Remote-sensing infrared thermography

Effectiveness of Systemic Hydration on Thermal and Multi-Dimensional Voice Outcome in Speech-Language Pathologists

PURPOSE

Professional voice users utilize systematic hydration to preserve the quality of their voice. However, the existing literature provides limited research on the systemic hydration of voice quality from a thermal and multi-dimensional perspective, particularly in speech-language pathologists (SLPs). Thus, using thermal and multidimensional measures, the current study inspected the effectiveness of systemic hydration in SLPs' voice quality.

METHOD

The study involved 20 vocally healthy female SLPs allocated to vocal loading (control group), who read passage loudly for 1 hour, and systemic hydration (experimental group), who consumed water during the vocal loading task. Pre evaluation and post evaluation of multidimensional voice measures: thermal (front view of throat), acoustic (fundamental frequency, perturbation [frequency and amplitude], and noise-related measures), aerodynamic (maximum phonation time: MPT and s/z ratio), and self-perceptual [perceived phonatory effort (PPE), perceived vocal tiredness (PVT)] measures were collected for two groups.

RESULTS

Pre-post comparison in the vocal loading group had a significant increase in thermal (FVT), acoustic [STD of F0, vF0, jitter, shimmer, amplitude perturbation quotient (APQ), and noise-to-harmonic ratio (NHR)], self-perceptual (PPE and PVT), and decreased aerodynamic measures MPT. However, no significant differences were noted in the systemic hydration group's thermal and multidimensional voice outcome measures. Between-group post test comparisons, the systemic hydration group showed a significant decrease in thermal front view of the throat (FVT), acoustic [jitter, NHR], and an increase in aerodynamic (MPT) compared with the vocal loading group.

CONCLUSION

The voice quality was decreased in the vocal loading group, while the systemic hydration group remained stable, as depicted on multidimensional voice measures. This study confirms the positive benefits of systemic hydration on voice quality and recommends its incorporation into clinical practice for SLPs.

Thermographic images for screening oral health problems in older adults: A pilot study

OBJECTIVE

This pilot study assessed the feasibility of using facial thermography to detect intra-oral problems in older adults with cognitive decline and care-resistant behaviors, who are often unable to communicate pain or early symptoms.

METHODS

Twenty-three older adults (mean age 73.7 ± 13.2 years) with cognitive decline were enrolled. Thermal images of four facial views were taken using a smartphone-connected thermal camera. Intra-oral examinations were conducted, and the thermographic data were analyzed to extract temperature values in the regions of interest (ROI). Point-biserial correlations and ROC curve analyses were performed to evaluate associations between temperature data and clinical findings, with a significance level of p < 0.05.

RESULTS

Intra-oral issues requiring treatment were found in 12 participants, with six reporting clinical pain. The overall mean temperature in the ROI was 33.5 ± 3.9 °C, and significant temperature differences were found between the body and ROI temperatures. Correlations were observed between clinical problems and various temperature metrics, including the minimum and maximum ROI temperatures (rpb=-0.327, p = 0.002 and rpb=-0.309, p = 0.003). ROC analysis indicated that ROI temperature could predict the presence or absence of clinical problems, with AUC values ranging from 0.651 to 0.796 for different metrics.

CONCLUSION

Thermographic facial imaging shows significant potential as a non-invasive tool for detecting oral health problems in vulnerable older adults. While promising, further research is essential to enhance image quality, streamline the technique, and incorporate AI for improved diagnostic accuracy and ease of use.

CLINICAL SIGNIFICANCE

This non-invasive, inexpensive technique is easy to perform, independent of patient compliance and, is promising to detect early oral problems in noncommunicative patients.

Thermal, Acoustic, and Self-Perceptual Measures of Pre-Post Vocal Change After Surface Hydration in Speech-Language Pathologists

PURPOSE

Numerous clinical findings support the idea that increased surface laryngeal hydration prevents and manages voice problems in professional voice users. However, empirical evidence for surface laryngeal hydration (nebulized saline solution) through multidimensional voice measures is lacking, especially in speech-language pathologists (SLPs). Hence, the present study investigated the effect of surface hydration using nebulized saline solution on voice quality using thermal, acoustic, and self-perceptual measures in SLPs.

