Daily rhythm of skin temperature of women evaluated by infrared thermal imaging

Can the inner eye canthus temperature be used as an alternative method to measure core temperature in sleep-deprived individuals?

Core temperature is used in several situations, including studies on biological rhythms and circadian markers of physical performance. Measuring the inner eye canthus (Tco) temperature is a method proposed to identify core temperature, but it has shown little concordance in physical exercise situations and has not yet been used in studies with measurements taken throughout the day. The objective of this study was to compare the measurements and daily behavior of Tco obtained by infrared thermography with rectal temperature (Tre) during a prolonged waking protocol. Eleven male individuals participated in the study, who remained in the laboratory for at least 38 h using an actigraph to determine the wakefulness time and were monitored during the entire period. The Tre and Tco measurements were performed every 3 h. The ANOVA was used for repeated measurements followed by Bonferroni's post-hoc test to find the limits of concordance/proximity, while the Bland and Altman method and the Intraclass Correlation Coefficient were used to establish the reliability between the pairs. The significance level adopted was p < 0.05. The results demonstrate significant differences, low levels of concordance and unsatisfactory reliability levels between Tco and Tre at all 13 analyzed moments, in addition to not showing measurement reliability when all data are used together with the 143 temperature measurements. Daily behavior analysis shows moments with similar behavior with an increase in Tco and Tre, but at other times the behavior was the opposite, with a decrease in one measurement and an increase in the other. Based on the results presented, it is not recommended to use the inner eye canthus temperature as a substitute for rectal temperature for measuring core temperature at different times of the day or in sleep-deprived individuals.

Reference Standards for Digital Infrared Thermography Measuring Surface Temperature of the Upper Limbs

(1) Background: although digital infrared thermographic imaging (DITI) is used for diverse medical conditions of the upper limbs, no reference standards have been established. This study aims to establish reference standards by analyzing DITI results of the upper limbs. (2) Methods: we recruited 905 healthy Korean adults and conducted thermography on six regions (dorsal arm, ventral arm, lateral arm, medial arm, dorsal hand, and ventral hand region). We analyzed the data based on the proximity of regions of interest (ROIs), sex, and age. (3) Results: the average temperature (°C) and temperature discrepancy between the right and the left sides (ΔT) of each ROI varied significantly (p < 0.001), ranging from 28.45 ± 5.71 to 29.74 ± 5.14 and from 0.01 ± 0.49 to 0.15 ± 0.62, respectively. The temperature decreased towards the distal ROIs compared to proximal ROIs. The average temperatures of the same ROIs were significantly higher for men than women in all regions (p < 0.001). Across all regions, except the dorsal hand region, average temperatures tended to increase with age, particularly in individuals in their 30s and older (p < 0.001). (4) Conclusions: these data could be used as DITI reference standards to identify skin temperature abnormalities of the upper limbs. However, it is important to consider various confounding factors, and further research is required to validate the accuracy of our results under pathological conditions.

Can Adipose Tissue Influence the Evaluation of Thermographic Images in Adolescents?

Infrared thermography (IRT) is a technology easy to use for clinical purposes as a pre-diagnostic tool for many health conditions. However, the analysis process of a thermographic image needs to be meticulous to make an appropriate decision. The adipose tissue is considered a potential influence factor in the skin temperature (Tsk) values obtained by IRT. This study aimed to verify the influence of body fat percentage (%BF) on Tsk measured by IRT in male adolescents. A total of 100 adolescents (16.79 ± 0.97 years old and body mass index of 18.41 ± 2.32 kg/m²) was divided into two groups through the results of a dual-energy X-ray absorptiometry analysis: obese (n = 50, %BF 30.21 ± 3.79) and non-obese (n = 50, %BF 11.33 ± 3.08). Thermograms were obtained by a FLIR T420 infrared camera and analyzed by ThermoHuman^® software version 2.12, subdividing the body into seven regions of interest (ROI). The results showed that obese adolescents presented lower mean Tsk values than the non-obese for all ROIs (p < 0.05), with emphasis on the global Tsk (0.91 °C) and anterior (1.28 °C) and posterior trunk (1.18 °C), with "very large" effect size values. A negative correlation was observed in all the ROI (p < 0.01), mainly in the anterior (r = -0.71, p < 0.001) and posterior trunk (r = -0.65, p < 0.001). Tables of thermal normality were proposed for different ROIs according to the classification of obesity. In conclusion, the %BF affects the registered Tsk values in male Brazilian adolescents assessed by IRT.

