Body Core Temperature Assessment in Emergency Care Departments.

BACKGROUND: There is concern that the values provided by devices using infrared thermometry in emergency departments (EDs) do not reflect body core temperature accurately. OBJECTIVES: Evaluation of three thermometers commonly used in the ED. METHODS: Two infrared ear thermometers and an infrared forehead thermometer were evaluated using 1) the Voltcraft IRS-350 calibration device, 2) comparing temperature values to a rectal end-exercise temperature (T-RECT) of 38.1°C in 12 participants, and 3) comparing temperature values to rectal temperature in 133 ED patients. RESULTS: Calibration across the human core temperature range revealed that the ear thermometers underestimated radiant temperature by 0.77 ± 0.39°C and 1.84 ± 0.26°C, respectively, whereas the forehead thermometer overestimated radiant temperature by 0.90 ± 0.51°C. After cycling exercise, all thermometers underestimated T-RECT (0.54 ± 0.27°C and 1.03 ± 0.48°C for the ear thermometers and 1.14 ± 0.38°C for the forehead thermometer). In the ED, the ear thermometers underestimated T-RECT by 0.31 ± 0.37°C and 0.46 ± 0.50°C, whereas the forehead thermometer exhibited a nonsignificant overestimation of 0.04 ± 0.46°C. If the threshold for fever in all systems had been set to 37.5°C instead of 38.0°C, the sensitivity and specificity of the systems for real fever (T-RECT ≥ 38°C) are, respectively, 71% and 96% (ear thermometer 1), 57% and 97% (ear thermometer 2), and 86% and 90% (forehead thermometer). CONCLUSION: We conclude that the investigated thermometers are not reliable as devices to measure radiant temperature, cannot be used to assess body core temperature during exercise, but may be used as a screening device, with 37.5°C as a threshold for fever in emergency care settings.

Assessment of emotional distress in palliative care: Edmonton Symptom Assessment System-revised (ESAS-r) vs Distress Thermometer.

OBJECTIVES: To evaluate the sensitivity and specificity of the Distress Thermometer (DT) as a screening tool for emotional distress in oncological palliative care patients and to compare the DT with the Edmonton Symptom Assessment System-revised (ESAS-r) and the gold standard to determine the most appropriate assessment method in palliative psychological care. METHODS: Data were collected from psychological screening tests (ESAS-r and DT), and clinical interviews (gold standard) were conducted by a clinical psychologist specialist in palliative oncology from January 2021 to January 2022 in an oncology palliative care service. RESULTS: The sample consisted of 356 first-time patients with a diagnosis of advanced cancer in palliative care. The most frequently reported oncological diagnoses were gastrointestinal tract (49.3%) and breast (18.3%). Most patients were female (n = 206; 57.9%), 60.4% were married/with a partner, 55.4% had between 6 and 9 years of schooling, and a median age of 57 (range, 46-65) years. The cutoff of the DT was 5, with a sensitivity of 75.88% and specificity of 54.3%. Emotional problems (sadness and nervousness) had a greater area under the curve (AUC) when measured using the DT than the ESAS-r; however, only in the case of the comparative sadness and discouragement was the difference between the AUC marginally significant. SIGNIFICANCE OF RESULTS: The use of the DT as a screening tool in oncological palliative care is more effective in the evaluation of psychological needs than the ESAS-r. The DT, in addition to evaluation by an expert psychologist, allows for a more comprehensive identification of signs and symptoms to yield an accurate mental health diagnosis based on the International Classification of Diseases-11th Revision and/or Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.

Zero-heat-flux thermometry over the carotid artery in assessment of core temperature in craniotomy patients.