METHODS

The study involved 30 SLPs divided into three groups: group I had no voice usage, group II read aloud passage for 1 hour without surface hydration, and group III read aloud passage for 1 hour with surface hydration for 10 minutes. Multidimensional voice outcomes such as thermal (front, right, and left view of the throat), acoustic (Multidimensional Voice Program), and self-perceptual (perceived phonatory effort, perceived vocal tiredness) were measured for the pretest and post test condition in all the group.

RESULTS

Pre-post comparison shows that thermal measures showed a significant increase in group II and a significant decrease in group III. Also, fundamental frequency, perturbation, and self-perceptual measures showed a significant increase in group II compared to group III. Further, the between-group post test comparisons revealed a significant decrease in many outcome measures in group III compared to group II. The above results support that surface hydration significantly influenced the voice quality during the vocal loading task.

CONCLUSION

The study confirms the benefits of surface hydration using saline solution in SLPs. Surface hydration preserves vocal quality compared to those not hydrated during vocal loading.

Free Flap Monitoring Using Infrared Thermography: An Objective Adjunct to Clinical Monitoring

Background  Early detection of free flap compromise is critical for salvage of the flap. Various methods of free flap monitoring have been described, but clinical assessment is the standard method for among all. In this study, role of infrared thermography is evaluated for free flap monitoring. Materials and Methods  In patients undergoing free flap surgery, monitoring was done using standard clinical parameters and infrared thermography as per our institutional protocol. Mean temperature difference (∆T) between the flap and the surrounding skin was calculated using the temperature readings from the thermal images intra- and postoperatively. The accuracy of infrared thermography in flap monitoring was assessed in comparison to the standard clinical protocol. Results  Forty-one flaps were included in the analysis, out of which five flaps got compromised. It was observed that the mean temperature difference was higher (mean ∆T 0.20-0.59 vs. 2.38-3.32) when there was a flap compromise, and this temperature difference was evident even before the development of clinical signs. The temperature difference in venous thrombosis (mean ∆T 1.0-2.7) was found to be slightly lower than in arterial insufficiency (mean ∆T 2.1-4.4). For a ∆T cutoff value of 2°C, the thermal camera had a sensitivity of 88.6%, specificity of 98.9%, positive predictive value of 93.9%, and negative predictive value of 97.7%. Conclusion  Infrared thermography is a valuable and noninvasive objective tool in free flap monitoring, which can detect flap compromise (increasing value of ∆T) even before it becomes clinically evident.

Best Practices for Body Temperature Measurement with Infrared Thermography: External Factors Affecting Accuracy

Infrared thermographs (IRTs) are commonly used during disease pandemics to screen individuals with elevated body temperature (EBT). To address the limited research on external factors affecting IRT accuracy, we conducted benchtop measurements and computer simulations with two IRTs, with or without an external temperature reference source (ETRS) for temperature compensation. The combination of an IRT and an ETRS forms a screening thermograph (ST). We investigated the effects of viewing angle (θ, 0-75°), ETRS set temperature (TETRS, 30-40 °C), ambient temperature (Tatm, 18-32 °C), relative humidity (RH, 15-80%), and working distance (d, 0.4-2.8 m). We discovered that STs exhibited higher accuracy compared to IRTs alone. Across the tested ranges of Tatm and RH, both IRTs exhibited absolute measurement errors of less than 0.97 °C, while both STs maintained absolute measurement errors of less than 0.12 °C. The optimal TETRS for EBT detection was 36-37 °C. When θ was below 30°, the two STs underestimated calibration source (CS) temperature (TCS) of less than 0.05 °C. The computer simulations showed absolute temperature differences of up to 0.28 °C and 0.04 °C between estimated and theoretical temperatures for IRTs and STs, respectively, considering d of 0.2-3.0 m, Tatm of 15-35 °C, and RH of 5-95%. The results highlight the importance of precise calibration and environmental control for reliable temperature readings and suggest proper ranges for these factors, aiming to enhance current standard documents and best practice guidelines. These insights enhance our understanding of IRT performance and their sensitivity to various factors, thereby facilitating the development of best practices for accurate EBT measurement.