Thermography in ergonomic assessment: a study of wood processing industry workers

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.

Controllable self-replicating RNA vaccine delivered intradermally elicits predominantly cellular immunity

Intradermal delivery of self-replicating RNA (srRNA) is a promising vaccine platform. Considering that human skin temperature is around 33°C, lower than core body temperature of 37°C, we have developed an srRNA that functions optimally at skin temperature and is inactivated at or above 37°C as a safety switch. This temperature- c ontrollable srRNA (c-srRNA), when tested as an intradermal vaccine against SARS-CoV-2, functions when injected naked without lipid nanoparticles. Unlike most currently available vaccines, c-srRNA vaccines predominantly elicit cellular immunity with little or no antibody production. Interestingly, c-srRNA-vaccinated mice produced antigen-specific antibodies upon subsequent stimulation with antigen protein. Antigen-specific antibodies were also produced when B-cell stimulation using antigen protein was followed by c-srRNA booster vaccination. Using c-srRNA, we have designed a pan-coronavirus booster vaccine that incorporates both spike receptor binding domains as viral surface proteins and evolutionarily conserved nucleoproteins as viral non-surface proteins, from both SARS-CoV-2 and MERS-CoV. It can thereby potentially immunize against SARS-CoV-2, SARS-CoV, MERS-CoV, and their variants. c-srRNA may provide a route to activate cellular immunity against a wide variety of pathogens.

Do ginger footbaths improve symptoms of insomnia more than footbaths with warm water only? - A randomized controlled study

OBJECTIVES

To compare the effects between warm water (WW) and ginger footbaths (WW+ginger) on sleep quality and warmth regulation in adults with self-reported insomnia symptoms.

METHODS

A prospective randomized-controlled study in which 28 participants (mean age 50.9 years, 64.3% women, insomnia symptom duration 11.4 years) were randomized to receive WW (n = 13) or WW+ginger (n = 15) daily for 2 weeks. Treatment involved nightly footbaths (12 liters of 38-42 °C warm tap water, maximum duration 20 min) with and without topical ginger (80 g of powdered ginger rhizomes).

MAIN OUTCOME MEASURES

The primary outcome measure was self-reported sleep quality (global score from Pittsburgh Sleep Quality Index, PSQI) at 2 weeks. Secondary outcomes included measures of insomnia severity (Insomnia Severity Index, ISI) and warmth regulation (Herdecke Warmth Perception Questionnaire, HWPQ and 24-hour distal-proximal skin temperature gradient, DPG).

RESULTS

WW+ginger had no greater effect on PSQI (mean between-difference 0.0 [95% CI -3.0 to 2.9], Cohen's d=0.0) or ISI (-0.2 [-3.9 to 3.4], 0.0) than WW. Nor were there any significant differences in HWPQ perceived warmth (0.1 ≥d≥0.5) or DPG (0.1 ≥d≥0.4) between WW and WW+ginger. Both groups improved over time in PSQI (WW+ginger: d=0.7, WW: d=1.3) and ISI (WW+ginger: d=0.8, WW: d=1.0). Perceived warmth of the feet increased only in WW+ginger over time (d=0.6, WW: d=0.0).

CONCLUSIONS

This dose of ginger (6.67 g/liter) did not have greater effects on sleep quality, insomnia severity or warmth regulation than WW. Considering effect sizes, costs and risks, the use of WW would be recommended over WW+ginger in this patient population.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

