MKK, Alamgir HM. High temperatures on mental health: Recognizing the association and the need for proactive strategies-A perspective. Health Sci Rep 2023; 6:e1729. [PMID: 38059052 PMCID: PMC10696165 DOI: 10.1002/hsr2.1729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/28/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023] Open
Abstract
Background and Aims The influence of temperature on various aspects of daily life is often underestimated, and its effects on mental health are not widely recognized. Understanding and addressing the relationship between temperature and mental well-being is crucial in the context of climate change and rising global temperatures. This perspective aimed to investigate the effects of high temperatures on mental health and identify proactive strategies to mitigate these effects. Methods This perspective adopted a twofold approach, including a comprehensive literature review and socioecological framework. The literature review involved extensive searches across Google Scholar, PubMed, and Scopus to identify relevant, peer-reviewed articles, and reports from diverse disciplines. Results The perspective emphasized the significance of recognizing heat stress and its consequences on mental well-being. Chronic heat stress can lead to increased stress, anxiety, and cognitive impairment. Vulnerable populations include, the very young, older adults, and individuals with pre-existing mental health conditions. Socioeconomic factors can further exacerbate vulnerability, highlighting the need for tailored strategies to manage mental health challenges during high temperatures. Additionally, the article identified and discussed proactive coping strategies to minimize both the psychological and physical impacts of heat stress. Mindfulness, stress management techniques, and therapy are suggested as effective means for individuals to manage psychological distress. Conclusion Implementing preventive measures are essential steps in promoting mental wellness in high temperatures. Proactive strategies by addressing the physiological and psychological effects of heat and considering the specific needs of vulnerable populations can help individuals and communities navigate the challenges posed by rising temperatures and promote resilience and preserve their mental well-being.
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Affiliation(s)
- Moustaq Karim Khan Rony
- Department of Public HealthBangladesh Open UniversityGazipurBangladesh
- Department of Institute of Social Welfare and ResearchUniversity of DhakaDhakaBangladesh
| | - Hasnat M. Alamgir
- Department of Career & Professional Development Services (CPDS)Southeast UniversityDhakaBangladesh
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21
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Martins Januário W, Prata ERBDA, Natali AJ, Prímola-Gomes TN. Normal gastrointestinal temperature values measured through ingestible capsules technology: a systematic review. J Med Eng Technol 2023; 47:389-395. [PMID: 38780358 DOI: 10.1080/03091902.2024.2354793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Climate change has amplified the importance of continuous and precise body core temperature (Tcore) monitoring in the everyday life. In this context, assessing Tcore through ingestible capsules technology, i.e., gastrointestinal temperature (Tgastrointestinal), emerges as a good alternative to prevent heat-related illness. Therefore, we conducted a systematic review to point out values of normal Tgastrointestinal measured through ingestible capsules in healthy humans. The study followed PRISMA guidelines and searched the PubMed and Scielo databases from 1971 to 2023. Our search strategy included the descriptors ("gastrointestinal temperature") AND ("measurement"), and eligible studies had to be written in English and measured Tgastrointestinal using ingestible capsules or sensors in healthy adults aged 18-59 at rest. Two pairs of researchers independently reviewed titles and abstracts and identified 35 relevant articles out of 1,088 in the initial search. An average value of 37.13 °C with a standard deviation of 0.24 °C was observed, independently of the gender. The values measured ranged from 36.70 °C to 37.69 °C. In conclusion, this systematic review pointed out the mean value of 37.13 ± 0.24 °C measured by ingestible capsules as reference for resting Tgastrointestinal in healthy adult individuals.
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Affiliation(s)
- William Martins Januário
- Departamento de Educação Física, Laboratório de Performance Humana, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brasil
| | | | - Antônio José Natali
- Departamento de Educação Física, Laboratório de Biologia do Exercício, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brasil
| | - Thales Nicolau Prímola-Gomes
- Departamento de Educação Física, Laboratório de Performance Humana, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brasil
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22
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Bruce LK, Kasl P, Soltani S, Viswanath VK, Hartogensis W, Dilchert S, Hecht FM, Chowdhary A, Anglo C, Pandya L, Dasgupta S, Altintas I, Gupta A, Mason AE, Smarr BL. Variability of temperature measurements recorded by a wearable device by biological sex. Biol Sex Differ 2023; 14:76. [PMID: 37915069 PMCID: PMC10619297 DOI: 10.1186/s13293-023-00558-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Females have been historically excluded from biomedical research due in part to the documented presumption that results with male subjects will generalize effectively to females. This has been justified in part by the assumption that ovarian rhythms will increase the overall variance of pooled random samples. But not all variance in samples is random. Human biometrics are continuously changing in response to stimuli and biological rhythms; single measurements taken sporadically do not easily support exploration of variance across time scales. Recently we reported that in mice, core body temperature measured longitudinally shows higher variance in males than cycling females, both within and across individuals at multiple time scales. METHODS Here, we explore longitudinal human distal body temperature, measured by a wearable sensor device (Oura Ring), for 6 months in females and males ranging in age from 20 to 79 years. In this study, we did not limit the comparisons to female versus male, but instead we developed a method for categorizing individuals as cyclic or acyclic depending on the presence of a roughly monthly pattern to their nightly temperature. We then compared structure and variance across time scales using multiple standard instruments. RESULTS Sex differences exist as expected, but across multiple statistical comparisons and timescales, there was no one group that consistently exceeded the others in variance. When variability was assessed across time, females, whether or not their temperature contained monthly cycles, did not significantly differ from males both on daily and monthly time scales. CONCLUSIONS These findings contradict the viewpoint that human females are too variable across menstrual cycles to include in biomedical research. Longitudinal temperature of females does not accumulate greater measurement error over time than do males and the majority of unexplained variance is within sex category, not between them.
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Affiliation(s)
- Lauryn Keeler Bruce
- UC San Diego Health Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA
| | - Patrick Kasl
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA
| | - Severine Soltani
- Bioinformatics and Systems Biology, University of California San Diego, San Diego, CA, USA
| | - Varun K Viswanath
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, USA
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY, USA
| | - Frederick M Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Leena Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Subhasis Dasgupta
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ilkay Altintas
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Amarnath Gupta
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ashley E Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Benjamin L Smarr
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA.
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA.
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23
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O'Grady NP, Alexander E, Alhazzani W, Alshamsi F, Cuellar-Rodriguez J, Jefferson BK, Kalil AC, Pastores SM, Patel R, van Duin D, Weber DJ, Deresinski S. Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU. Crit Care Med 2023; 51:1570-1586. [PMID: 37902340 DOI: 10.1097/ccm.0000000000006022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
RATIONALE Fever is frequently an early indicator of infection and often requires rigorous diagnostic evaluation. OBJECTIVES This is an update of the 2008 Infectious Diseases Society of America and Society (IDSA) and Society of Critical Care Medicine (SCCM) guideline for the evaluation of new-onset fever in adult ICU patients without severe immunocompromise, now using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. PANEL DESIGN The SCCM and IDSA convened a taskforce to update the 2008 version of the guideline for the evaluation of new fever in critically ill adult patients, which included expert clinicians as well as methodologists from the Guidelines in Intensive Care, Development and Evaluation Group. The guidelines committee consisted of 12 experts in critical care, infectious diseases, clinical microbiology, organ transplantation, public health, clinical research, and health policy and administration. All task force members followed all conflict-of-interest procedures as documented in the American College of Critical Care Medicine/SCCM Standard Operating Procedures Manual and the IDSA. There was no industry input or funding to produce this guideline. METHODS We conducted a systematic review for each population, intervention, comparison, and outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the GRADE approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak or as best-practice statements. RESULTS The panel issued 12 recommendations and 9 best practice statements. The panel recommended using central temperature monitoring methods, including thermistors for pulmonary artery catheters, bladder catheters, or esophageal balloon thermistors when these devices are in place or accurate temperature measurements are critical for diagnosis and management. For patients without these devices in place, oral or rectal temperatures over other temperature measurement methods that are less reliable such as axillary or tympanic membrane temperatures, noninvasive temporal artery thermometers, or chemical dot thermometers were recommended. Imaging studies including ultrasonography were recommended in addition to microbiological evaluation using rapid diagnostic testing strategies. Biomarkers were recommended to assist in guiding the discontinuation of antimicrobial therapy. All recommendations issued were weak based on the quality of data. CONCLUSIONS The guidelines panel was able to formulate several recommendations for the evaluation of new fever in a critically ill adult patient, acknowledging that most recommendations were based on weak evidence. This highlights the need for the rapid advancement of research in all aspects of this issue-including better noninvasive methods to measure core body temperature, the use of diagnostic imaging, advances in microbiology including molecular testing, and the use of biomarkers.
