A new noninvasive technique for heat-flux-based deep body thermometry together with possible estimation of thermal resistance of the skin tissue.

A new noninvasive core-thermometry technique, based on the use of two heat flux sensors with different very low thermal resistances, is proposed. Thermodynamically derived equations, using a pair of skin temperatures and heat fluxes detected from the sensors, can give the estimated deep body temperature (DBT) together with thermal resistance of the skin tissue itself. The validity and accuracy of this method are firstly investigated through in vitro experiments using a tissue phantom model and, secondly, as in vivo comparisons with sublingual (Tsub) or rectal temperature (Trec) measurements in 9 volunteers, attaching the sensors around the upper sternum or the nape. Model experiments showed a good agreement between the measured and estimated temperatures, ranging from approximately 36 to 42 ℃. In vivo experiments demonstrated linear correlations between the estimated DBT and both Tsub and Trec values, though the estimated DBT was 0.13 ℃ higher than Tsub and 0.42 ℃ lower than Trec on average. The results also strongly suggested the possibility to estimate the tissue thermal resistance; this is discussed herein. Although further in vivo experiments under various environmental conditions are necessary, this method appears highly promising as an accurate, useful and convenient core-thermometry system for medical and healthcare settings.

Current status of active cooling, deep body temperature measurement, and face mask wearing in heat stroke and heat exhaustion patients in Japan: a nationwide observational study based on the Heatstroke STUDY 2020 and 2021.

Aim: The study aimed to determine the current status of face mask use, deep body temperature measurement, and active cooling in patients suffering from heat stroke and heat exhaustion in Japan. Methods: This was a prospective, observational, multicenter study using data from the Heatstroke STUDY 2020-2021, a nationwide periodical registry of heat stroke and heat exhaustion patients. Based on the Bouchama heatstroke criteria, we classified the patients into two groups: severe and mild-to-moderate. We compared the outcomes between the two groups and reclassified them into two subgroups according to the severity of the illness, deep body temperature measurements, and face mask use. Cramer's V was used to determine the effect sizes for a comparison between groups. Results: Almost all patients in this study were categorized as having degree III based on the Japanese Association for Acute Medicine heatstroke criteria (JAAM-HS). However, the severe group was significantly worse than the mild-to-moderate group in outcomes like in-hospital death and modified Rankin Scale scores, when discharged. Heat strokes had significantly higher rates of active cooling and lower mortality rates than heat stroke-like illnesses. Patients using face masks often use them during labor, sports, and other exertions, had less severe conditions, and were less likely to be young male individuals. Conclusions: It is suggested that severe cases require a more detailed classification of degree III in the JAAM-HS criteria, and not measuring deep body temperature could have been a factor in the nonperformance of active cooling and worse outcomes.

An Advanced Internet of Things System for Heatstroke Prevention with a Noninvasive Dual-Heat-Flux Thermometer.

Heatstroke is a concern during sudden heat waves. We designed and prototyped an Internet of Things system for heatstroke prevention, which integrates physiological information, including deep body temperature (DBT), based on the dual-heat-flux method. A dual-heat-flux thermometer developed to monitor DBT in real-time was also evaluated. Real-time readings from the thermometer are stored on a cloud platform and processed by a decision rule, which can alert the user to heatstroke. Although the validation of the system is ongoing, its feasibility is demonstrated in a preliminary experiment.

Relationship between body composition indices and changes in body temperature due to hot pack use.

BACKGROUND: Hot pack application is used to reduce pain and muscle stiffness at the treated site. However, the effects of hot pack application on the whole body have not been clarified. We investigated the relationship between body composition indices and the hot pack-induced increase in body temperature. METHODS: We recruited 17 healthy men (age, 22.0 ± 3.3 years) who participated in the study on five different days and applied "dry" hot packs at four different sites (the most frequently used sites): right shoulder, lower back, both popliteal areas, and lower back plus popliteal areas. The study protocol involved the measurement of body composition followed by 10 min of bed rest, 15 min of warming with a hot pack, and 20 min of subsequent rest. Heart rate and body temperature were measured continuously, and blood pressure was recorded at 5-min intervals. Body temperature was measured at the right upper arm, precordium, abdomen, lumbus, right hallux, right femur, and right auditory canal. RESULTS: Skin temperature increased significantly at and near the hot pack application site, but this finding showed no relationship with body composition indices. The warmability distal to the application site was negatively correlated with the body water content index. The auditory canal temperature did not change in any of the sessions. CONCLUSIONS: Hot pack usage alone did not increase the deep-body temperature and only increased the temperature around the application area. Moreover, higher body water content may allow for easier dissipation of heat from the peripheral extremities.