Zero-heat-flux core temperature measurements on the forehead (ZHF-forehead) show acceptable agreement with invasive core temperature measurements but are not always possible in general anesthesia. However, ZHF measurements over the carotid artery (ZHF-neck) have been shown reliable in cardiac surgery. We investigated these in non-cardiac surgery. In 99 craniotomy patients, we assessed agreement of ZHF-forehead and ZHF-neck (3M™ Bair Hugger™) with esophageal temperatures. We applied Bland-Altman analysis and calculated mean absolute differences (difference index) and proportion of differences within ± 0.5 °C (percentage index) during entire anesthesia and before and after esophageal temperature nadir. In Bland-Altman analysis [mean (limits of agreement)], agreement with esophageal temperature during entire anesthesia was 0.1 (-0.7 to +0.8) °C (ZHF-neck) and 0.0 (-0.8 to +0.8) °C (ZHF-forehead), and, after core temperature nadir, 0.1 (-0.5 to +0.7) °C and 0.1 (-0.6 to +0.8) °C, respectively. In difference index [median (interquartile range)], ZHF-neck and ZHF-forehead performed equally during entire anesthesia [ZHF-neck: 0.2 (0.1-0.3) °C vs ZHF-forehead: 0.2 (0.2-0.4) °C], and after core temperature nadir [0.2 (0.1-0.3) °C vs 0.2 (0.1-0.3) °C, respectively; all p > 0.017 after Bonferroni correction]. In percentage index [median (interquartile range)], both ZHF-neck [100 (92-100) %] and ZHF-forehead [100 (92-100) %] scored almost 100% after esophageal nadir. ZHF-neck measures core temperature as reliably as ZHF-forehead in non-cardiac surgery. ZHF-neck is an alternative to ZHF-forehead if the latter cannot be applied.

An assessment of the validity and reliability of the P022-P version of e-Celsius core temperature capsules.

Core temperature monitoring is a research tool used in many studies, though most popularly, heat strain. Ingestible core temperature capsules are a non-invasive and increasingly popular choice for measuring core body temperature, particularly considering the well-established validation of capsule systems. A newer version of the e-Celsius ingestible core temperature capsule has been released since the preceding validation study resulting in a paucity of validated research for the current version of capsules, P022-P, used by researchers. Using a 1:1 ratio of propylene glycol to water in a circulating water bath, and a reference thermometer with resolution and uncertainty of 0.01 °C, we assessed the validity and reliability of 24 P022-P e-Celsius capsules in three groups of eight, at seven temperature plateaus between 35 °C, and 42 °C in a test-retest format. The systematic bias of these capsules across all 3360 measurements was found to be -0.038 °C ± 0.086 °C (p < .001), The TEST-RETEST evaluation revealed excellent reliability by way of a minute overall mean difference of 0.0095 °C ± 0.048 °C (p < .001), and an intraclass correlation coefficient of 1.00 for each of TEST and RETEST conditions. Although quite small, differences in systematic bias across temperature plateaus were observed for both the OVERALL bias-between 0.00066 °C and 0.041°C-and TEST/RETEST bias-between 0.00010 °C and 0.016 °C. We found that the new capsule version outperforms manufacturer guarantees, with half of the systematic bias observed in a validation study of the previous capsule version. Though these capsules tend to slightly underestimate temperature, we find they possess excellent validity and reliability between 35 °C and 42 °C.

Impact of engineering renovation on dynamic health risk assessment of mercury in a thermometer enterprise.

The occupational health risk assessments (OHRA) of inorganic mercury (Hg) are rarely reported. We conducted an internal and external exposure monitoring of employees in a thermometer enterprise which experienced the renovation of occupational health engineering, followed by an evaluation on the health risks of Hg exposure with four OHRA methods in order to find out a most suitable model. The results showed that the concentrations of airborne and urinary Hg in all testing positions and subjects obviously decreased after the engineering renovation, meeting the occupational exposure limits (OELs) of China. Subsequently, four OHRA models, namely the models from US Environmental Protection Agency (EPA), Ministry of Manpower (MOM), International Council on Mining and Metals (ICMM), and Classification of occupational hazards at workplaces Part 2: Occupational exposure to chemicals (GBZ/T 229.2-2010) were applied in the qualitative risk assessment. And the evaluation results of different methods were standardized by risk ratio (RR), which indicated MOM, ICMM risk rating, and GBZ/T 229.2 models were consistent with the order of inherent risk levels in those working processes. The order of RR between four models was: RR EPA > RR ICMM > RR MOM> RR GBZ/T229.2 (P < 0.05). Based on the strict limits of Hg, GBZ/T 229.2, and MOM methods may have more potentials in practical application. Though the working environment has been significantly improved via engineering renovation, it is strongly suggested that the thermometer company conduct more effective risk management covering all production processes to minimize Hg exposure levels and health risk ratings.