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Affiliation(s)
- Naomi P O'Grady
- Internal Medicine Services, National Institutes of Health Clinical Center, Bethesda, MD
| | - Earnest Alexander
- Clinical Pharmacy Services, Department of Pharmacy, Tampa General Hospital, Tampa, FL
| | - Waleed Alhazzani
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Fayez Alshamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jennifer Cuellar-Rodriguez
- Laboratory of Clinical Immunology and Microbiology, National Institutes of Allergy and Infectious Diseases, Bethesda, MD
| | - Brian K Jefferson
- Division of Hepatobiliary and Pancreatic Surgery, Department of Internal Medicine-Critical Care Services, Atrium Health Cabarrus, Concord, NC
| | - Andre C Kalil
- Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE
| | - Stephen M Pastores
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Rochester, MN
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN
| | - David van Duin
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC
| | - David J Weber
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC
| | - Stanley Deresinski
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA
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Charde V, Sanklecha M, Rajan P, Sangoi RV, A P, Palande A, Dighe P, Kothari R, Mittal G. Comparing the Efficacy of Paracetamol, Ibuprofen, and a Combination of the Two Drugs in Relieving Pain and Fever in the Pediatric Age Group: A Prospective Observational Study. Cureus 2023; 15:e46907. [PMID: 37954757 PMCID: PMC10636696 DOI: 10.7759/cureus.46907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Fever and pain are common afflictions in the pediatric population, prompting the use of paracetamol and ibuprofen as primary treatment options. However, a comprehensive understanding of their comparative efficacy, safety profiles, and potential combined use remains crucial for informed clinical decision-making. In this prospective observational study, we aimed to delve into these aspects, shedding light on the optimal management strategies for fever and pain in pediatric patients. Methodology A total of 108 children were enrolled and categorized into three groups, namely, paracetamol monotherapy, ibuprofen monotherapy, and a combination of both drugs. Axillary temperature monitoring and assessment of pain on the Face, Legs, Activity, Cry, and Controllability (FLACC) scale/Visual Analog Scale (VAS) were employed as critical indicators. Concurrently, associated symptoms encompassing discomfort, activity levels, and appetite were meticulously recorded. To ensure safety, laboratory parameters including serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), serum creatinine, platelet count, and stool for occult blood were closely monitored before and after drug administration. The study duration spanned 48 hours post-initiation of the initial drug dose. Results A total of 108 pediatric cases were included in the study, spanning ages from six months to 18 years. Among them, the majority fell within the age group of six months to five years (n = 77). Participants were categorized based on the duration of fever, with 81 cases having a fever lasting more than 24 hours and 27 cases having a fever lasting less than 24 hours. The majority of cases presented with temperatures ranging from 38°C to 39°C. Comparison of drug efficacy in defervescence within the first four hours revealed that paracetamol alone took significantly longer than ibuprofen monotherapy or the paracetamol and ibuprofen combination (p = 0.026). In terms of the onset of effect, the paracetamol and ibuprofen combination showed comparable efficacy to ibuprofen alone. Regarding the total time without fever in 48 hours, significant differences were observed among the three drug regimens (p = 0.001 by the one-way analysis of variance (ANOVA) test). Paracetamol and ibuprofen were superior to paracetamol alone (p < 0.001) and ibuprofen alone (p = 0.014), while paracetamol alone and ibuprofen alone exhibited similar efficacy (p = 0.197). Based on the laboratory results as well as the clinical profile observed over 48 hours, we confirm safety based on this study. The combination of paracetamol and ibuprofen showed enhanced effectiveness in fever and pain relief. Conclusion This study demonstrates the favourable efficacy of paracetamol, ibuprofen, and their combination in the pediatric population. The combination of paracetamol and ibuprofen showed enhanced effectiveness in fever and pain relief, with minimal adverse effects and no significant derangements in biochemical parameters. This study thus contributes valuable insights to optimize the therapeutic approach to fever and pain in pediatric patients.
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Affiliation(s)
- Vivek Charde
- Pediatrics and Child Health, Bhanukrupa Hospital, Nagpur, IND
- Pediatrics and Child Health, Bombay Hospital, Mumbai, IND
| | | | - Priyank Rajan
- Pediatrics and Child Health, SRCC (Society for Rehabilitation of Crippled Children) Children's Hospital, Mumbai, IND
| | - Ravi V Sangoi
- Pharmacology and Therapeutics, Punyashlok Ahilyadevi Holkar Government Medical College, Baramati, IND
| | - Prashanth A
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | | | - Pranav Dighe
- Pharmacology and Therapeutics, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Ruchi Kothari
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Gaurav Mittal
- Research and Development, Rotaract Club of Indian Medicos, Mumbai, IND
- Research, Student Network Organization, Mumbai, IND
- Internal Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
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Ley C, Heath F, Hastie T, Gao Z, Protsiv M, Parsonnet J. Defining Usual Oral Temperature Ranges in Outpatients Using an Unsupervised Learning Algorithm. JAMA Intern Med 2023; 183:1128-1135. [PMID: 37669046 PMCID: PMC10481327 DOI: 10.1001/jamainternmed.2023.4291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/05/2023] [Indexed: 09/06/2023]
Abstract
Importance Although oral temperature is commonly assessed in medical examinations, the range of usual or "normal" temperature is poorly defined. Objective To determine normal oral temperature ranges by age, sex, height, weight, and time of day. Design, Setting, and Participants This cross-sectional study used clinical visit information from the divisions of Internal Medicine and Family Medicine in a single large medical care system. All adult outpatient encounters that included temperature measurements from April 28, 2008, through June 4, 2017, were eligible for inclusion. The LIMIT (Laboratory Information Mining for Individualized Thresholds) filtering algorithm was applied to iteratively remove encounters with primary diagnoses overrepresented in the tails of the temperature distribution, leaving only those diagnoses unrelated to temperature. Mixed-effects modeling was applied to the remaining temperature measurements to identify independent factors associated with normal oral temperature and to generate individualized normal temperature ranges. Data were analyzed from July 5, 2017, to June 23, 2023. Exposures Primary diagnoses and medications, age, sex, height, weight, time of day, and month, abstracted from each outpatient encounter. Main Outcomes and Measures Normal temperature ranges by age, sex, height, weight, and time of day. Results Of 618 306 patient encounters, 35.92% were removed by LIMIT because they included diagnoses or medications that fell disproportionately in the tails of the temperature distribution. The encounters removed due to overrepresentation in the upper tail were primarily linked to infectious diseases (76.81% of all removed encounters); type 2 diabetes was the only diagnosis removed for overrepresentation in the lower tail (15.71% of all removed encounters). The 396 195 encounters included in the analysis set consisted of 126 705 patients (57.35% women; mean [SD] age, 52.7 [15.9] years). Prior to running LIMIT, the mean (SD) overall oral temperature was 36.71 °C (0.43 °C); following LIMIT, the mean (SD) temperature was 36.64 °C (0.35 °C). Using mixed-effects modeling, age, sex, height, weight, and time of day accounted for 6.86% (overall) and up to 25.52% (per patient) of the observed variability in temperature. Mean normal oral temperature did not reach 37 °C for any subgroup; the upper 99th percentile ranged from 36.81 °C (a tall man with underweight aged 80 years at 8:00 am) to 37.88 °C (a short woman with obesity aged 20 years at 2:00 pm). Conclusions and Relevance The findings of this cross-sectional study suggest that normal oral temperature varies in an expected manner based on sex, age, height, weight, and time of day, allowing individualized normal temperature ranges to be established. The clinical significance of a value outside of the usual range is an area for future study.