Predicting Deep Body Temperature (Tb) from Forehead Skin Temperature: Tb or Not Tb?

There is a need to rapidly screen individuals for heat strain and fever using skin temperature (Tsk) as an index of deep body temperature (Tb). This study's aim was to assess whether Tsk could serve as an accurate and valid index of Tb during a simulated heatwave. Seven participants maintained a continuous schedule over 9-days, in 3-day parts; pre-/post-HW (25.4 °C), simulated-HW (35.4 °C). Contact thermistors measured Tsk (Tforehead, Tfinger); radio pills measured gastrointestinal temperature (Tgi). Proximal-distal temperature gradients (ΔTforehead-finger) were also measured. Measurements were grouped into ambient conditions: 22, 25, and 35 °C. Tgi and Tforehead only displayed a significant relationship in 22 °C (r: 0.591; p < 0.001) and 25 °C (r: 0.408; p < 0.001) conditions. A linear regression of all conditions identified Tforehead and ΔTforehead-finger as significant predictors of Tgi (r2: 0.588; F: 125.771; p < 0.001), producing a root mean square error of 0.26 °C. Additional residual analysis identified Tforehead to be responsible for a plateau in Tgi prediction above 37 °C. Contact Tforehead was shown to be a statistically suitable indicator of Tgi in non-HW conditions; however, an error of ~1 °C makes this physiologically redundant. The measurement of multiple sites may improve Tb prediction, though it is still physiologically unsuitable, especially at higher ambient temperatures.

Heat adaptation in humans: the significance of controlled and regulated variables for experimental design and interpretation.

Herein, the principles of homoeostasis are re-visited, but with an emphasis upon repeated homoeostatic disturbances that give rise to physiological adaptation. The central focus is human heat adaptation, and how, for experimental purposes, one might standardise successive adaptation stimuli, and then evaluate and compare the resulting adaptations. To provide sufficient background for that discussion, the principles of physiological control and regulation have been reviewed. The case is presented that, since it is the regulated variables that drive both the effector organs and the processes of physiological adaptation, then it is those variables (e.g., body temperature) that should be used to set and standardise the adaptation stimuli. Alternatively, some have proposed that the same outcome can be achieved through standardising a controlled variable (e.g., heart rate), and so the merits of that proposition are evaluated. Indeed, it can be an effective approach, although some experimental pitfalls are described to highlight its limitations with regard to between-group (e.g., able-bodied versus spinal-injured participants) and between-treatment comparisons (e.g., hot-water versus hot-air adaptation stimuli). The concept of setting the adaptation stimulus relative to an anaerobic or lactate threshold is also critically evaluated. Finally, an appraisal is offered concerning the merits of three different strategies for using deep-body and mean body temperature changes for evaluating thermoeffector adaptations.

Central administration of aminooxyacetate, an inhibitor of H2S production, affects thermoregulatory but not cardiovascular and ventilatory responses to hypercapnia in spontaneously hypertensive rats.

Hydrogen sulfide (H2S) is classically known for its toxic effects. More recently H2S has been documented as a neuromodulator. Here we investigated the central effects of aminooxyacetate (AOA; inhibitor of the H2S-synthesizing enzyme cystathionine ß-synthase, CBS) on cardiovascular, respiratory and thermoregulatory responses to hypercapnia in spontaneously hypertensive rats (SHR). To attain this goal we measured mean arterial pressure (MAP), heart rate (HR), ventilation (VE), and deep body temperature (Tb) of SHR and (normotensive) Wistar Kyoto (WKY) rats before and after microinjection of AOA (9 nmol/µL) or saline into the fourth ventricle immediately followed by 30-min hypercapnia exposure (7% inspired CO2). In saline-treated WKY rats, hypercapnia caused an increase in MAP accompanied by bradycardia, an increase in VE, and a drop in Tb. In AOA-treated WKY rats exposed to hypercapnia, the drug did not affect the increased MAP, potentiated the bradycardic response, attenuated the increased VE, and potentiated the drop in Tb. In saline-treated SHR, in comparison to the saline-treated WKY rats, hypercapnia elicited a minor, shorter-lasting increase in MAP with no changes in HR, evoked a greater increase in VE, and did not induce a drop in Tb. In AOA-treated SHR exposed to hypercapnia, the drug did not change the hypercapnia-induced cardiovascular and ventilatory responses while permitted a drop in Tb. Our findings indicate that AOA, an inhibitor of H2S production, modulates cardiorespiratory and thermoregulatory responses to hypercapnia in normotensive rats, whereas hypertension development in SHR is accompanied by suppression of the AOA effect on the cardiovascular and respiratory responses.