Applicability of the auricular temperature for the assessment of body temperature in healthy large and small domestic species, in a normal metabolic state and in controlled environmental conditions.

In clinical practice, an important aspect of animal health status evaluation is the body temperature recording obtained using different methods. Within them, the non-contact and non-invasive infrared thermometer can provide an accurate estimation of body temperature improving the quality of care and medical decision. To evaluate the use of the monitoring of auricular temperature to improve the quality of care and medical decision. To evaluate the use of the monitoring of auricular temperature as indices of body temperature, as well as rectal temperature in eleven clinically healthy mixed bred cats, eleven Rottweiler dogs, and eleven Italian saddle horses temperature values were obtained by means of an infrared thermometer in the left and right ears and by means of a digital thermometer in the rectum. Two-way analysis of variance (ANOVA) indicated a statistically higher rectal temperature value than the temperature recorded in the left and right ears (P<0.001). In all species, no differences between the right and left ear were recorded (p>0.05). Cats and dogs showed a statistically higher auricular (p<0.001) and rectal (p<0.01) temperature compared to horses. No differences were observed between cats and dogs (p>0.05). Auricular and rectal temperature agreement was shown by the Bland-Altman test. Between the two methods, the average difference was 1.6 °C for cats, 1.4 °C for dogs, and 3.3 °C for horses. In dogs, rectal and auricular temperature showed a positive correlation (r2=0.78). In conclusion, only in healthy dogs maintained in controlled conditions the monitoring of auricular temperature reflects the clinical practice gold standard of core body temperature measurement represented by rectal temperature. The lower value of about 1.5 °C must be taken into consideration when this technique is used.

Accuracy of parents' subjective assessment of paediatric fever with thermometer measured fever in a primary care setting.

BACKGROUND: Fever is a common symptom of benign childhood illness but a high fever may be a sign of a serious infection. Temperature is often used by parents to check for illness in their children, and the presence of a high temperature can act as a prompt to consult a healthcare professional. It would be helpful for GPs to understand how well parental assessment of the presence of fever correlates with temperature measurement in the clinic in order to incorporate the history of the child's fever into their clinical assessment. METHODS: Secondary analysis of a cross-sectional diagnostic method comparison study. Parents were asked whether they thought their child had fever before their temperature was measured by a researcher. Fever was defined as a temperature of 38 °C and higher using either an axillary or tympanic thermometer. RESULTS: Of 399 children recruited, 119 (29.8%) were believed by their parents to be febrile at the time of questioning and 23 (6.3%) had a fever as measured by a researcher in the clinic. 23.5% of children with a parental assessment of fever were found to have a fever in the clinic. Less than 1% of children whose parents thought they did not have a fever were found to be febrile in the clinic. Having more than one child did not improve accuracy of parents assessing fever in their child. CONCLUSIONS: In the GP surgery setting, a child identified as afebrile by their parent is highly likely to be measured as such in the clinic. A child identified as febrile by their parent is less likely to be measured as febrile.

Reliability of Low-Cost Thermometers for Monitoring Foot Temperature.

The prevalence of diabetes in the United States and the world is high. Often the burden of this disease falls on those who are economically disadvantaged, contributing to disparities in access to care. Considering the risk for foot complications related to diabetes, foot temperature monitoring has been shown to be effective in mitigating risk for plantar ulceration. Higher-cost thermometers have been assessed for reliability, while very low-cost thermometers have not. Validation of low-cost thermometers could improve access to this preventive measure. In this study, inexpensive commercially available infrared thermometers were shown to be a reliable and valid means to assess local skin temperature.

The accuracy of tactile assessment of canine nose temperature to identify rectal hyperthermia and hypothermia in dogs presenting on an emergency basis.