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Affiliation(s)
- Catherine Ley
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Frederik Heath
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- currently with University of California, Irvine, School of Medicine
| | - Trevor Hastie
- Department of Statistics, School of Humanities and Sciences, Stanford University, Stanford, California
- Division of Biostatistics, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California
| | - Zijun Gao
- Department of Statistics, School of Humanities and Sciences, Stanford University, Stanford, California
- currently with USC Marshall Business School, University of Southern California, Los Angeles
| | - Myroslava Protsiv
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
- currently with Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Julie Parsonnet
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
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Charpignon ML, Carrel A, Jiang Y, Kwaga T, Cantada B, Hyslop T, Cox CE, Haines K, Koomson V, Dumas G, Morley M, Dunn J, Ian Wong AK. Going beyond the means: Exploring the role of bias from digital determinants of health in technologies. PLOS DIGITAL HEALTH 2023; 2:e0000244. [PMID: 37824494 PMCID: PMC10569586 DOI: 10.1371/journal.pdig.0000244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND In light of recent retrospective studies revealing evidence of disparities in access to medical technology and of bias in measurements, this narrative review assesses digital determinants of health (DDoH) in both technologies and medical formulae that demonstrate either evidence of bias or suboptimal performance, identifies potential mechanisms behind such bias, and proposes potential methods or avenues that can guide future efforts to address these disparities. APPROACH Mechanisms are broadly grouped into physical and biological biases (e.g., pulse oximetry, non-contact infrared thermometry [NCIT]), interaction of human factors and cultural practices (e.g., electroencephalography [EEG]), and interpretation bias (e.g, pulmonary function tests [PFT], optical coherence tomography [OCT], and Humphrey visual field [HVF] testing). This review scope specifically excludes technologies incorporating artificial intelligence and machine learning. For each technology, we identify both clinical and research recommendations. CONCLUSIONS Many of the DDoH mechanisms encountered in medical technologies and formulae result in lower accuracy or lower validity when applied to patients outside the initial scope of development or validation. Our clinical recommendations caution clinical users in completely trusting result validity and suggest correlating with other measurement modalities robust to the DDoH mechanism (e.g., arterial blood gas for pulse oximetry, core temperatures for NCIT). Our research recommendations suggest not only increasing diversity in development and validation, but also awareness in the modalities of diversity required (e.g., skin pigmentation for pulse oximetry but skin pigmentation and sex/hormonal variation for NCIT). By increasing diversity that better reflects patients in all scenarios of use, we can mitigate DDoH mechanisms and increase trust and validity in clinical practice and research.
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Affiliation(s)
- Marie-Laure Charpignon
- Massachusetts Institute of Technology; Institute for Data, Systems, and Society; Laboratory for Information and Decision Systems, Boston, Massachusetts, United States of America
| | - Adrien Carrel
- CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France
- Imperial College London, London, United Kingdom
| | - Yihang Jiang
- Duke University, Pratt School of Engineering, Department of Biomedical Engineering, Durham, North Carolina, United States of America
| | - Teddy Kwaga
- Mbarara University of Science and Technology, Department of Ophthalmology, Mbarara, Uganda
| | - Beatriz Cantada
- Massachusetts Institute of Technology; Institute Community and Equity Office, Boston, Massachusetts, United States of America
| | - Terry Hyslop
- Duke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina, United States of America
| | - Christopher E. Cox
- Duke University, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Durham, North Carolina, United States of America
| | - Krista Haines
- Duke University, Department of Surgery, Durham, North Carolina, United States of America
| | - Valencia Koomson
- Tufts University, Department of Electrical and Computer Engineering, Boston, Massachusetts, United States of America
| | - Guillaume Dumas
- CHU Sainte-Justine Research Center, Department of Psychiatry, Université de Montréal, Montréal, Quebec, Canada
- Mila–Quebec AI Institute, University of Montreal, Montréal, Quebec, Canada
| | - Michael Morley
- Ophthalmic Consultants of Boston, Boston, Massachusetts, United States of America
- Assistant Clinical Professor of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jessilyn Dunn
- Duke University, Pratt School of Engineering, Department of Biomedical Engineering, Durham, North Carolina, United States of America
- Duke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina, United States of America
| | - An-Kwok Ian Wong
- Duke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina, United States of America
- Duke University, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Durham, North Carolina, United States of America
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Kim SH, Jeon M, Jang S, Mun SJ. Factors for mortality in patients with persistent Staphylococcus aureus bacteremia: The importance of treatment response rather than bacteremia duration. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:1007-1015. [PMID: 37580183 DOI: 10.1016/j.jmii.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/06/2023] [Accepted: 07/26/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The criteria for antibiotic failure in persistent Staphylococcus aureus bacteremia (SAB) are unclear, but treatment response and bacteremia duration are commonly used indicators of antibiotic failure. We evaluated the effects of treatment response and bacteremia duration on mortality in persistent SAB. METHODS We retrospectively identified patients with persistent SAB in four university-affiliated hospitals between 2017 and 2021. Bacteremia duration was calculated from the first day of active antibiotic therapy, and persistent SAB was defined as bacteremia lasting for 2 or more days. Defervescence and Pitt bacteremia score (PBS) were used to evaluate treatment response at treatment day 4. The primary outcome was 30-day in-hospital mortality. Time-dependent multivariable Cox regression analysis and subgroup analysis according to methicillin resistance were performed. RESULTS A total of 221 patients was included in the study, and the 30-day in-hospital mortality was 28.5%. There was no significant difference in bacteremia duration between survived and deceased patients. Independent factors for mortality included age, Charlson comorbidity index, initial PBS, pneumonia, and removal of the eradicable focus. PBS at treatment day 4 ≥ 3 was the strongest risk factor (adjusted hazard ratio [HR] = 4.260), but defervescence was not. Bacteremia duration was not an independent factor except for 13 days or more of methicillin-resistant SAB (adjusted HR = 1.064). CONCLUSIONS In patients with persistent SAB, PBS at treatment day 4 was associated with 30-day in-hospital mortality rather than defervescence and bacteremia duration. The results of this study could help determine early intensified treatment strategies in persistent SAB patients.
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Affiliation(s)
- Si-Ho Kim
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Minji Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Sukbin Jang
- Division of Infectious Diseases, Department of Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Seok Jun Mun
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea; Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Republic of Korea.
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Granfeldt A, Holmberg MJ, Nolan JP, Soar J, Andersen LW. Temperature control after adult cardiac arrest: An updated systematic review and meta-analysis. Resuscitation 2023; 191:109928. [PMID: 37558083 DOI: 10.1016/j.resuscitation.2023.109928] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
AIM To perform an updated systematic review and meta-analysis on temperature control in adult patients with cardiac arrest. METHODS The review is an update of a previous systematic review published in 2021. An updated search including PubMed, Embase, and the Cochrane Central Register of Controlled Trials was performed on May 31, 2023. Controlled trials in humans were included. The population included adult patients with cardiac arrest. The review included all aspects of temperature control including timing, temperature, duration, method of induction and maintenance, and rewarming. Two investigators reviewed trials for relevance, extracted data, and assessed risk of bias. Data were pooled using random-effects models. Certainty of evidence was evaluated using GRADE. RESULTS The updated systematic search identified six new trials. Risk of bias in the trials was assessed as intermediate for most of the outcomes. For temperature control with a target of 32-34 °C vs. normothermia or 36 °C, two new trials were identified, with seven trials included in an updated meta-analysis. Temperature control with a target of 32-34 °C did not result in an improvement in survival (risk ratio: 1.06 [95%CI: 0.91, 1.23]) or favorable neurological outcome (risk ratio: 1.27 [95%CI: 0.89, 1.81]) at 90-180 days after the cardiac arrest (low certainty evidence). Subgroup analysis according to location of cardiac arrest (in-hospital vs. out-of-hospital) found similar results. A sensitivity analysis of nine trials comparing temperature control at 32-34 °C to normothermia or 36 °C for favorable neurological outcome at any time point also did not show an improvement in outcomes (risk ratio: 1.14 [95%CI 0.98, 1.34]). New individual trials comparing a target of 31-34 °C, temperature control for 12-24 hours to 36 hours, a rewarming rate of 0.25-0.5 °C/hour, and the effect of temperature control with fever prevention found no differences in outcomes. CONCLUSIONS This updated systematic review showed no benefit of temperature control at 32-34 °C compared to normothermia or 36 °C, although the 95% confidence intervals cannot rule out a potential beneficial effect. Important knowledge gaps exist for topics such as hypothermic temperature targets, rewarming rate, and fever control.