Temperature and creatine kinase changes during a 10d taper period in sprinters

Objective.The aim of this prospective cohort study, performed during a 10 d training camp, was to analyze the effect of a series of successive speed-power training sessions on the concurrent circadian changes in resting leg skin temperature and blood creatine kinase (CK) levels and to determine the correlation between them.Approach. Seventeen elite sprinters, aged 22-31 years, were examined. Every morning and evening, capillary blood samples were drawn to assay CK levels. Lower limb skin temperature was measured simultaneously, and thermal images were taken using an infrared camera.Main results. From the first day of the training camp, the base temperature levels began to drop to obtain a significant reduction from the 6th day (male) and from the 8th day (female) to the end of the camp. Simultaneously, CK levels increased in the male group from 8th to the end of the camp, but it did not change significantly in females. Regarding the circadian rhythm, the CK levels always rose during the day and declined during the night. The temperature decreased during the day and increased during the night until the 6th day. After that, the temperature changed oppositely till the end of camp, i.e. it increased during the day and decreased during the night. This could suggest that the training microcycle should last about a week because after this time there may be a disturbance in the temperature circadian rhythm and a significant CK accumulationSignificance. Multi-day speed-power training induced a progressive reduction in resting skin temperature and an elevation in CK levels. It also altered the circadian rhythm of the body skin temperature, which may indicate that after about 6 d of regular exercise, physiological deregulation may occur.

Evaluation of infrared thermography combined with behavioral biometrics for estrus detection in naturally cycling dairy cows

Low estrus detection rates (>50%) are associated to extended calving intervals, low economic profit and reduced longevity in Holstein dairy cows. The objective of this study was to evaluate the accuracy of infrared thermography and behavioral biometrics combined as potential estrus alerts in naturally (not induced) cycling dairy cows housed in a tie-stall barn. Eighteen first lactation cows were subjected to transrectal ultrasonography to determine spontaneous ovulation. The dominant follicle (DF) disappearance was used retrospectively as an indirect indicator of ovulation, and to establish the estrus period (48-24 h prior the DF disappearance). Raw skin temperature (Raw IR) and residual skin temperature (Res IR) were recorded using an infrared camera at the Vulva area with the tail (Vtail), Vulva area without the tail (Vnotail), and Vulva's external lips (Vlips) at AM and PM milking from Day 14 until two days after ovulation was confirmed. Behavioral biometrics were recorded on the same schedule as infrared scan. Behavioral biometrics included large hip movements (L-hip), small hip movements (S-hip), large tail movements and small tail movements to compare behavioral changes between estrus and nonestrus periods. Significant increases in Raw IR skin temperature were observed two days prior to ovulation (Vtail; 35.93 ± 0.27 °C, Vnotail; 35.59 ± 0.27 °C, and Vlips; 35.35 ± 0.27 °C) compared to d -5 (Proestrus; Vtail; 35.29 ± 0.27 °C, Vnotail; 34.93 ± 0.31 °C, and Vlips; 34.68 ± 0.27 °C). No significant changes were found for behavioral parameters with the exception of S-hip movements, which increased at two days before ovulation (d -2; 11.13 ± 1.44 Events/5min) compared to d -5 (7.30 ± 1.02 Events/5min). To evaluate the accuracy of thermal and behavioral biometrics, receiver operating characteristic curve analysis was performed using Youden index (YJ), diagnostic odds ratio, positive likelihood ratio (LR+), Sensitivity, Specificity and Positive predicted value to score the estrus alerts. The greatest accuracy achieved using thermal parameters was for Res IR Vtail PM (YJ = 0.34) and L-hip PM (YJ = 0.27) for behavioral biometrics. Combining thermal and behavioral parameters did not improve the YJ index score but reduced the false-positive occurrence observed by increasing the diagnostic odds ratio (26.62), LR+ (12.47), Specificity (0.97) and positive predicted value (0.90) in a Res IR Vtail PM, S-hip AM, S-hip PM combination. The combination of thermal and behavioral parameters increased the accuracy of estrus detection compared to either thermal or behavioral biometrics, independently in naturally cycling cows during milking.

Infrared Thermal Imaging as a Novel Non-Invasive Point-of-Care Tool to Assess Filarial Lymphoedema

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema.

Is skin temperature associated with muscle recovery status following a single bout of leg press?