The goals of this study were to evaluate whether touch can identify a warm nose as opposed to a cold nose, to examine the correlation between thermographically measured nose temperatures and rectal temperatures, and to calculate the accuracy of tactile assessment of nose temperature in detecting rectal hyperthermia and hypothermia in dogs. A total of 100 dogs presenting to an emergency room was prospectively enrolled. Tactile nose assessment was carried out on triage. Noses were subjectively categorized as warm, cold, or intermediate (neither warm nor cold). Thermographic nose temperatures were recorded using a thermal imaging camera. Tactile assessment categorized noses as warm, intermediate, or cold (P < 0.01). There was no correlation between thermographically measured nose temperature and rectal temperature (r = 0.02). Tactile assessment of noses as warm had a sensitivity of 29.4% and a specificity of 79.5% for detecting rectal hyperthermia; calculated test accuracy was 71%. Tactile assessment of noses as cold had a sensitivity of 54.5% and a specificity of 62.9%; calculated test accuracy was 62%. It was concluded that nose temperatures do not correlate with rectal temperatures. Tactile assessment of nose temperature is inaccurate for identifying rectal hyperthermia or hypothermia.

Les objectifs de cette étude étaient d'évaluer si le toucher peut identifier un nez chaud par opposition à un nez froid, d'examiner la corrélation entre les températures nasales mesurées thermographiquement et les températures rectales, et de calculer la précision de l'évaluation tactile de la température nasale dans la détection de l'hyperthermie et l'hypothermie rectale chez le chien. Un total de 100 chiens se présentant aux urgences a été enrôlé de manière prospective. Une évaluation tactile du nez a été réalisée lors du triage. Les nez ont été classés subjectivement comme chaud, froid ou intermédiaire (ni chaud ni froid). Les températures thermographiques du nez ont été enregistrées à l'aide d'une caméra thermique. L'évaluation tactile a classé les nez comme chauds, intermédiaires ou froids (P < 0,01). Il n'y avait pas de corrélation entre la température nasale mesurée par thermographie et la température rectale (r = 0,02). L'évaluation tactile des nez chauds avait une sensibilité de 29,4 % et une spécificité de 79,5 % pour détecter l'hyperthermie rectale; la précision calculée du test était de 71 %. L'évaluation tactile des nez froids avait une sensibilité de 54,5 % et une spécificité de 62,9 %; la précision calculée du test était de 62 %. Il a été conclu que les températures nasales ne sont pas corrélées avec les températures rectales. L'évaluation tactile de la température du nez est imprécise pour identifier l'hyperthermie ou l'hypothermie rectale.(Traduit par les auteurs).

Design and Development of a Low Cost, Non-Contact Infrared Thermometer with Range Compensation.

Fever is a common symptom of many infections, e.g., in the ongoing COVID-19 pandemic, keeping monitoring devices such as thermometers in constant demand. Recent technological advancements have made infrared (IR) thermometers the choice for contactless screening of multiple individuals. Yet, even so, the measurement accuracy of such thermometers is affected by many factors including the distance from the volunteers' forehead, impurities (such as sweat), and the location measured on the volunteers' forehead. To overcome these factors, we describe the assembly of an Arduino-based digital IR thermometer with distance correction using the MLX90614 IR thermometer and HC-SR04 ultrasonic sensors. Coupled with some analysis of these factors, we also found ways to programme compensation methods for the final assembled digital IR thermometer to provide more accurate readings and measurements.

Mobile Health-Based Thermometer for Monitoring Wound Healing After Endovascular Therapy in Patients With Chronic Foot Ulcer: Prospective Cohort Study.