Infrared image method for possible COVID-19 detection through febrile and subfebrile people screening

This study proposed an infrared image-based method for febrile and subfebrile people screening to comply with the society need for alternative, quick response, and effective methods for COVID-19 contagious people screening. The methodology consisted of: (i) Developing a method based on facial infrared imaging for possible COVID-19 early detection in people with and without fever (subfebrile state); (ii) Using 1206 emergency room (ER) patients to develop an algorithm for general application of the method, and (iii) Testing the method and algorithm effectiveness in 2558 cases (RT-qPCR tested for COVID-19) from 227,261 workers evaluations in five different countries. Artificial intelligence was used through a convolutional neural network (CNN) to develop the algorithm that took facial infrared images as input and classified the tested individuals in three groups: fever (high risk), subfebrile (medium risk), and no fever (low risk). The results showed that suspicious and confirmed COVID-19 (+) cases characterized by temperatures below the 37.5 °C fever threshold were identified. Also, average forehead and eye temperatures greater than 37.5 °C were not enough to detect fever similarly to the proposed CNN algorithm. Most RT-qPCR confirmed COVID-19 (+) cases found in the 2558 cases sample (17 cases/89.5%) belonged to the CNN selected subfebrile group. The COVID-19 (+) main risk factor was to be in the subfebrile group, in comparison to age, diabetes, high blood pressure, smoking and others. In sum, the proposed method was shown to be a potentially important new tool for COVID-19 (+) people screening for air travel and public places in general.

Determination of Internal Temperature by Measuring the Temperature of the Body Surface Due to Environmental Physical Factors-First Study of Fever Screening in the COVID Pandemic

The SARS-CoV-2 virus pandemic has shown that the use of a contact thermometer to verify the elevated body temperature of a suspected person carries a risk of spreading disease. The perfect solution seems to be the use of thermal imaging as a diagnostic method in fever evaluation. The aim of the research is to develop an algorithm for thermovision measurements in fever screening standards in the context of the impact of various weather conditions on the temperature of people entering the public institution. Each examined person had two thermal images of the face-AP and lateral projection. Using a T1020 FLIR thermal camera with a resolution of 1024 × 768 pixels; the mean temperature was measured from the area of the forehead, the maximum forehead, the corners of the eyes, the inside of the mouth and the external auditory canal temperature. On the other hand, using classic contact thermometers, the temperature in the armpit and ear was measured. The obtained preliminary results showed very strong and positive correlations between the temperature in the ear measured with an ear thermometer and the maximum, minimum and average forehead temperature. These correlations oscillate at approximately r = 0.6, but the highest value of Spearman coefficient was obtained for the mean temperature of the forehead. Moreover, high correlations were also obtained between the temperature in the ear, measured with an ear thermometer, and the maximum temperature in the corners of the eyes and in the ear, measured with a thermal imaging camera. These values were, respectively, r = 0.54, r = 0.65. In summarizing, remote body temperature measurement taken with a thermal camera can be useful in the assessment of the body's core temperature.

The Use of Thermography as an Auxiliary Method for Monitoring Convalescence after Facelift Surgery: A Case Study