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Affiliation(s)
- Asger Granfeldt
- Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Mathias J Holmberg
- Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Jerry P Nolan
- University of Warwick, Warwick Medical School, Coventry, United Kingdom; Royal United Hospital, Bath, United Kingdom
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Lars W Andersen
- Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Prehospital Emergency Medical Services, Central Denmark Region, Denmark; Department of Anesthesiology and Intensive Care, Viborg Regional Hospital, Viborg, Denmark
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De Meneck F, Santana V, Brioschi GC, Haddad DS, Neves EB, Franco MDC, Brioschi ML. Infrared Imaging of the Brain-Eyelid Thermal Tunnel: A Promising Method for Measuring Body Temperature in Afebrile Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6867. [PMID: 37835137 PMCID: PMC10572929 DOI: 10.3390/ijerph20196867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
(1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland-Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing-Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.
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Affiliation(s)
- Franciele De Meneck
- Division of Nephrology, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil
| | - Vinicius Santana
- Division of Psychiatry, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil;
| | | | - Denise Sabbagh Haddad
- Faculty of Dentistry, University of São Paulo (FOUSP), São Paulo 05508-000, SP, Brazil;
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Federal Technological University of Paraná (UTFPR), Curitiba 80230-901, PR, Brazil;
| | - Maria do Carmo Franco
- School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil;
| | - Marcos Leal Brioschi
- Faculty of Medicine, University of São Paulo (HCFMUSP), São Paulo 05508-000, SP, Brazil
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30
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Kim J, Threadcraft MA, Xue W, Yue S, Wenzel RP, Southwick FS. Home Monitoring for Fever: An Inexpensive Screening Method to Prevent Household Spread of COVID-19. JOURNAL OF BIOTECHNOLOGY AND BIOMEDICINE 2023; 6:392-400. [PMID: 38745997 PMCID: PMC11093523 DOI: 10.26502/jbb.2642-91280101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The COVID-19 pandemic surge has exceeded testing capacities in many parts of the world. We investigated the effectiveness of home temperature monitoring for early identification of COVID-19 patients. Study Design – We compared home temperature measurements from a convenience sample of 1180 individuals who reported being test positive for SARS-CoV-2 to an age, sex, and location matched control group of 1249 individuals who had not tested positive. Methods – All individuals monitored their temperature at home using an electronic smartphone thermometer that relayed temperature measurements and symptoms to a centralized cloud based, de-identified data bank. Results - Individuals varied in the number of times they monitored their temperature. When temperature was monitored for over 72 hours fever (≥ 37.6°C or 99.7°F or a change in temperature of ≥ 1°C or 1.8°F) was detected in 73% of test positive individuals, a sensitivity comparable to rapid SARS-CoV-2 antigen tests. When compared to our control group the specificity of fever for COVID-19 was 0.70. However, when fever was combined with complaints of loss of taste and smell, difficulty breathing, fatigue, chills, diarrhea, or stuffy nose the odds ratio of having COVID-19 was sufficiently high as to obviate the need to employ RTPCR or antigen testing to screen for and isolate coronavirus infected cases. Conclusions - Our findings suggest that home temperature monitoring could serve as an inexpensive convenient screen for the onset of COVID-19, encourage earlier isolation of potentially infected individuals, and more effectively reduce the spread of infection in closed spaces.
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Affiliation(s)
- Justin Kim
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610
| | - Marcus A. Threadcraft
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610
| | - Wei Xue
- Department of Biostatistics, University of Florida, Gainesville, FL 32610
| | - Sijie Yue
- Department of Biostatistics, University of Florida, Gainesville, FL 32610
| | - Richard P. Wenzel
- Department of Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA 23298
| | - Frederick S. Southwick
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610
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Hausmann J, Dedeoglu F, Broderick L. Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis Syndrome and Syndrome of Unexplained Recurrent Fevers in Children and Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1676-1687. [PMID: 36958521 DOI: 10.1016/j.jaip.2023.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent infections, aphthous stomatitis, and abnormal blood cell counts, may present to the allergist/immunologist because the symptoms mimic allergies and disorders of immunity. In recent years, there has been increased recognition of non-monogenic autoinflammatory disorders, including periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and syndrome of undifferentiated recurrent fevers. For many clinical practitioners, the natural history, diagnostic criteria, differential diagnoses, and preferred therapies remain challenging because of the presumed rarity of patients and the evolving field of autoinflammation. Here, we aim to provide a practical framework for the clinical allergist/immunologist to evaluate and treat this patient population.
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Affiliation(s)
- Jonathan Hausmann
- Department of Medicine, Harvard Medical School, Boston, Mass; Program in Rheumatology, Division of Immunology, Boston Children's Hospital, Boston, Mass; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Mass
| | - Fatma Dedeoglu
- Department of Medicine, Harvard Medical School, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Lori Broderick
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California-San Diego, La Jolla, Calif; Rady Children's Foundation, Rady Children's Hospital, San Diego, Calif.
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32
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Etienne S, Oliveras R, Schiboni G, Durrer L, Rochat F, Eib P, Zahner M, Osthoff M, Bassetti S, Eckstein J. Free-living core body temperature monitoring using a wrist-worn sensor after COVID-19 booster vaccination: a pilot study. Biomed Eng Online 2023; 22:25. [PMID: 36915134 PMCID: PMC10010220 DOI: 10.1186/s12938-023-01081-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Core body temperature (CBT) is a key vital sign and fever is an important indicator of disease. In the past decade, there has been growing interest for vital sign monitoring technology that may be embedded in wearable devices, and the COVID-19 pandemic has highlighted the need for remote patient monitoring systems. While wrist-worn sensors allow continuous assessment of heart rate and oxygen saturation, reliable measurement of CBT at the wrist remains challenging. In this study, CBT was measured continuously in a free-living setting using a novel technology worn at the wrist and compared to reference core body temperature measurements, i.e., CBT values acquired with an ingestible temperature-sensing pill. Fifty individuals who received the COVID-19 booster vaccination were included. The datasets of 33 individuals were used to develop the CBT prediction algorithm, and the algorithm was then validated on the datasets of 17 participants. Mean observation time was 26.4 h and CBT > 38.0 °C occurred in 66% of the participants. CBT predicted by the wrist-worn sensor showed good correlation to the reference CBT (r = 0.72). Bland-Altman statistics showed an average bias of 0.11 °C of CBT predicted by the wrist-worn device compared to reference CBT, and limits of agreement were - 0.67 to + 0.93 °C, which is comparable to the bias and limits of agreement of commonly used tympanic membrane thermometers. The small size of the components needed for this technology would allow its integration into a variety of wearable monitoring systems assessing other vital signs and at the same time allowing maximal freedom of movement to the user.
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Affiliation(s)
- Samuel Etienne
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | | | | | | | | | | | | | - Michael Osthoff
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Jens Eckstein
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Department Digitalization and ICT, University Hospital Basel, Basel, Switzerland.