BACKGROUND: Foot temperature may increase after endovascular therapy, but the relationship between foot temperature and wound healing is unclear. OBJECTIVE: This study was performed to evaluate the feasibility of a mobile health (mHealth)-based thermometer for foot temperature monitoring in patients with chronic foot ulcer before and after endovascular therapy and to determine the association between temperature change and wound healing time. METHODS: This was a prospective cohort study. Patients who had a chronic foot ulcer (>3 months) and underwent endovascular therapy between July 2019 and December 2019 were included. The participants received standard medical care and endovascular therapy for revascularization. The mHealth-based thermometer, composed of 4 temperature-sensing chips, was put on the foot before and after endovascular therapy. Data from the chips were transferred to an associated mobile phone app via Bluetooth. Wound healing time was estimated using the Kaplan-Meier method, and the associations between baseline characteristics and clinical outcomes were evaluated using a Cox proportional hazard model. RESULTS: A total of 163 patients with chronic foot ulcer who underwent endovascular therapy were enrolled and followed up until wound healing was complete or for 180 days. The mean foot temperature before endovascular therapy was 30.6 (SD 2.8 °C). Foot temperature increased significantly (mean 32.1 °C, SD 2.8 °C; P=.01) after the procedure. Wound healing time was significantly different in the Kaplan-Meier curves of the patient group with temperature changes ≥2 °C and the group with temperature changes ≤2 °C (log-rank P<.001). A foot temperature increase ≥2 °C after endovascular therapy was associated with increased wound healing in univariate analysis (hazard ratio [HR] 1.78, 95% CI 1.24-2.76, P=.02), and the association remained significant in multivariate analysis (HR 1.69, 95% CI 1.21-2.67, P=.03). CONCLUSIONS: The mHealth-based thermometer was feasible and useful for foot temperature monitoring, which may provide health care professionals with a new endpoint for endovascular therapy. Foot temperature increases ≥2 °C after endovascular therapy were associated with faster wound healing in patients with chronic foot ulcer. Further studies are needed, however, to confirm these findings.

Parents' concerns and beliefs about temperature measurement in children: a qualitative study.

BACKGROUND: Nearly 40% of parents with children aged 6 to 17 months consult a healthcare professional when their child has a high temperature. Clinical guidelines recommend temperature measurement in these children, but little is known about parents' experiences of and beliefs about temperature measurement. This study aimed to explore parents' concerns and beliefs about temperature measurement in children. METHODS: Semi-structured qualitative interviews were conducted from May 2017 to June 2018 with 21 parents of children aged 4 months to 5.5 years, who were purposively sampled from the METRIC study (a method comparison study comparing non-contact infrared thermometers to axillary and tympanic thermometers in acutely ill children). Data analysis followed a thematic approach. RESULTS: Parents described the importance of being able to detect fever, in particular high fevers, and how this then influenced their actions. The concept of "accuracy" was valued by parents but the aspects of performance which were felt to reflect accuracy varied. Parents used numerical values of temperature in four main ways: determining precision of the thermometer on repeat measures, detecting a "bad" fever, as an indication to administer antipyretics, or monitoring response to treatment. Family and social networks, the internet, and medical professionals and resources, were all key sources of advice for parents regarding fever, and guiding thermometer choice. CONCLUSIONS: Temperature measurement in children has diagnostic value but can either empower, or cause anxiety and practical challenges for parents. This represents an opportunity for both improved communication between parents and healthcare professionals, and technological development, to support parents to manage febrile illness with greater confidence in the home.

The relationship between COPD Assessment Test (CAT) scores and Distress Thermometer (DT) results in COPD patients.

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a condition that affects over 2 million adults in Poland. In recent years, increasing attention has been focused on improving the quality of life of patients with COPD, which includes alleviating their physical discomfort and relates to their mental health. It is therefore critically important to evaluate research tools that can accurately assess the relationship between the physical and mental health of patients with this disease. OBJECTIVE: This aim of the study is to evaluate the relationship between the COPD Assessment Test (CAT) and the Distress Thermometer and Problem List results in COPD patients. MATERIAL AND METHODS: The research evaluated 70 patients with COPD as defined by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) criteria. Demographic data was obtained at baseline. Disease-specific quality of life was assessed using the CAT score, while overall distress was determined using the Distress Thermometer (DT) scale and a modified Problem List. The relationship between the CAT scores and the results of the Distress Thermometer and Problem List was statistically compared. The study was approved by the Bioethics Committee, and all patients provided written informed consent. RESULTS: The mean ± SD age was 69.6±9.05 (range 47-90) years. The average distress level was 4.09±1.95. A significant relationship was established between the CAT score and the results of the Distress Thermometer Scale (p<0.001); patients with higher CAT scores showed the highest level of distress. CONCLUSIONS: CAT was shown to be a simple, fast and clear measurement of disease-specific quality of life and was correlated with levels of distress in patients with COPD. Every patient with COPD should be evaluated using a scale such as the DT to measure their level of psychological distress.