Although IR thermography is widely used in medical diagnostics, there are no reports that describe the use of IR thermography in the evaluation of post-plastic-surgery regeneration processes. The aim of the study was to evaluate the potential of thermography as a method which, among others, allows us to determine the location and extent of the inflammatory process, supporting the clinical evaluation of the patient’s convalescence after a facelift surgery using the SMAS technique. During the study and in order to monitor the convalescence process, the patient had a series of face thermograms performed before surgery and up to the 6th week after it. The healing process after surgery was multidirectional for the contralateral areas of the face, leading to thermal asymmetry lasting up to the 3rd week of convalescence. The lowest T_mean values for ROIs were recorded in week 3 of the study and then they gradually increased, in week 6 after surgery, to the following values: chin = 33.1 ± 0.72 °C; cheek left = 33.0 ± 0.26 °C; cheek right = 33.2 ± 0.51 °C; ZFL = 33.8 ± 0.45 °C; ZFR = 33.6 ± 0.74 °C; ZLL = 32.6 ±0.55 °C; ZLR = 32.3 ± 0.32 °C. The temperatures of these areas were still lower than the baseline values obtained before surgery by 0.5–1.4 °C. The usefulness of thermography in the evaluation of post-operative convalescence in facial plastic surgery procedures shows potential in the context of diagnostic assessment of the dynamics of changes in the healing process.

SARS-CoV-2 (Covid-19) workplace temperature screening: Seasonal concerns for thermal detection in northern regions

Workplace temperature screening has become standard practice during the SARS-CoV-2 pandemic. The objective was to determine the consistency of four temperature devices during exposure to simulated and actual environmental conditions reflective of a workplace. An infrared (IR) digital thermometer (accuracy(A)±0.2), IR laser thermometer (A±1), and thermal imaging camera (A±0.3) were used to measure forehead and tympanic (digital only) temperatures. The first experiment was conducted in a controlled simulated environment (-20 to 20 °C) with three participants (32-YOF, 27-YOM, 20-YOF). The second experiment used actual outdoor conditions (-0.48 to 45.6 °C) with two participants (32-YOF, 27-YOM). The tympanic measurement was the least impacted by environmental temperature (mean(±SD)): simulated (36.8(±0.18) °C) and actual (36.9(±0.16) °C). The thermal imaging camera had the lowest RMSE values (0.81-0.97 °C), with outdoor temperatures ranging from 0 to 45 °C. Environmental temperature influenced forehead temperature readings and required a resting period in a thermoneutral environment (5-9 min (-20 to -10 °C) to immediate (15-20 °C)).

Infrared Thermography for Measuring Elevated Body Temperature: Clinical Accuracy, Calibration, and Evaluation

Infrared thermographs (IRTs) implemented according to standardized best practices have shown strong potential for detecting elevated body temperatures (EBT), which may be useful in clinical settings and during infectious disease epidemics. However, optimal IRT calibration methods have not been established and the clinical performance of these devices relative to the more common non-contact infrared thermometers (NCITs) remains unclear. In addition to confirming the findings of our preliminary analysis of clinical study results, the primary intent of this study was to compare methods for IRT calibration and identify best practices for assessing the performance of IRTs intended to detect EBT. A key secondary aim was to compare IRT clinical accuracy to that of NCITs. We performed a clinical thermographic imaging study of more than 1000 subjects, acquiring temperature data from several facial locations that, along with reference oral temperatures, were used to calibrate two IRT systems based on seven different regression methods. Oral temperatures imputed from facial data were used to evaluate IRT clinical accuracy based on metrics such as clinical bias (Δcb), repeatability, root-mean-square difference, and sensitivity/specificity. We proposed several calibration approaches designed to account for the non-uniform data density across the temperature range and a constant offset approach tended to show better ability to detect EBT. As in our prior study, inner canthi or full-face maximum temperatures provided the highest clinical accuracy. With an optimal calibration approach, these methods achieved a Δcb between ±0.03 °C with standard deviation (σΔcb) less than 0.3 °C, and sensitivity/specificity between 84% and 94%. Results of forehead-center measurements with NCITs or IRTs indicated reduced performance. An analysis of the complete clinical data set confirms the essential findings of our preliminary evaluation, with minor differences. Our findings provide novel insights into methods and metrics for the clinical accuracy assessment of IRTs. Furthermore, our results indicate that calibration approaches providing the highest clinical accuracy in the 37-38.5 °C range may be most effective for measuring EBT. While device performance depends on many factors, IRTs can provide superior performance to NCITs.

