Assessment of axillary temperature for the evaluation of normal body temperature of healthy young adults at rest in a thermoneutral environment

Hyperthermia: Is it always an accidental death?

INTRODUCTION

The research aimed to determine individual variations in different core temperature measurements before the experiment, after submersion, after 20 min of exposure for heat stroke.

METHODS

Rats were divided into three groups depending on the temperature and length of exposure to water: CG, G41-20 and G41-UD. The protocol was made according to the earlier described methodology of heat shock induction.

RESULTS

A significant difference was observed in the G41-UD group; p < 0.0005. The lowest body temperature of the rats was observed, from normothermia, and the highest temperature after death, 37.87 ± 0.62 °C vs 41.20 ± 0.76 °C, the difference between all three groups is p < 0.0005.

CONCLUSION

Exposure of Wistar rats to water temperatures in the CG and G41 groups led to a significant change in core temperature. In the control group, the thermoregulatory mechanism firmly established normothermia, while hyperthermia was revealed in the G41 group during the 20-minute exposure.

Efficient assessment of real-world dynamics of circadian rhythms in heart rate and body temperature from wearable data

Laboratory studies have made unprecedented progress in understanding circadian physiology. Quantifying circadian rhythms outside of laboratory settings is necessary to translate these findings into real-world clinical practice. Wearables have been considered promising way to measure these rhythms. However, their limited validation remains an open problem. One major barrier to implementing large-scale validation studies is the lack of reliable and efficient methods for circadian assessment from wearable data. Here, we propose an approximation-based least-squares method to extract underlying circadian rhythms from wearable measurements. Its computational cost is ∼ 300-fold lower than that of previous work, enabling its implementation in smartphones with low computing power. We test it on two large-scale real-world wearable datasets: [Formula: see text] of body temperature data from cancer patients and ∼ 184 000 days of heart rate and activity data collected from the 'Social Rhythms' mobile application. This shows successful extraction of real-world dynamics of circadian rhythms. We also identify a reasonable harmonic model to analyse wearable data. Lastly, we show our method has broad applicability in circadian studies by embedding it into a Kalman filter that infers the state space of the molecular clocks in tissues. Our approach facilitates the translation of scientific advances in circadian fields into actual improvements in health.

The effect of an infection control guideline on the incidence of ventilator-associated pneumonia in patients admitted to the intensive care units

BACKGROUND AND AIM

Standard airway care can reduce the incidence of ventilator-associated pneumonia (VAP). This study aimed to determine the effect of implementing infection control guidelines on the incidence of VAP in patients admitted to the intensive care unit (ICU).

MATERIALS AND METHODS

In this clinical trial, 121 patients admitted to the intensive care units of Golestan and Imam Khomeini hospitals of Ahvaz, Iran who were under mechanical ventilation were assigned to two groups of control and intervention in non-randomly allocation. The study was conducted in two consecutive periods. In the intervention group, infection control guidelines were performed to prevent VAP and in the control group, routine care was performed. Data collection is done by used a three-part instrument. The first part included questions on the patients' demographics and clinical information. The second part was the modified clinical pulmonary infection scale (MCPIS) for the early detection of VAP. The third part of the data collection instrument was a developed checklist through literature review. The MCPIS was completed for all patients on admission and the 5th day of the study.

RESULTS

The two groups were homogenous respecting their baseline characteristics (P > 0.05) including the mean MCPIS score (P > 0.05). However, the intervention group had lower body temperature (P < 0.001), lower white blood cell counts (P < 0.038), lower MCPIS score (P < 0.001), and higher PaO2/FIO2 (P < 0.013) at the end of the study. The incidence of VAP was significantly lower in the intervention group when compared to the control group (i.e. 30% vs. 65.6%, P < 0.001).

CONCLUSIONS

The implementation of infection control guidelines could significantly reduce the incidence of VAP and its diagnostic indicators in patients admitted to the ICU. Nurses are advised to use these guidelines to prevent VAP in patients admitted to ICU.