Non-contact infrared thermometers compared with current approaches in primary care for children aged 5 years and under: a method comparison study.

BACKGROUND: Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the child and the risk of cross-infection. OBJECTIVES: The objective of this study was to compare the use of non-contact thermometers with the use of electronic axillary and infrared tympanic thermometers in children presenting to primary care. DESIGN: Method comparison study with a nested qualitative study. SETTING: Primary care in Oxfordshire. PARTICIPANTS: Children aged ≤ 5 years attending with an acute illness. INTERVENTIONS: Two types of non-contact infrared thermometers [i.e. Thermofocus (Tecnimed, Varese, Italy) and Firhealth (Firhealth, Shenzhen, China)] were compared with an electronic axillary thermometer and an infrared tympanic thermometer. MAIN OUTCOME MEASURES: The primary outcome was agreement between the Thermofocus non-contact infrared thermometer and the axillary thermometer. Secondary outcomes included agreement between all other sets of thermometers, diagnostic accuracy for detecting fever, parental and child ratings of acceptability and discomfort, and themes arising from our qualitative interviews with parents. RESULTS: A total of 401 children (203 boys) were recruited, with a median age of 1.6 years (interquartile range 0.79-3.38 years). The readings of the Thermofocus non-contact infrared thermometer differed from those of the axillary thermometer by -0.14 °C (95% confidence interval -0.21 to -0.06 °C) on average with the lower limit of agreement being -1.57 °C (95% confidence interval -1.69 to -1.44 °C) and the upper limit being 1.29 °C (95% confidence interval 1.16 to 1.42 °C). The readings of the Firhealth non-contact infrared thermometer differed from those of the axillary thermometer by -0.16 °C (95% confidence interval -0.23 to -0.09 °C) on average, with the lower limit of agreement being -1.54 °C (95% confidence interval -1.66 to -1.41 °C) and the upper limit being 1.22 °C (95% confidence interval 1.10 to 1.34 °C). The difference between the first and second readings of the Thermofocus was -0.04 °C (95% confidence interval -0.07 to -0.01 °C); the lower limit was -0.56 °C (95% confidence interval -0.60 to -0.51 °C) and the upper limit was 0.47 °C (95% confidence interval 0.43 to 0.52 °C). The difference between the first and second readings of the Firhealth thermometer was 0.01 °C (95% confidence interval -0.02 to 0.04 °C); the lower limit was -0.60 °C (95% confidence interval -0.65 to -0.54 °C) and the upper limit was 0.61 °C (95% confidence interval 0.56 to 0.67 °C). Sensitivity and specificity for the Thermofocus non-contact infrared thermometer were 66.7% (95% confidence interval 38.4% to 88.2%) and 98.0% (95% confidence interval 96.0% to 99.2%), respectively. For the Firhealth non-contact infrared thermometer, sensitivity was 12.5% (95% confidence interval 1.6% to 38.3%) and specificity was 99.4% (95% confidence interval 98.0% to 99.9%). The majority of parents found all methods to be acceptable, although discomfort ratings were highest for the axillary thermometer. The non-contact thermometers required fewer readings than the comparator thermometers. LIMITATIONS: A method comparison study does not compare new methods against a reference standard, which in this case would be central thermometry requiring the placement of a central line, which is not feasible or acceptable in primary care. Electronic axillary and infrared tympanic thermometers have been found to have moderate agreement themselves with central temperature measurements. CONCLUSIONS: The 95% limits of agreement are > 1 °C for both non-contact infrared thermometers compared with electronic axillary and infrared tympanic thermometers, which could affect clinical decision-making. Sensitivity for fever was low to moderate for both non-contact thermometers. FUTURE WORK: Better methods for peripheral temperature measurement that agree well with central thermometry are needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15413321. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 53. See the NIHR Journals Library website for further project information.