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Gulias-Cañizo R, Rodríguez-Malagón ME, Botello-González L, Belden-Reyes V, Amparo F, Garza-Leon M. Applications of Infrared Thermography in Ophthalmology. Life (Basel) 2023; 13:life13030723. [PMID: 36983878 PMCID: PMC10053626 DOI: 10.3390/life13030723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023] Open
Abstract
Body temperature is one of the key vital signs for determining a disease’s severity, as it reflects the thermal energy generated by an individual’s metabolism. Since the first study on the relationship between body temperature and diseases by Carl Reinhold August Wunderlich at the end of the 19th century, various forms of thermometers have been developed to measure body temperature. Traditionally, methods for measuring temperature can be invasive, semi-invasive, and non-invasive. In recent years, great technological advances have reduced the cost of thermographic cameras, which allowed extending their use. Thermal cameras capture the infrared radiation of the electromagnetic spectrum and process the images to represent the temperature of the object under study through a range of colors, where each color and its hue indicate a previously established temperature. Currently, cameras have a sensitivity that allows them to detect changes in temperature as small as 0.01 °C. Along with its use in other areas of medicine, thermography has been used at the ocular level for more than 50 years. In healthy subjects, the literature reports that the average corneal temperature ranges from 32.9 to 36 °C. One of the possible sources of variability in normal values is age, and other possible sources of variation are gender and external temperature. In addition to the evaluation of healthy subjects, thermography has been used to evaluate its usefulness in various eye diseases, such as Graves’ orbitopathy, and tear duct obstruction for orbital diseases. The ocular surface is the most studied area. Ocular surface temperature is influenced by multiple conditions, one of the most studied being dry eye; other diseases studied include allergic conjunctivitis and pterygium as well as systemic diseases such as carotid artery stenosis. Among the corneal diseases studied are keratoconus, infectious keratitis, corneal graft rejection, the use of scleral or soft contact lenses, and the response to refractive or cataract surgery. Other diseases where thermographic features have been reported are glaucoma, diabetic retinopathy, age-related macular degeneration, retinal vascular occlusions, intraocular tumors as well as scleritis, and other inflammatory eye diseases.
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Affiliation(s)
- Rosario Gulias-Cañizo
- Centro de Investigación en Ciencias de la Salud, Universidad Anahuac México, Naucalpan de Juárez 52786, Mexico
| | - Maria Elisa Rodríguez-Malagón
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Loubette Botello-González
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Valeria Belden-Reyes
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Francisco Amparo
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
| | - Manuel Garza-Leon
- Division of Health Sciences, Department of Clinical Sciences, University of Monterrey, San Pedro Gaza García 66238, Mexico
- Correspondence:
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Mackowiak PA. The 'Body Temperature' Myth. Am J Med 2023; 136:221. [PMID: 36356921 DOI: 10.1016/j.amjmed.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Philip A Mackowiak
- Department of Medicine, University of Maryland School of Medicine, Baltimore.
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35
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Alonso-Alonso ML, Sampedro-Viana A, Rodríguez-Yáñez M, López-Dequidt I, Pumar JM, Mosqueira AJ, Fernández-Rodicio S, Bazarra-Barreiros M, Sobrino T, Campos F, Castillo J, Hervella P, Iglesias-Rey R. Influence of Temperature Chronobiology on Stroke Outcome. Int J Mol Sci 2023; 24:ijms24043746. [PMID: 36835156 PMCID: PMC9967262 DOI: 10.3390/ijms24043746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
The circadian system regulates numerous physiological variables, including body temperature. Additionally, a circadian patter has been described in stroke onset. Considering this, we hypothesised that the chronobiology of temperature may have an impact on stroke onset and functional outcomes. We also studied the variation of blood biomarkers according to stroke onset time. This is a retrospective observational study. Of the patients included, 2763 had a stroke between midnight and 8:00 h; 1571 between 8:00-14:00 h; and 655 between 14:00 h and midnight. Axillary temperature was measured at admission. At this time, blood samples were collected for biomarker analysis (TNF-α, IL-1β, IL-6, IL-10, and glutamate). Temperature was higher in patients admitted from 8:00 h to midnight (p < 0.0001). However, the percentage of poor outcome at 3 months was highest in patients from midnight to 8:00 h (57.7%, p < 0.001). The association between temperature and mortality was highest during night time (OR: 2.79; CI 95%: 2.36-3.28; p < 0.001). These patients exhibited high glutamate (220.2 ± 140.2 µM), IL-6 (32.8 ± 14.3 pg/mL) and low IL-10 (9.7 ± 14.3 pg/mL) levels. Therefore, temperature chronobiology could have a significant impact on stroke onset and functional outcome. Superficial body hyperthermia during sleep seems to be more dangerous than during wakefulness. Further studies will be necessary to confirm our data.
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Affiliation(s)
- Maria Luz Alonso-Alonso
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Ana Sampedro-Viana
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Manuel Rodríguez-Yáñez
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain
| | - Iria López-Dequidt
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain
| | - José M. Pumar
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Antonio J. Mosqueira
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Sabela Fernández-Rodicio
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Marcos Bazarra-Barreiros
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Tomás Sobrino
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Francisco Campos
- Translational Stroke Laboratory (TREAT), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - José Castillo
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Pablo Hervella
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Ramón Iglesias-Rey
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence:
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Yusuf KO, Miljukov O, Schoneberg A, Hanß S, Wiesenfeldt M, Stecher M, Mitrov L, Hopff SM, Steinbrecher S, Kurth F, Bahmer T, Schreiber S, Pape D, Hofmann AL, Kohls M, Störk S, Stubbe HC, Tebbe JJ, Hellmuth JC, Erber J, Krist L, Rieg S, Pilgram L, Vehreschild JJ, Reese JP, Krefting D. Consistency as a Data Quality Measure for German Corona Consensus Items Mapped from National Pandemic Cohort Network Data Collections. Methods Inf Med 2023. [PMID: 36596462 DOI: 10.1055/a-2006-1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND As a national effort to better understand the current pandemic, three cohorts collect sociodemographic and clinical data from coronavirus disease 2019 (COVID-19) patients from different target populations within the German National Pandemic Cohort Network (NAPKON). Furthermore, the German Corona Consensus Dataset (GECCO) was introduced as a harmonized basic information model for COVID-19 patients in clinical routine. To compare the cohort data with other GECCO-based studies, data items are mapped to GECCO. As mapping from one information model to another is complex, an additional consistency evaluation of the mapped items is recommended to detect possible mapping issues or source data inconsistencies. OBJECTIVES The goal of this work is to assure high consistency of research data mapped to the GECCO data model. In particular, it aims at identifying contradictions within interdependent GECCO data items of the German national COVID-19 cohorts to allow investigation of possible reasons for identified contradictions. We furthermore aim at enabling other researchers to easily perform data quality evaluation on GECCO-based datasets and adapt to similar data models. METHODS All suitable data items from each of the three NAPKON cohorts are mapped to the GECCO items. A consistency assessment tool (dqGecco) is implemented, following the design of an existing quality assessment framework, retaining their-defined consistency taxonomies, including logical and empirical contradictions. Results of the assessment are verified independently on the primary data source. RESULTS Our consistency assessment tool helped in correcting the mapping procedure and reveals remaining contradictory value combinations within COVID-19 symptoms, vital signs, and COVID-19 severity. Consistency rates differ between the different indicators and cohorts ranging from 95.84% up to 100%. CONCLUSION An efficient and portable tool capable of discovering inconsistencies in the COVID-19 domain has been developed and applied to three different cohorts. As the GECCO dataset is employed in different platforms and studies, the tool can be directly applied there or adapted to similar information models.