Cardiovascular and thermal strain during 3-4 days of a metabolically demanding cold-weather military operation.

BACKGROUND: Cardiovascular (CV) and thermal responses to metabolically demanding multi-day military operations in extreme cold-weather environments are not well described. Characterization of these operations will provide greater insights into possible performance capabilities and cold injury risk. METHODS: Soldiers from two cold-weather field training exercises (FTX) were studied during 3-day (study 1, n = 18, age: 20 ± 1 year, height: 182 ± 7 cm, mass: 82 ± 9 kg) and 4-day (study 2, n = 10, age: 20 ± 1 year, height: 182 ± 6 cm, mass: 80.7 ± 8.3 kg) ski marches in the Arctic. Ambient temperature ranged from -18 to -4 °C during both studies. Total daily energy expenditure (TDEE, from doubly labeled water), heart rate (HR), deep body (Tpill), and torso (Ttorso) skin temperature (obtained in studies 1 and 2) as well as finger (Tfing), toe (Ttoe), wrist, and calf temperatures (study 2) were measured. RESULTS: TDEE was 6821 ± 578 kcal day-1 and 6394 ± 544 for study 1 and study 2, respectively. Mean HR ranged from 120 to 140 bpm and mean Tpill ranged between 37.5 and 38.0 °C during skiing in both studies. At rest, mean Tpill ranged from 36.0 to 36.5 °C, (lowest value recorded was 35.5 °C). Mean Tfing ranged from 32 to 35 °C during exercise and dropped to 15 °C during rest, with some Tfing values as low as 6-10 °C. Ttoe was above 30 °C during skiing but dropped to 15-20 °C during rest. CONCLUSIONS: Daily energy expenditures were among the highest observed for a military training exercise, with moderate exercise intensity levels (~65% age-predicted maximal HR) observed. The short-term cold-weather training did not elicit high CV and Tpill strain. Tfing and Ttoe were also well maintained while skiing, but decreased to values associated with thermal discomfort at rest.

The "Ice-Mile": Case Study of 2 Swimmers' Selected Physiological Responses and Performance.

PURPOSE: "Ice-mile" swimming presents significant physiological challenges and potential safety issues, but few data are available. This study examined deep body temperature (BT), respiratory rate (RR), and swim performance in 2 swimmers completing an ice-mile swim of 1 mile (1600 m) in water less than 5°C. METHODS: Two male cold-water-habituated swimmers completed a 1-mile lake swim in 3.9°C water. For comparative purposes, they completed an indoor 1-mile swim in 28.1°C water. The Equivital physiological monitoring system was used to record BT and RR before, during, and after each swim. Total time to complete the swims and 400-m splits were recorded. RESULTS: One swimmer became hypothermic after 27 min while swimming, reaching BT of 33.7°C at swim's end. On exiting the water the swimmers experienced large BT after-drops of -3.6°C and -2.4°C, reaching low points of 33.2°C and 31.3°C 38 and 23 min postswim, respectively. Respiratory rate and swim pace decreased over the course of the ice-mile swim for both swimmers. Swim pace for 1 swimmer declined sharply in the final 400-m lap of the ice mile when he was hypothermic. Both swimmers remained hypothermic 60 min postswim (34.2°C and 33.4°C). CONCLUSION: Ice-mile swimmers may become hypothermic while swimming, and the postswim BT after drop may expose them to dangerous levels of hypothermia. Pace and RR should be monitored as proxies for a swimmer's physiological state. Postswim recovery should also be monitored for hypothermia for at least 1 h.

Skin sites to predict deep-body temperature while wearing firefighters' personal protective equipment during periodical changes in air temperature.

The aim of this study was to investigate stable and valid measurement sites of skin temperatures as a non-invasive variable to predict deep-body temperature while wearing firefighters' personal protective equipment (PPE) during air temperature changes. Eight male firefighters participated in an experiment which consisted of 60-min exercise and 10-min recovery while wearing PPE without self-contained breathing apparatus (7.75 kg in total PPE mass). Air temperature was periodically fluctuated from 29.5 to 35.5 °C with an amplitude of 6 °C. Rectal temperature was chosen as a deep-body temperature, and 12 skin temperatures were recorded. The results showed that the forehead and chest were identified as the most valid sites to predict rectal temperature (R(2) = 0.826 and 0.824, respectively) in an environment with periodically fluctuated air temperatures. This study suggests that particular skin temperatures are valid as a non-invasive variable when predicting rectal temperature of an individual wearing PPE in changing ambient temperatures. Practitioner Summary: This study should offer assistance for developing a more reliable indirect indicating system of individual heat strain for firefighters in real time, which can be used practically as a precaution of firefighters' heat-related illness and utilised along with physiological monitoring.