IoT Platform for COVID-19 Prevention and Control: A Survey

As a result of the worldwide transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19) has evolved into an unprecedented pandemic. Currently, with unavailable pharmaceutical treatments and low vaccination rates, this novel coronavirus results in a great impact on public health, human society, and global economy, which is likely to last for many years. One of the lessons learned from the COVID-19 pandemic is that a long-term system with non-pharmaceutical interventions for preventing and controlling new infectious diseases is desirable to be implemented. Internet of things (IoT) platform is preferred to be utilized to achieve this goal, due to its ubiquitous sensing ability and seamless connectivity. IoT technology is changing our lives through smart healthcare, smart home, and smart city, which aims to build a more convenient and intelligent community. This paper presents how the IoT could be incorporated into the epidemic prevention and control system. Specifically, we demonstrate a potential fog-cloud combined IoT platform that can be used in the systematic and intelligent COVID-19 prevention and control, which involves five interventions including COVID-19 Symptom Diagnosis, Quarantine Monitoring, Contact Tracing & Social Distancing, COVID-19 Outbreak Forecasting, and SARS-CoV-2 Mutation Tracking. We investigate and review the state-of-the-art literatures of these five interventions to present the capabilities of IoT in countering against the current COVID-19 pandemic or future infectious disease epidemics.

Clinical evaluation of fever-screening thermography: impact of consensus guidelines and facial measurement location

SIGNIFICANCE

Infrared thermographs (IRTs) have been used for fever screening during infectious disease epidemics, including severe acute respiratory syndrome, Ebola virus disease, and coronavirus disease 2019 (COVID-19). Although IRTs have significant potential for human body temperature measurement, the literature indicates inconsistent diagnostic performance, possibly due to wide variations in implemented methodology. A standardized method for IRT fever screening was recently published, but there is a lack of clinical data demonstrating its impact on IRT performance.

AIM

Perform a clinical study to assess the diagnostic effectiveness of standardized IRT-based fever screening and evaluate the effect of facial measurement location.

APPROACH

We performed a clinical study of 596 subjects. Temperatures from 17 facial locations were extracted from thermal images and compared with oral thermometry. Statistical analyses included calculation of receiver operating characteristic (ROC) curves and area under the curve (AUC) values for detection of febrile subjects.

RESULTS

Pearson correlation coefficients for IRT-based and reference (oral) temperatures were found to vary strongly with measurement location. Approaches based on maximum temperatures in either inner canthi or full-face regions indicated stronger discrimination ability than maximum forehead temperature (AUC values of 0.95 to 0.97 versus 0.86 to 0.87, respectively) and other specific facial locations. These values are markedly better than the vast majority of results found in prior human studies of IRT-based fever screening.

CONCLUSION

Our findings provide clinical confirmation of the utility of consensus approaches for fever screening, including the use of inner canthi temperatures, while also indicating that full-face maximum temperatures may provide an effective alternate approach.

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.

Best practices for standardized performance testing of infrared thermographs intended for fever screening

Infrared (IR) modalities represent the only currently viable mass fever screening approaches for outbreaks of infectious disease pandemics such as Ebola virus disease and severe acute respiratory syndrome. Non-contact IR thermometers (NCITs) and IR thermographs (IRTs) have been used for fever screening in public areas such as airports. While NCITs remain a more popular choice than IRTs, there has been increasing evidences in the literature that IRTs can provide great accuracy in estimating body temperature if qualified systems are used and appropriate procedures are consistently applied. In this study, we addressed the issue of IRT qualification by implementing and evaluating a battery of test methods for objective, quantitative assessment of IRT performance based on a recent international standard (IEC 80601-2-59). We tested two commercial IRTs to evaluate their stability and drift, image uniformity, minimum resolvable temperature difference, and radiometric temperature laboratory accuracy. Based on these tests, we illustrated how experimental and data processing procedures could affect results, and suggested methods for clarifying and optimizing test methods. Overall, the insights into thermograph standardization and acquisition methods provided by this study may improve the utility of IR thermography and aid in comparing IRT performance, thus improving the potential for producing high quality disease pandemic countermeasures.