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Affiliation(s)
- Khalid O Yusuf
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Olga Miljukov
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany
| | - Anne Schoneberg
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Sabine Hanß
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Wiesenfeldt
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Melanie Stecher
- Department I for Internal Medicine, University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Lazar Mitrov
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - Sina Marie Hopff
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - Sarah Steinbrecher
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany.,Airway Research Center North (ARCN), German Center for Lung Research (DZL), Wöhrendamm Großhansdorf, Germany
| | - Stefan Schreiber
- Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Daniel Pape
- Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Anna-Lena Hofmann
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany
| | - Mirjam Kohls
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Department Clinical Research & Epidemiology, University Hospital Würzburg, Comprehensive Heart Failure Center, and Department Internal Medicine I, Würzburg, Germany
| | | | - Johannes J Tebbe
- Department of Gastroenterology and Infectious Diseases, University Medical Center East Westphalia-Lippe, Klinikum Lippe, Lemgo, Germany
| | - Johannes C Hellmuth
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.,COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany
| | - Johanna Erber
- Department II of Internal Medicine, Technical University of Munich, School of Medicine, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Siegbert Rieg
- Department of Medicine II, Division of Infectious Diseases, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lisa Pilgram
- Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Frankfurt am Main, Germany.,Department of Nephrology and Medical Intensive Care, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Jörg J Vehreschild
- Department I for Internal Medicine, University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.,Department of Nephrology and Medical Intensive Care, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Jens-Peter Reese
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany
| | - Dagmar Krefting
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany.,Campus Institute Data Science (CIDAS), Georg-August-University, Göttingen, Germany
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Ramezani F, Khatiban M, Rahimbashar F, Soltanian AR, Mousavi-bahar SH, Elyasi E. Evaluating the Potential of a New Low-Profile Urinary Catheter in Preventing Catheter-Associated Urinary Tract Infections: A Prospective Randomized Blinded Clinical Trial. Health Serv Res Manag Epidemiol 2023; 10:23333928231211410. [PMID: 37954479 PMCID: PMC10638883 DOI: 10.1177/23333928231211410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Aim To investigate the efficacy of a new low-profile catheter on incidence of the catheter-associated urinary tract infections (CAUTI) in comatose patients admitted to the intensive care unit. Background Catheter-induced urothelial injury is a key component in the development of urinary tract infections in catheterized patients. Methods In this prospective randomized blinded clinical trial, 80 patients requiring indwelling urinary catheterization were equally randomized to either the standard Foley catheter (control) or the low-profile catheter (experimental) group. The signs of urinary tract infection for comatose patients were considered (ie, ≥105 of colony-forming unit/milliliter of urine, hematuria, serum leukocytes, and body temperature) and recorded at baseline and on days 3 and 5 after catheterization. The analysis of covariance was applied by the SPSS-20 software at a 95% confidence level. Results An increasing proportion of patients with elevated urinary colony counts were seen in the Foley catheter group compared with the low-profile catheter group (12.5% vs 5%). However, there were no between-group differences in the urinary colony counts and body temperature after controlling for antibiotic doses and fluid intake. Patients in the low-profile catheter group had significantly lower rates of hematuria and serum leukocytes than those in the Foley catheter group. Conclusion A newly designed low-profile urinary catheter has demonstrated a trend toward reducing the incidence of CAUTI in patients with indwelling urinary catheters. Further studies with larger sample sizes and follow-up are needed to confirm the benefits.
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Affiliation(s)
- Farahnaz Ramezani
- Besat Specialized and Sub-specialized Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahnaz Khatiban
- Mother and Child Care Research Center, Department of Medical-Surgical Nursing, Department of Ethics Education in Medical Sciences, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farshid Rahimbashar
- Besat Specialized and Sub-specialized Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Modeling of Noncommunicable Disease Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Habibollah Mousavi-bahar
- Besat Specialized and Sub-specialized Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
- Urology & Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ensieh Elyasi
- Besat Specialized and Sub-specialized Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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Varol A, Albayrak S, Ozkan H, Demir Y, Taskin M, Adiguzel A. Production, purification and characterization of novel fibrinolytic enzyme from Bacillus atrophaeus V4. Biologia (Bratisl) 2022. [DOI: 10.1007/s11756-022-01281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Geneva II, Wegman AD, Lupone CD. Fever and hypothermia do not affect the all-cause 30-day hospital readmission. Am J Med Sci 2022; 364:714-723. [PMID: 35803309 DOI: 10.1016/j.amjms.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/16/2022] [Accepted: 06/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND One of the goals of the Affordable Care Act is to decrease hospital readmissions. While widely adhered to, there is no published research to support the practice of delaying discharge if patients exhibit fever or hypothermia in the preceding 24 h, which is the focus of our study. METHODS Retrospective analysis of the minimal (Tmin) and maximal (Tmax) body temperatures collected during the last 24 h before discharge of 19,038 inpatients. Fever was defined as Tmax >99.5F (+1SD from the mean Tmax) or >100.2F (+2SDs), and hypothermia as Tmin <97.1F (-1SD from the mean Tmin) or <96.7F (-2SDs). RESULTS The overall readmission rate was 10.2% (highest for General Medicine and Pediatrics). The rate of readmission was not different between normothermic patients and those with abnormal body temperature, except for higher readmission rate (12.2%) for patients with fever at 1SD from Tmax compared with normothermic patients (9.96%). Neither fever nor hypothermia was associated with shorter time to readmission, except for fever at 2 SDs from Tmax (10.6 days) compared with normothermic patients (12.6 days). Surprisingly, univariate analysis revealed that higher Tmax and older age were associated with lower readmission probability. Both uni- and multivariate analysis showed that the presence of fever is associated with lower readmission probability. Evaluating 200 individual cases, the most common explanation for body temperature abnormality was infection and 90% of the preventable readmissions were due to infection. CONCLUSIONS Abnormal body temperature 24 h prior to discharge was not useful for predicting the probability of readmission.
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Affiliation(s)
- Ivayla I Geneva
- Department of Internal Medicine, Division of Infectious Diseases, State University of New York - Upstate Medical University, Syracuse, NY, United States.
| | - Adam D Wegman
- Department of Microbiology and Immunology, State University of New York - Upstate Medical University, Syracuse, NY, United States
| | - Christina D Lupone
- Department of Public Health and Preventive Medicine, State University of New York - Upstate Medical University, Syracuse, NY, United States
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Hajdarovic KH, Yu D, Webb AE. Understanding the aging hypothalamus, one cell at a time. Trends Neurosci 2022; 45:942-954. [PMID: 36272823 PMCID: PMC9671837 DOI: 10.1016/j.tins.2022.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022]
Abstract
The hypothalamus is a brain region that integrates signals from the periphery and the environment to maintain organismal homeostasis. To do so, specialized hypothalamic neuropeptidergic neurons control a range of processes, such as sleep, feeding, the stress response, and hormone release. These processes are altered with age, which can affect longevity and contribute to disease status. Technological advances, such as single-cell RNA sequencing, are upending assumptions about the transcriptional identity of cell types in the hypothalamus and revealing how distinct cell types change with age. In this review, we summarize current knowledge about the contribution of hypothalamic functions to aging. We highlight recent single-cell studies interrogating distinct cell types of the mouse hypothalamus and suggest ways in which single-cell 'omics technologies can be used to further understand the aging hypothalamus and its role in longevity.
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Affiliation(s)
| | - Doudou Yu
- Graduate program in Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI 02912, USA
| | - Ashley E Webb
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI 02912, USA; Center on the Biology of Aging, Brown University, Providence, RI 02912, USA; Carney Institute for Brain Science, Brown University, Providence, RI 02912, USA; Center for Translational Neuroscience, Brown University, Providence, RI 02912, USA.
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Švantner M, Lang V, Skála J, Kohlschütter T, Honner M, Muzika L, Kosová E. Statistical Study on Human Temperature Measurement by Infrared Thermography. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22218395. [PMID: 36366093 PMCID: PMC9654967 DOI: 10.3390/s22218395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/01/2023]
Abstract
Increased temperature in humans is the symptom of many infectious diseases and it is thus an important diagnostic tool. Infrared temperature measurement methods have been developed and applied over long periods due to their advantage of non-contact and fast measurements. This study deals with a statistical evaluation of the possibilities and limitations of infrared/thermographic human temperature measurement. A short review of the use of infrared temperature measurement in medical applications is provided. Experiments and statistics-based evaluation to confirm the expected accuracy and limits of thermography-based human temperature measurement are introduced. The results presented in this study show that the standard deviation of the thermographic measurement of the eyes maximum temperature was 0.4-0.9 °C and the mean values differences from the armpit measurement were up to 0.5 °C, based on the used IR camera, even though near ideal measurement conditions and permanent blackbody correction were used. It was also shown that a certain number of outliers must be assumed in such measurements. Extended analyses including simulations of true negative/false positive, sensitivity/specificity and receiver operating characteristics (ROC) curves are presented. The statistical evaluation as well as the extended analyses show that maximum eyes temperature is more relevant than a forehead temperature examination.