General practitioners commonly measure children's temperature using a thermometer placed in the armpit or ear canal. New 'non-contact' thermometers use infrared light to measure temperature without touching the child. They are easy to use and there is no risk of passing on infections. However, we do not know how well they measure temperature compared with thermometers that use the armpit or the ear. This study aimed to compare two non-contact thermometers with current thermometers. We measured children's temperature with all thermometer types, and asked children and their parents about their views. The study was performed in general practices in Oxfordshire with children aged ≤ 5 years who had come to see their general practitioner because they had recently become unwell. Both the cheaper and more expensive non-contact thermometers gave slightly lower temperature readings on average than current thermometers. The vast majority of readings ranged from 1.6 °C lower to 1.3 °C higher than current thermometers. The detection of fever of at least 38 °C was low to moderate for both non-contact thermometers. Most parents did not think that their child was distressed by having their temperature taken using any of the thermometers, but the armpit thermometer was rated as the least comfortable. When interviewed, parents were more negative about the armpit thermometers, although still willing to use them if they were recommended by doctors. Although we found that the readings from the different thermometers did not match, we do not know whether the non-contact or the current thermometers were giving readings that were closer to the real temperature of the child. To understand this, we would need to do a study that included a more invasive procedure for temperature assessment.

Tracking Sleep to Optimize Health.

With the advent of wearable biometric technology like smart watches, "hacking" our bodies' functions and cycles has become a tool in the never-ending quest for better health. And sleep is no exception. For example, a staggering one-third of Americans don't get enough sleep, according to the Centers for Disease Control and Prevention (CDC).

Towards the targeted assessment of relevant problems: Optimization of the distress Thermometer for adult neuro-oncological patients.

OBJECTIVE: Generic psychosocial screening tools may not reflect the unique symptom profile of brain tumour patients (BTPs). The aim was to adapt the problem list of the distress thermometer (DT) for BTPs. METHODS: First, items of low relevance for BTPs were identified on basis of retrospective analyses. Second, relevant yet missing problems were identified via an extensive literature search, qualitative interviews with BTPs and experts, as well as an online expert survey. The resulting raw version of the adapted problem list in BTPs was subsequently pretested. RESULTS: In the first part, data of n = 657 BTPs were analysed. Twelve items (20%) were excluded in this step as they proved to be less relevant for BTPs (i.e., items were endorsed by less than 10% and without significant correlations to patients' DT score). In the second part, qualitative interviews and the online survey with 102 professionals led to the addition of 21 new and the modification and condensation of 17 relevant problems specific for BTPs. This adapted list was than successfully pretested in n = 19 patients, leading to the 'distress thermometer brain tumour problem list' (DT-BT), consisting of 42 relevant problems. CONCLUSION: The adapted problem list for the DT particularly reflects the neurological and psychosocial burden of an intracranial tumour and allows for the targeted assessment of the specific burdens and needs of BTPs. Our revised version of the DTs problem list (DT-BT) should in the next step be widely validated in multinational samples.

Detection and Prediction of Ovulation From Body Temperature Measured by an In-Ear Wearable Thermometer.

OBJECTIVE: We present a non-invasive wearable device for fertility monitoring and propose an effective and flexible statistical learning algorithm to detect and predict ovulation using data captured by this device. METHODS: The system consists of an earpiece, which measures the ear canal temperature every 5 min during night sleep hours, and a base station that transmits data to a smartphone application for analysis. We establish a data-cleaning protocol for data preprocessing and then fit a Hidden Markov Model (HMM) with two hidden states of high and low temperature to identify the more probable state of each time point via the predicted probabilities. Finally, a post-processing procedure is developed to incorporate biorhythm information to form a time-course biphasic profile for each subject. RESULTS: The performance of the proposed algorithms applied to data collected by the device are compared with traditional methods in terms of match rate with self-reported ovulation days confirmed with an ovulation test kit. Empirical study results from a group of 34 users yielded significant improvements over the traditional methods in terms of detection accuracy (with sensitivity 92.31%) and prediction power (23.07-31.55% higher). CONCLUSION: We demonstrated the feasibility for reliable ovulation detection and prediction with high-frequency temperature data collected by a non-invasive wearable device. SIGNIFICANCE: Traditional fertility monitoring methods are often either inaccurate or inconvenient. The wearable device and learning algorithm presented in this paper provide a user friendly and reliable platform for tracking ovulation, which may have a broad impact on both fertility research and real-world family planning.