A Comparative Study of Forehead Temperature and Core Body Temperature under Varying Ambient Temperature Conditions

When the ambient temperature, in which a person is situated, fluctuates, the body's surface temperature will alter proportionally. However, the body's core temperature will remain relatively steady. Consequently, using body surface temperature to characterize the core body temperature of the human body in varied situations is still highly inaccurate. This research aims to investigate and establish the link between human body surface temperature and core body temperature in a variety of ambient conditions, as well as the associated conversion curves.

METHODS

Plan an experiment to measure temperature over a thousand times in order to get the corresponding data for human forehead, axillary, and oral temperatures at varying ambient temperatures (14-32 °C). Utilize the axillary and oral temperatures as the core body temperature standards or the control group to investigate the new approach's accuracy, sensitivity, and specificity for detecting fever/non-fever conditions and the forehead temperature as the experimental group. Analyze the statistical connection, data correlation, and agreement between the forehead temperature and the core body temperature.

RESULTS

A total of 1080 tests measuring body temperature were conducted on healthy adults. The average axillary temperature was (36.7 ± 0.41) °C, the average oral temperature was (36.7 ± 0.33) °C, and the average forehead temperature was (36.2 ± 0.30) °C as a result of the shift in ambient temperature. The forehead temperature was 0.5 °C lower than the average of the axillary and oral temperatures. The Pearson correlation coefficient between axillary and oral temperatures was 0.41 (95% CI, 0.28-0.52), between axillary and forehead temperatures was 0.07 (95% CI, -0.07-0.22), and between oral and forehead temperatures was 0.26 (95% CI, 0.11-0.39). The mean differences between the axillary temperature and the oral temperature, the oral temperature and the forehead temperature, and the axillary temperature and the forehead temperature were -0.08 °C, 0.49 °C, and 0.42 °C, respectively, according to a Bland-Altman analysis. Finally, the regression analysis revealed that there was a linear association between the axillary temperature and the forehead temperature, as well as the oral temperature and the forehead temperature due to the change in ambient temperature.

CONCLUSION

The changes in ambient temperature have a substantial impact on the temperature of the forehead. There are significant differences between the forehead and axillary temperatures, as well as the forehead and oral temperatures, when the ambient temperature is low. As the ambient temperature rises, the forehead temperature tends to progressively converge with the axillary and oral temperatures. In clinical or daily applications, it is not advised to utilize the forehead temperature derived from an uncorrected infrared thermometer as the foundation for a body temperature screening in public venues such as hospital outpatient clinics, shopping malls, airports, and train stations.

Assessment of Alternative Body Points for Temperature Screening As Precautionary Screening During the Pandemic Using Infrared Thermometry

BACKGROUND

The recent coronavirus disease 2019 (COVID-19) pandemic, which swept across the globe in a short period, demonstrated that disease transmission management is a critical step in preventing an outbreak, as is good viral infectious disease screening. Infrared thermography (IRT) has long been considered ideal for screening body temperatures during pandemics.

METHODS

Single-centre cross-sectional study with 159 participants. Using infrared thermometry, participants were subjected to temperature measurement twice daily on various sites. This was compared to oral temperature.

RESULTS

The findings of the study revealed that infrared thermometry could be utilised as a proxy approach for screening by both individuals and medical professionals when employed at the glabella, cubits, or axillae.

CONCLUSION

 Temperature screening is implied as a prophylactic method during pandemics. Owing to contact limitations, oral thermometry cannot be used for mass screening during the pandemic. Infrared thermometry is a noncontact method of temperature screening that can readily be applied for mass temperature screening in congested venues such as airports, shopping malls, places of public convenience, and other similar locations.

Using wearable devices to generate real-world, individual-level data in rural, low-resource contexts in Burkina Faso, Africa: A case study

Background

Wearable devices may generate valuable data for global health research for low- and middle-income countries (LMICs). However, wearable studies in LMICs are scarce. This study aims to investigate the use of consumer-grade wearables to generate individual-level data in vulnerable populations in LMICs, focusing on the acceptability (quality of the devices being accepted or even liked) and feasibility (the state of being workable, realizable, and practical, including aspects of data completeness and plausibility).