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Badrou A, Tardif N, Even A, Chaudet P, Lescanne N, Szewczyk J, Gravouil A, Hamila N, Bel-Brunon A. Characterization of Surgical Tools for Specific Endovascular Navigation. Cardiovasc Eng Technol 2022; 13:751-763. [PMID: 35237938 DOI: 10.1007/s13239-022-00612-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/02/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE The aim of this work was to mechanically characterize a specific active guidewire and catheters that are commercially available, for further implementation into numerical simulation of endovascular navigation towards complex targets. METHODS For the guidewire, 3-point bending tests and bending with added masses were used to obtain the Young moduli of its various components. To study its behavior, the guidewire was activated under "ideal" conditions and its performance was investigated. As for the various catheters, they were measured and 3-point bending tests were conducted to determine their mechanical properties. RESULTS & CONCLUSION The Young moduli of the shaft and the distal tip of the guidewire were determined. We defined a suitable current intensity to activate the guidewire related to an optimal curvature. Then, the time of activation/deactivation was measured at 1.7 s. On the flip side, parts of the catheters were considered either elastic or viscoelastic. In all cases, the rigidity gradients along the various catheters were highlighted. The characterization of the aforementioned surgical tools provides the opportunity to simulate the endovascular nagivation process.
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Affiliation(s)
- A Badrou
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Tardif
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - A Even
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - P Chaudet
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Lescanne
- BaseCamp Vascular (BCV), 75005, Paris, France
| | - J Szewczyk
- BaseCamp Vascular (BCV), 75005, Paris, France
- Sorbonne Université, CNRS, INSERM, Institut des Systèmes Intelligents et de Robotique, ISIR, ISIR - AGATHE, 75005, Paris, France
| | - A Gravouil
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France
| | - N Hamila
- Ecole Nationale d'Ingénieurs de Brest, ENIB, UMR CNRS 6027, IRDL, 29200, Brest, France
| | - A Bel-Brunon
- Univ Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621, Villeurbanne, France.
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Factors Associated with Pressure Injury Among Critically Ill Patients in a Coronary Care Unit. Adv Skin Wound Care 2022; 35:1-10. [PMID: 36125458 DOI: 10.1097/01.asw.0000872172.83299.0d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To ascertain the incidence of pressure injuries (PIs) in patients in the coronary care unit (CCU), identify PI characteristics, and determine associated risk factors. METHODS Researchers conducted a retrospective investigational study of patients' medical records. A total of 820 patients who were admitted to the CCU between January 2018 and December 2020 met the study criteria. Of these, 200 patients who developed PIs after admission to the CCU were included in this study. This study examined the clinical features of PIs, as well as five PI risk factors: patient characteristics; length of stay; intrinsic factors; care factors, including medical devices; and vasopressor agents. RESULTS The incidence of PIs among patients in the CCU was 24.4%. At initial detection, 79.5% of these injuries were already at stage 2 or higher. The results indicated a significant correlation between PI stage and hemoglobin level. Moreover, the authors also found relationships between the use of medical devices (eg, arterial catheters, oxygen tubes, and Levin tubes) and PI onset. CONCLUSIONS Critically ill patients in the CCU use various medical devices for an extended period with severe consequences. The risk factors affecting PI are multifactorial. Therefore, the implementation of PI prevention and early detection strategies for patients in the CCU are crucial.
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Dzierzęcki S, Ząbek M, Zapolska G, Tomasiuk R. The S-100B level, intracranial pressure, body temperature, and transcranial blood flow velocities predict the outcome of the treatment of severe brain injury. Medicine (Baltimore) 2022; 101:e30348. [PMID: 36197246 PMCID: PMC9509168 DOI: 10.1097/md.0000000000030348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study evaluates the applicability of S100B levels, mean maximum velocity (Vmean) over time, pulsatility index (PI), intracranial pressure (ICP), and body temperature (T) for the prediction of the treatment of patients with traumatic brain injury (TBI). Sixty patients defined by the Glasgow Coma Scale score ≤ 8 were stratified using the Glasgow Coma Scale into 2 groups: favorable (FG: Glasgow Outcome Scale ≥ 4) and unfavorable (UG: Glasgow Outcome Scale < 4). The S100B concentration was at the time of hospital admission. Vmean was measured using transcranial Doppler. PI was derived from a transcranial Doppler examination. T was measured in the temporal artery. The differences in mean between FG and UG were tested using a bootstrap test of 10,000 repetitions with replacement. Changes in S100B, Vmean, PI, ICP, and T levels stratified by the group were calculated using the one-way aligned rank transform for nonparametric factorial analysis of variance. The reference ranges for the levels of S100B, Vmean, and PI were 0.05 to 0.23 µg/L, 30.8 to 73.17 cm/s, and 0.62 to 1.13, respectively. Both groups were defined by an increase in Vmean, a decrease in S100B, PI, and ICP levels; and a virtually constant T. The unfavorable outcome is defined by significantly higher levels of all parameters, except T. A favorable outcome is defined by S100B < 3 mg/L, PI < 2.86, ICP > 25 mm Hg, and Vmean > 40 cm/s. The relationships provided may serve as indicators of the results of the TBI treatment.
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Affiliation(s)
- Sebastian Dzierzęcki
- Department of Neurosurgery, Postgraduate Medical Centre, Warsaw, Poland
- Gamma Knife Centre, Brodno Masovian Hospital, Warsaw, Poland
- *Correspondence: Sebastian Dzierzecki, Warsaw Gamma Knife Centre, Brodno Masovian Hospital, Kondratowicza 8 Building H, 03-242 Warsaw, Poland (e-mail: )
| | - Mirosław Ząbek
- Department of Neurosurgery, Postgraduate Medical Centre, Warsaw, Poland
- Clinical Department of Neurosurgery, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | | | - Ryszard Tomasiuk
- Kazimierz Pulaski University of Technology and Humanities Radom, Faculty of Medical Sciences and Health Sciences, Radom, Poland
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Soranso DR, Minette LJ, Marçal M, Marins JCB, Schettino S, Lima RCA, Oliveira M. Thermography in ergonomic assessment: a study of wood processing industry workers. PeerJ 2022; 10:e13973. [PMID: 36157059 PMCID: PMC9504449 DOI: 10.7717/peerj.13973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/09/2022] [Indexed: 01/19/2023] Open
Abstract
Background Workers in the wood processing industry perform activities that demand great physical and ergonomic demands, which favors the emergence of inflammatory processes and in turn the occurrence of heat regions in the body, thus making it possible to assess the inflammatory level by means of temperature gradients. This study aimed to evaluate the use of thermography as an ergonomic analysis tool to identify regions with musculoskeletal overload in workers in a wood processing industry. Methods The study was conducted with nine workers in the central-west region of Brazil. The evaluations to obtain the thermographic images were carried out before the beginning of the workday, on Monday (day I) and on Friday (day II), in order to verify the overload regions in the accumulation of days worked. The thermal images were collected in an acclimatized room with controlled conditions where the participants remained with the upper part of their bodies bare for acclimatization, and then the lumbar and scapular regions were evaluated. The images were obtained using the FLUKE TI 400 Thermal Imager, with analysis using the SmartView software program to demarcate the body regions of interest. Results The mean temperature values obtained on day I did not significantly differ from the mean values obtained on day II. Qualitative analysis showed thermal patterns with high temperature at the same points on both evaluated days. Although the thermographic analysis performed in this study cannot provide definitive results, they generally helped to provide evidence for a more accurate diagnosis in the evaluated workers.