Assessment of Non-Contact Infrared Thermometer Measurement Sites in Birds.

The standard method of obtaining body temperature in a bird can be a stressful event, making routine evaluations challenging. Twenty-eight privately owned birds in good health were enrolled in the study to compare digital and infrared (IR) temperature readings. Digital thermometer readings in the cloaca were compared with two different IR thermometers, Ototemp (OT) and VetTemp (VT), used at the skin of the cloaca, breast, axillary area and tympanic membrane. The majority of the IR temperature readings were not significantly different from the cloacal digital reading. Additionally, the different IR thermometers read close to each other at individual reading sites. The IR measurements at the axilla (OT, mean = 40.35°C, SD = 1.24°C; VT, mean = 40.20°C, SD = 1.38°C) were most similar to the standard cloacal measurement (mean = 40.83°C, SD = 0.88°C). For veterinarians who currently avoid measuring cloacal body temperatures to prevent unnecessary stress on avian patients utilizing IR thermometers in the axillary region provide a less invasive and reasonable measurement of core body temperature in birds to allow for a more comprehensive assessment of health status.

Bilateral assessment of body core temperature through axillar, tympanic and inner canthi thermometers in a young population.

There are several sites in which the human body core temperature can be estimated and used to identify febrile states in a threat of pandemic situations at high-populational-traffic places (e.g. airports, ports, universities, schools, public buildings). In these locations, a fast method is required for temperature screening of masses. The most common methods are axillar and tympanic thermometers. However, in addition, measurement of the inner canthi (IC) of the eye with infrared thermal (IRT) imaging has been suggested as a fast mass measurement screening tool. OBJECTIVE: It is the aim of this research to identify the bilateral difference of the available body temperature screening methods with potential use for large-scale fever screening and to verify if such a difference is acceptable. APPROACH: A total of 206 young participants (104 females and 102 males) were recruited, having their temperatures taken with the different methods bilaterally under neutral environmental conditions. The obtained results were statistically processed. MAIN RESULTS: Results established absent reference data for site and method in west European populations. The bilateral differences were minor using the IC of the eye monitored with infrared imaging, which was also proved with the Bland-Altmann limits of agreement. SIGNIFICANCE: Based on the findings of this research, despite all methods being able to estimate body core temperature, it is suggested to use IRT images of the IC of the eye, due to its fast, reliable and reproducible procedure for mass screening. Further research is required to understand the higher bilateral variability in using the traditional thermometer axilla and tympanic membrane assessments, since these are the methods currently used within a clinical setup. The same procedure must be applied to fever cases to establish a decision threshold per method.

GFP fluorescence peak fraction analysis based nanothermometer for the assessment of exothermal mitochondria activity in live cells.

Nanothermometry methods with intracellular sensitivities have the potential to make important contributions to fundamental cell biology and medical fields, as temperature is a relevant physical parameter for molecular reactions to occur inside the cells and changes of local temperature are well identified therapeutic strategies. Here we show how the GFP can be used to assess temperature-based on a novel fluorescence peak fraction method. Further, we use standard GFP transfection reagents to assess temperature intracellularly in HeLa cells expressing GFP in the mitochondria. High thermal resolution and sensitivity of around 0.26% °C-1 and 2.5% °C-1, were achieved for wt-GFP in solution and emGFP-Mito within the cell, respectively. We demonstrate that the GFP-based nanothermometer is suited to directly follow the temperature changes induced by a chemical uncoupler reagent that acts on the mitochondria. The spatial resolution allows distinguishing local heating variations within the different cellular compartments. Our discovery may lead to establishing intracellular nanothermometry as a standard method applicable to the wide range of live cells able to express GFP.