Methods

We utilized a mixed-methods approach within the health and demographic surveillance system (HDSS) to conduct a case study in Nouna, Burkina Faso (BF). All HDSS residents older than 6 years were eligible. N = 150 participants were randomly selected from the HDSS database to wear a wristband tracker (Withings Pulse HR) and n = 69 also a thermometer patch (Tucky thermometer) for 3 weeks. Every 4 days, a trained field worker conducted an acceptability questionnaire with participants, which included questions for the field workers as well. Descriptive and qualitative thematic analyses were used to analyze the responses of study participants and field workers.

Results

In total, n = 148 participants were included (and n = 9 field workers). Participant's acceptability ranged from 94 to 100% throughout the questionnaire. In 95% of the cases (n = 140), participants reported no challenges with the wearable. Most participants were not affected by the wearable in their daily activities (n = 122, 83%) and even enjoyed wearing them (n = 30, 20%). Some were concerned about damage to the wearables (n = 7, 5%). Total data coverage (i.e., the proportion of the whole 3-week study duration covered by data) was 43% for accelerometer (activity), 3% for heart rate, and 4% for body shell temperature. Field workers reported technical issues like faulty synchronization (n = 6, 1%). On average, participants slept 7 h (SD 3.2 h) and walked 8,000 steps per day (SD 5573.6 steps). Acceptability and data completeness were comparable across sex, age, and study arms.

Conclusion

Wearable devices were well-accepted and were able to produce continuous measurements, highlighting the potential for wearables to generate large datasets in LMICs. Challenges constituted data missingness mainly of technical nature. To our knowledge, this is the first study to use consumer-focused wearables to generate objective datasets in rural BF.

The importance of body core temperature evaluation in balneotherapy

It is not wrong to say that there are no application standards or best practices in balneotherapy considering traditional applications. There is not enough information about how changes in body temperature, duration, and frequency of exposure to heat affect therapeutic outcomes of balneotherapeutic applications. Body core temperature (BCT) is probably the best parameter for expressing the heat load of the body and can be used to describe the causal relationship between heat exposure and its effects. There are several reasons to take BCT changes into account; for example, it can be used for individualized treatment planning, defining the consequences of thermal effects, developing disease-specific approaches, avoiding adverse effects, and designing clinical trials. The reasons why BCT changes should be considered instead of conventional measures will be discussed while explaining the effects of balneotherapy in this article, along with a discussion of BCT measurement in balneotherapy practice.

Statistical Analysis of the Axillary Temperatures Measured by a Predictive Electronic Thermometer in Healthy Japanese Adults

Body temperature is important for diagnosing illnesses. However, its assessment is often a difficult task, considering the large individual differences. Although 37 °C has been the gold standard of body temperature for over a century, the temperature of modern people is reportedly decreasing year by year. However, a mean axillary temperature of 36.89 ± 0.34 °C reported in 1957 is still cited in Japan. To assess the measured axillary temperature appropriately, understanding its distribution in modern people is important. This study retrospectively analyzed 2454 axillary temperature measurement data of healthy Japanese adults in 2019 (age range, 20–79 years; 2258 males). Their mean temperature was 36.47 ± 0.28 °C (36.48 ± 0.27 °C in males and 36.35 ± 0.31 °C in females). Approximately 5% of the 20–39-year-old males had body temperature ≥37 °C, whereas 8% had a temperature ≥ 37 °C in the afternoon. However, none of the subjects aged ≥50 years reported body temperature ≥37 °C. In multivariable regression analysis, age, blood pressure, pulse rate, and measurement time of the day were associated with axillary temperature. Our data showed that the body temperature of modern Japanese adults was lower than that reported previously. When assessing body temperature, the age, blood pressure, pulse rate, and measurement time of the day should be considered.

Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies

A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.

Use of non-contact infrared thermometers in rehabilitation patients: a randomized controlled study

Objective

In this randomized controlled study, we aimed to determine whether non-contact infrared thermometers (NCITs) are more time-efficient and create less patient distress than mercury axillary thermometers (MATs) and infrared tympanic thermometers (ITTs).

Methods

Forty-five rehabilitation inpatients were randomly assigned to one of three groups (NCIT, MAT, and ITT). Time required to measure body temperature with an NCIT, MAT, and ITT was recorded. We examined associations between time required to take patients’ temperature and measuring device used. Patient distress experienced during temperature measurement using the three thermometers was recorded.

Results

A significantly longer average time was required to measure temperatures using the MAT (mean 43.17, standard deviation [SD] 8.39) than the ITT (mean 13.74, SD 1.63) and NCIT (mean 12.13, SD 1.18). The thermometer used influenced the time required to measure body temperature (t = 33.99). There were significant differences among groups (NCIT vs. ITT, NCIT vs. MAT, and ITT vs. MAT) regarding patient distress among the different thermometers. Most distress arose owing to needing help from others, sleep disruption, and boredom.

Conclusion

The NCIT has clinically relevant advantages over the ITT and MAT in measuring body temperature among rehabilitation patients, including saving nurses’ time and avoiding unnecessary patient distress.

Clinical trial registration number (http://www.chictr.org.cn): ChiCTR1800019756.

Ingestible sensors correlate closely with peripheral temperature measurements in febrile patients

BACKGROUNDS

Reliable non-invasive methods for measuring body temperature are essential for the diagnosis and monitoring of infectious disease.

METHODS

This study used Intraclass Correlation Coefficients (ICC) and the Bland- Altman plot to analyse the agreement between temperature measurements using an ingestible capsule sensor, a skin sensor and two non-invasive peripheral temperature measurements (axillary and infrared non-contact), collected from a population of febrile patient admitted for infectious disease.

RESULTS

Of the 77 febrile patients screened, 26 patients were enrolled. The ICC between axillary temperature measurements (Taxi) vs. non-contact measurements (Tno-c) were 0.34 [-0.18; 0.63], 0.87 [0.55; 0.94] between Taxi vs. ingestible capsule measurements (Tcap) and 0.12 [-0.09; 0.37] between Taxi vs. Tetac. The mean difference between Taxi vs Tno-c was -1.18 °C with limits of agreement (LoA) from -2.96 to 0.58 °C. The mean difference between Taxi vs Tcap was 0.48 °C, with LoA from -0.60 to 1.56 °C. The mean difference between Taxi vs Tetac was -4.23 °C with LoA from -7.22 to -1.23 °C.

CONCLUSIONS

Ingestible capsule measurements are reliable enough to adequately estimate the core body temperature in clinical practice. Its non-invasiveness, and the real-time remote control offer new opportunities for future research into fever during infectious diseases.

Normal Body Temperature: A Systematic Review

PubMed was searched from 1935 to December 2017 with a variety of search phrases among article titles. The references of the identified manuscripts were then manually searched. The inclusion criteria were as follows: (1) the paper presented data on measured normal body temperature of healthy human subjects ages 18 and older, (2) a prospective design was used, and (3) the paper was written in or translated into the English language. Thirty-six articles met the inclusion criteria. This comprised 9227 measurement sites from 7636 subjects. The calculated ranges (mean ± 2 standard deviations) were 36.32-37.76 (rectal), 35.76-37.52 (tympanic), 35.61-37.61 (urine), 35.73-37.41 (oral), and 35.01-36.93 (axillary). Older adults (age ≥60) had lower temperature than younger adults (age <60) by 0.23°C, on average. There was only insignificant gender difference. Compared with the currently established reference point for normothermia of 36.8°C, our means are slightly lower but the difference likely has no physiological importance. We conclude that the most important patient factors remain site of measurement and patient's age.