Developing a Three-Dimensional (3D) Assessment Method for Clubfoot-A Study Protocol

Background: Congenital talipes equinovarus (CTEV) or clubfoot is a common pediatric congenital foot deformity that occurs 1 in 1,000 live births. Clubfoot is characterized by four types of foot deformities: hindfoot equinus; midfoot cavus; forefoot adductus; and hindfoot varus. A structured assessment method for clubfoot is essential for quantifying the initial severity of clubfoot deformity and recording the progress of clubfoot intervention.

Aim: This study aims to develop a three-dimensional (3D) assessment method to evaluate the initial severity of the clubfoot and monitor the structural changes of the clubfoot after each casting intervention. In addition, this study explores the relationship between the thermophysiological changes in the clubfoot at each stage of the casting intervention and in the normal foot.

Methods: In this study, a total of 10 clubfoot children who are <2 years old will be recruited. Also, the data of the unaffected feet of a total of 10 children with unilateral clubfoot will be obtained as a reference for normal feet. A Kinect 3D scanner will be used to collect the 3D images of the clubfoot and normal foot, and an Infrared thermography camera (IRT camera) will be used to collect the thermal images of the clubfoot. Three-dimensional scanning and IR imaging will be performed on the foot once a week before casting. In total, 6–8 scanning sessions will be performed for each child participant. The following parameters will be calculated as outcome measures to predict, monitor, and quantify the severity of the clubfoot: Angles cross section parameters, such as length, width, and the radial distance; distance between selected anatomical landmarks, and skin temperature of the clubfoot and normal foot. The skin temperature will be collected on selected areas (forefoot, mid foot, and hindfoot) to find out the relationship between the thermophysiological changes in the clubfoot at each stage of the casting treatment and in the normal foot.

Ethics: The study has been reviewed and approved on 17 August 2016 by the Sydney Children's Hospitals Network Human Research Ethics Committee (SCHN HREC), Sydney, Australia. The Human Research Ethics Committee (HREC) registration number for this study is: HREC/16/SCHN/163.

A Survey on Computer Vision for Assistive Medical Diagnosis From Faces

Automatic medical diagnosis is an emerging center of interest in computer vision as it provides unobtrusive objective information on a patient's condition. The face, as a mirror of health status, can reveal symptomatic indications of specific diseases. Thus, the detection of facial abnormalities or atypical features is at upmost importance when it comes to medical diagnostics. This survey aims to give an overview of the recent developments in medical diagnostics from facial images based on computer vision methods. Various approaches have been considered to assess facial symptoms and to eventually provide further help to the practitioners. However, the developed tools are still seldom used in clinical practice, since their reliability is still a concern due to the lack of clinical validation of the methodologies and their inadequate applicability. Nonetheless, efforts are being made to provide robust solutions suitable for healthcare environments, by dealing with practical issues such as real-time assessment or patients positioning. This survey provides an updated collection of the most relevant and innovative solutions in facial images analysis. The findings show that with the help of computer vision methods, over 30 medical conditions can be preliminarily diagnosed from the automatic detection of some of their symptoms. Furthermore, future perspectives, such as the need for interdisciplinary collaboration and collecting publicly available databases, are highlighted.

Comparison of Infrared Thermal Detection Systems for mass fever screening in a tropical healthcare setting

Objectives

Fever screening systems, such as Infrared Thermal Detection Systems (ITDS), have been used for rapid identification of potential cases during respiratory disease outbreaks for public health management. ITDS detect a difference between the subject and ambient temperature, making deployment in hot climates more challenging. This study, conducted in Singapore, a tropical city, evaluates the accuracy of three different ITDS for fever detection compared with traditional oral thermometry and self-reporting in a clinical setting.

Study design

This study is a prospective operational evaluation conducted in the Singapore military on all personnel seeking medical care at a high-volume primary healthcare centre over a one week period in February 2014.

Methods

Three ITDS, the STE Infrared Fever Screening System (IFSS), the Omnisense Sentry MKIII and the handheld Quick Shot Infrared Thermoscope HT-F03B, were evaluated. Temperature measurements were taken outside the healthcare centre, under a sheltered walkway and compared to oral temperature. Subjects were asked if they had fever.