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Affiliation(s)
- Denise Ransolin Soranso
- Institute of Production Engineering and Management, Federal University of Itajubá, Itajubá, Minas Gerais, Brazil
| | - Luciano José Minette
- Department of Production Engineering and Mechanics, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Marcio Marçal
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Minas Gerais, Brazil
| | | | - Stanley Schettino
- Institute of Agrarian Sciences, Federal University of Minas Gerais, Montes Claros, Minas Gerais, Brazil
| | | | - Michel Oliveira
- Center for Agricultural Sciences and Engineering, Federal University of Espírito Santo, Jerônimo Monteiro, Espírito Santo, Brazil
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Rzechorzek NM, Thrippleton MJ, Chappell FM, Mair G, Ercole A, Cabeleira M, Rhodes J, Marshall I, O'Neill JS. A daily temperature rhythm in the human brain predicts survival after brain injury. Brain 2022; 145:2031-2048. [PMID: 35691613 PMCID: PMC9336587 DOI: 10.1093/brain/awab466] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/03/2021] [Accepted: 11/20/2021] [Indexed: 02/06/2023] Open
Abstract
Patients undergo interventions to achieve a 'normal' brain temperature; a parameter that remains undefined for humans. The profound sensitivity of neuronal function to temperature implies the brain should be isothermal, but observations from patients and non-human primates suggest significant spatiotemporal variation. We aimed to determine the clinical relevance of brain temperature in patients by establishing how much it varies in healthy adults. We retrospectively screened data for all patients recruited to the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) High Resolution Intensive Care Unit Sub-Study. Only patients with direct brain temperature measurements and without targeted temperature management were included. To interpret patient analyses, we prospectively recruited 40 healthy adults (20 males, 20 females, 20-40 years) for brain thermometry using magnetic resonance spectroscopy. Participants were scanned in the morning, afternoon, and late evening of a single day. In patients (n = 114), brain temperature ranged from 32.6 to 42.3°C and mean brain temperature (38.5 ± 0.8°C) exceeded body temperature (37.5 ± 0.5°C, P < 0.0001). Of 100 patients eligible for brain temperature rhythm analysis, 25 displayed a daily rhythm, and the brain temperature range decreased in older patients (P = 0.018). In healthy participants, brain temperature ranged from 36.1 to 40.9°C; mean brain temperature (38.5 ± 0.4°C) exceeded oral temperature (36.0 ± 0.5°C) and was 0.36°C higher in luteal females relative to follicular females and males (P = 0.0006 and P < 0.0001, respectively). Temperature increased with age, most notably in deep brain regions (0.6°C over 20 years, P = 0.0002), and varied spatially by 2.41 ± 0.46°C with highest temperatures in the thalamus. Brain temperature varied by time of day, especially in deep regions (0.86°C, P = 0.0001), and was lowest at night. From the healthy data we built HEATWAVE-a 4D map of human brain temperature. Testing the clinical relevance of HEATWAVE in patients, we found that lack of a daily brain temperature rhythm increased the odds of death in intensive care 21-fold (P = 0.016), whilst absolute temperature maxima or minima did not predict outcome. A warmer mean brain temperature was associated with survival (P = 0.035), however, and ageing by 10 years increased the odds of death 11-fold (P = 0.0002). Human brain temperature is higher and varies more than previously assumed-by age, sex, menstrual cycle, brain region, and time of day. This has major implications for temperature monitoring and management, with daily brain temperature rhythmicity emerging as one of the strongest single predictors of survival after brain injury. We conclude that daily rhythmic brain temperature variation-not absolute brain temperature-is one way in which human brain physiology may be distinguished from pathophysiology.
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Affiliation(s)
| | - Michael J Thrippleton
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Francesca M Chappell
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Grant Mair
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Ari Ercole
- Division of Anaesthesia, University of Cambridge, Box 93 Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Manuel Cabeleira
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | | | - Jonathan Rhodes
- Department of Anaesthesia, Critical Care and Pain Medicine, NHS Lothian, Room No. S8208 (2nd Floor), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Ian Marshall
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - John S O'Neill
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
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Ajčević M, Buoite Stella A, Furlanis G, Caruso P, Naccarato M, Accardo A, Manganotti P. A Novel Non-Invasive Thermometer for Continuous Core Body Temperature: Comparison with Tympanic Temperature in an Acute Stroke Clinical Setting. SENSORS 2022; 22:s22134760. [PMID: 35808257 PMCID: PMC9269248 DOI: 10.3390/s22134760] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023]
Abstract
There is a growing research interest in wireless non-invasive solutions for core temperature estimation and their application in clinical settings. This study aimed to investigate the use of a novel wireless non-invasive heat flux-based thermometer in acute stroke patients admitted to a stroke unit and compare the measurements with the currently used infrared (IR) tympanic temperature readings. The study encompassed 30 acute ischemic stroke patients who underwent continuous measurement (Tcore) with the novel wearable non-invasive CORE device. Paired measurements of Tcore and tympanic temperature (Ttym) by using a standard IR-device were performed 3−5 times/day, yielding a total of 305 measurements. The predicted core temperatures (Tcore) were significantly correlated with Ttym (r = 0.89, p < 0.001). The comparison of the Tcore and Ttym measurements by Bland−Altman analysis showed a good agreement between them, with a low mean difference of 0.11 ± 0.34 °C, and no proportional bias was observed (B = −0.003, p = 0.923). The Tcore measurements correctly predicted the presence or absence of Ttym hyperthermia or fever in 94.1% and 97.4% of cases, respectively. Temperature monitoring with a novel wireless non-invasive heat flux-based thermometer could be a reliable alternative to the Ttym method for assessing core temperature in acute ischemic stroke patients.
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Affiliation(s)
- Miloš Ajčević
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
- Department of Engineering and Architecture, University of Trieste, Via A. Valerio, 10-34127 Trieste, Italy;
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
- Correspondence: ; Tel.: +39-040-399-4075 (ext. 6582); Fax: +39-040-399-4284
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
| | - Paola Caruso
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
| | - Marcello Naccarato
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
| | - Agostino Accardo
- Department of Engineering and Architecture, University of Trieste, Via A. Valerio, 10-34127 Trieste, Italy;
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447-34149 Trieste, Italy; (M.A.); (G.F.); (P.C.); (M.N.); (P.M.)
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Los B, Preußner M, Eschke K, Vidal RM, Abdelgawad A, Olofsson D, Keiper S, Paulo-Pedro M, Grindel A, Meinke S, Trimpert J, Heyd F. Body temperature variation controls pre-mRNA processing and transcription of antiviral genes and SARS-CoV-2 replication. Nucleic Acids Res 2022; 50:6769-6785. [PMID: 35713540 PMCID: PMC9262603 DOI: 10.1093/nar/gkac513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/07/2022] [Accepted: 05/31/2022] [Indexed: 12/24/2022] Open
Abstract
Antiviral innate immunity represents the first defense against invading viruses and is key to control viral infections, including SARS-CoV-2. Body temperature is an omnipresent variable but was neglected when addressing host defense mechanisms and susceptibility to SARS-CoV-2 infection. Here, we show that increasing temperature in a 1.5°C window, between 36.5 and 38°C, strongly increases the expression of genes in two branches of antiviral immunity, nitric oxide production and type I interferon response. We show that alternative splicing coupled to nonsense-mediated decay decreases STAT2 expression in colder conditions and suggest that increased STAT2 expression at elevated temperature induces the expression of diverse antiviral genes and SARS-CoV-2 restriction factors. This cascade is activated in a remarkably narrow temperature range below febrile temperature, which reflects individual, circadian and age-dependent variation. We suggest that decreased body temperature with aging contributes to reduced expression of antiviral genes in older individuals. Using cell culture and in vivo models, we show that higher body temperature correlates with reduced SARS-CoV-2 replication, which may affect the different vulnerability of children versus seniors toward severe SARS-CoV-2 infection. Altogether, our data connect body temperature and pre-mRNA processing to provide new mechanistic insight into the regulation of antiviral innate immunity.
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Affiliation(s)
- Bruna Los
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Marco Preußner
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Kathrin Eschke
- Omiqa Bioinformatics, Altensteinstraße 40, 14195 Berlin, Germany
| | | | - Azza Abdelgawad
- Omiqa Bioinformatics, Altensteinstraße 40, 14195 Berlin, Germany
| | - Didrik Olofsson
- Institute of Virology, Freie Universität Berlin, Robert-von-Ostertag-Straße 7-13, 14163 Berlin, Germany
| | - Sandra Keiper
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Margarida Paulo-Pedro
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Alica Grindel
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Stefan Meinke
- Laboratory of RNA Biochemistry, Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustrasse 6, 14195 Berlin, Germany
| | - Jakob Trimpert
- Omiqa Bioinformatics, Altensteinstraße 40, 14195 Berlin, Germany
| | - Florian Heyd
- To whom correspondence should be addressed. Tel: +49 30 83862938; Fax: +49 30 838 4 62938;
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Temperature Screening of Healthcare Personnel Is Ineffective in Controlling COVID-19. J Occup Environ Med 2022; 64:382-384. [DOI: 10.1097/jom.0000000000002518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2022. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2022. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
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Affiliation(s)
- Thomas De Corte
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
| | | | - Jan De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
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