Objective. The measurement of skin temperature using infrared thermography has gained a lot of attention in sport and science since it might be related to the recovery process following high intensity, potentially damaging exercise. This study investigated the time course of the skin temperature response and the muscle recovery status following a resistance training session involving leg press exercise.Approach. Fourteen young male college students (19.9 ± 1.7 years, 176 ± 6 cm, 66.1 ± 7.6 kg, 21.1 ± 1.8 kg.m^-2) performed one session involving 10 sets, of 10 repetition maximum each (RM), of unilateral leg press 45° exercise, performed to momentary muscle failure, with 2 min rest between sets. Perceived recovery, mean and maximum thigh skin temperatures, thigh muscle thickness, maximal isometric strength, muscle soreness, and horizontal jump performance were measured pre, 24, 48, and 72 h following exercise.Main results. The exercise protocol resulted in significant reduction in isometric strength, horizontal jump performance, and perceived recovery (p < 0.05). There was also a significant (p < 0.05) increase in muscle thickness and muscle soreness. With exception of jump performance, that recovered at 48 (p > 0.05), recovery parameters did not recover up to 72 h post-exercise (p > 0.05). Surprisingly, skin temperatures were not altered throughout the entire 72 h post-exercise period (p > 0.05). No significant positive correlation was found between skin temperatures and muscle thickness. Additionally, only one out of 16 correlation coefficients showed significant (r = -0.56,p = 0.036) inverse association between skin temperature and isometric strength.Significance. In conclusion, thigh skin temperature remains unaffected up to 72 h following a leg press exercise, and the time course response of thigh skin temperature was not associated with recovery status.

The molecular clock in the skin, its functionality, and how it is disrupted in cutaneous melanoma: a new pharmacological target?

The skin is the interface between the organism and the external environment, acting as its first barrier. Thus, this organ is constantly challenged by physical stimuli such as UV and infrared radiation, visible light, and temperature as well as chemicals and pathogens. To counteract the deleterious effects of the above-mentioned stimuli, the skin has complex defense mechanisms such as: immune and neuroendocrine systems; shedding of epidermal squamous layers and apoptosis of damaged cells; DNA repair; and pigmentary system. Here we have reviewed the current knowledge regarding which stimuli affect the molecular clock of the skin, the consequences to skin-related biological processes and, based on such knowledge, we suggest some therapeutic targets. We also explored the recent advances regarding the molecular clock disruption in melanoma, its impact on the carcinogenic process, and its therapeutic value in melanoma treatment.

Effect of different carbon dioxide (CO2) insufflation for laparoscopic colorectal surgery in elderly patients: A randomized controlled trial

BACKGROUND

Evidence suggests that dry CO2 insufflation during laparoscopic colorectal surgery results in greater structural injury to the peritoneum and longer hospital stay than the use of warm, humidified CO2. We aimed to test the hypothesis that warm, humidified CO2 insufflation could reduce postoperative pain and improve recovery in laparoscopic colorectal surgery.

METHODS

One hundred fifty elderly patients undergoing laparoscopic colorectal surgery under general anesthesia from May 2017 to October 2018 were randomly divided into 3 groups. The primary outcomes were resting pain, cough pain, and consumption of sufentanil at 2, 4, 6, 12, 24, and 48 hours postoperatively. Quality of visual image, hemodynamic changes, esophageal temperature, mean skin temperature, mean body temperature, recovery time, days to first flatus and solid food intake, shivering, incidence of postoperative ileus, length of hospital stay, surgical site infections, patients and surgeon satisfaction scores, adverse events, prothrombin time, activated partial thromboplastin time, and thrombin time were recorded.

RESULTS

Group CE patients were associated with significantly higher early postoperative cough pain and sufentanil consumption than the other 2 groups (P < .05). Compared with group CE, patients in both groups WH and CF had significantly reduced intraoperative hypothermia, recovery time of PACU, days to first flatus and solid food intake, and length of hospital stay, while the satisfaction scores of both patients and surgeon were significantly higher (P < .05). Prothrombin time, activated partial thromboplastin time, and thrombin time were significantly higher in group CE from 60 minutes after pneumoperitoneum to the end of pneumoperitoneum than the other 2 groups (P < .05). The number of patients with a shivering grade of 0 was significantly lower and grade of 3 was significantly higher in group CE than in the other 2 groups (P < .05).

CONCLUSION

Use of either warm, humidified CO2 insufflations or 20°C, 0% relative humidity CO2 combined with forced-air warmer set to 38°C during insufflations can both reduce intraoperative hypothermia, dysfunction of coagulation, early postoperative cough pain, sufentanil consumption, days to first flatus, solid food intake, and length of hospital stay.