Evaluation of structural and thermophysical effects on the measurement accuracy of deep body thermometers based on dual-heat-flux method.

To help pave a path toward the practical use of continuous unconstrained noninvasive deep body temperature measurement, this study aims to evaluate the structural and thermophysical effects on measurement accuracy for the dual-heat-flux method (DHFM). By considering the thermometer's height, radius, conductivity, density and specific heat as variables affecting the accuracy of DHFM measurement, we investigated the relationship between those variables and accuracy using 3-D models based on finite element method. The results of our simulation study show that accuracy is proportional to the radius but inversely proportional to the thickness of the thermometer when the radius is less than 30.0mm, and is also inversely proportional to the heat conductivity of the heat insulator inside the thermometer. The insights from this study would help to build a guideline for design, fabrication and optimization of DHFM-based thermometers, as well as their practical use.

The relationship between radiant heat, air temperature and thermal comfort at rest and exercise.

The aims of the present work were to investigate the relationships between radiant heat load, air velocity and body temperatures with or without coincidental exercise to determine the physiological mechanisms that drive thermal comfort and thermoregulatory behaviour. Seven male volunteers wearing swimming trunks in 18°C, 22°C or 26°C air were exposed to increasing air velocities up to 3 m s(-1) and self-adjusted the intensity of the direct radiant heat received on the front of the body to just maintain overall thermal comfort, at rest or when cycling (60 W, 60 rpm). During the 30 min of the experiments, skin and rectal temperatures were continuously recorded. We hypothesized that mean body temperature should be maintained stable and the intensity of the radiant heat and the mean skin temperatures would be lower when cycling. In all conditions, mean body temperature was lower when facing winds of 3 m s(-1) than during the first 5 min, without wind. When facing winds, in all but the 26°C air, the radiant heat was statistically higher at rest than when exercising. In 26°C air mean skin temperature was lower at rest than when exercising. No other significant difference was observed. In all air temperatures, high correlation coefficients were observed between the air velocity and the radiant heat load. Other factors that we did not measure may have contributed to the constant overall thermal comfort status despite dropping mean skin and body temperatures. It is suggested that the allowance to behaviourally adjust the thermal environment increases the tolerance of cold discomfort.

Effects of High Concentration Mineral Water Bathing on Deep Body Temperature and Circulatory Function / 日本温泉気候物理医学会雑誌

The effects of high concentration mineral water bating (31.16g/kg, mainly composed of Na, Ca, Mg chloride and sulfate) were studied in 13 healthy men (44.9±16.3y.o.). The subjects took 41°C, 10min bathing and kept warmth by a blanket for 30min. Blood pressure (BP), Heart rate (HR), cardiac output (CO), total peripheral resistance (TPR) and sublingual temperature by electric thermista as deep body temperature were measured during and after bathing. Skin blood flow by LASER doppler flow meter and venous partial gas pressure and pH were also measured.<br>Sublingual and forehead temperature was increased significantly by +1.4°C after 10min bathing and +0.9°C increase continued even after 30min. Diastolic BP and TPR were significantly decreased, and HR and CO were significantly increased by +20bpm and +2.7<i>l</i>/min, respectively. Significant increase of skin blood flow was also demonstrated. Significant increase of venous pO₂ (+20 Torr) and decrease of pCO₂ (-8.0 Torr) suggested the improvement of peripheral oxidative metabolism due to increased CO.<br>High concentration mineral water bathing was highly effective than simple water bathing probably due to the thick coating effect by binding concentrated minerals with skin furface protein.

Antihypertensive Effect of Artificial Mineral Bathing / 日本温泉気候物理医学会雑誌

We investigated the effects of artificial mineral bathing in water containing sodium sulfate and sodium bicarbonate on venous blood gas, blood pressure, heart rate, and deep body temperature in 10 patients with hypertension or history of hypertension. After a 10-minute bathing at 40°C, the parameters described above were carefully checked. The pH and P_O₂ levels in venous blood increased and the P_CO₂ level decreased after the artificial mineral bathing in comparison with plain water bathing. However, these changes were not statistically significant. The systolic blood pressure tended to decrease up to 10 hours after the artificial mineral bathing. The heart rate markedly reduced after the artificial mineral bathing and remained at a low level for 10 hours. The deep body temperature began to decrease 40 minutes after the artificial mineral bathing. However, it increased over the base-line level 6 hours later. From the above result, it is considered that artificial mineral bathing is useful for patients with hypertension.