Results

There were 430 subjects screened, of whom 34 participants (7.9%) had confirmed fever, determined by oral thermometer measurement. The handheld infrared thermoscope had a very low sensitivity (29.4%), but a high specificity (96.8%). The STE ITDS had a moderate sensitivity (44.1%), but a very high specificity (99.1%). Self-reported fevers showed good sensitivity (88.2%) and specificity (93.9%). The sensitivity of the Omnisense ITDS (89.7%) was the highest among the three methods with good specificity (92.0%).

Conclusion

The new generation Omnisense ITDS displayed a relatively high sensitivity and specificity for fever. Though it has a lower sensitivity, the old generation STE ITDS system showed a very high specificity. Self-reporting of fever was reliable. The handheld thermograph should not be used as a fever-screening tool under tropical conditions.

•

The new generation fever screening system displayed a relatively high sensitivity and specificity for fever.

•

Self-reporting of fever was reliable compared to measured temperature.

•

The handheld thermograph should not be used as a fever-screening tool under tropical conditions.

Application of infrared thermography in computer aided diagnosis

The invention of thermography, in the 1950s, posed a formidable problem to the research community: What is the relationship between disease and heat radiation captured with Infrared (IR) cameras? The research community responded with a continuous effort to find this crucial relationship. This effort was aided by advances in processing techniques, improved sensitivity and spatial resolution of thermal sensors. However, despite this progress fundamental issues with this imaging modality still remain. The main problem is that the link between disease and heat radiation is complex and in many cases even non-linear. Furthermore, the change in heat radiation as well as the change in radiation pattern, which indicate disease, is minute. On a technical level, this poses high requirements on image capturing and processing. On a more abstract level, these problems lead to inter-observer variability and on an even more abstract level they lead to a lack of trust in this imaging modality. In this review, we adopt the position that these problems can only be solved through a strict application of scientific principles and objective performance assessment. Computing machinery is inherently objective; this helps us to apply scientific principles in a transparent way and to assess the performance results. As a consequence, we aim to promote thermography based Computer-Aided Diagnosis (CAD) systems. Another benefit of CAD systems comes from the fact that the diagnostic accuracy is linked to the capability of the computing machinery and, in general, computers become ever more potent. We predict that a pervasive application of computers and networking technology in medicine will help us to overcome the shortcomings of any single imaging modality and this will pave the way for integrated health care systems which maximize the quality of patient care.

APPLICATION ANALYSIS OF FAR INFRARED CERAMICS IN THE REHABILITATION OF SPORTS INJURY

Far infrared ceramic beads can release far infrared light with wavelengths in the range of 8–14μm, which matches the waveband of living organisms. They exhibit the pyrometric effect and resonance effect through fomentation and radiation, which can accelerate blood circulation and metabolism and can aid in human body rehabilitation. Therefore, it is of great significance to use far infrared ceramics for the rehabilitation of sports injuries. In this study, we fabricated a new type of infrared ceramic bead and applied these beads on the human body. The results showed their reliable application on the rehabilitation of sports injuries.

BREAST THERMOGRAPHY AS A POTENTIAL NON-CONTACT METHOD IN THE EARLY DETECTION OF CANCER: A REVIEW

This review paper discusses recent research achievements in medical thermography with concerns about the possibility of early breast cancer detection. With the advancements in infrared (IR) technology, image processing methods, and the pathophysiological-based knowledge of thermograms, IR screening is sufficiently mature to be utilized as a first-line complement to both health managing and clinical prognosis. In addition, it explains the performance and environmental conditions in identifying thermography for breast tumor imaging under strict indoor controlled environmental circumstances. An irregular thermogram is indicated as a significant biological risk marker for the presence or growth of breast tumors. Breast thermography is completely non-contact, with no form of radiation and compression. It is useful for all women of all ages, for pregnant and breastfeeding women, for women with implants, for women with dense or fibrocystic breasts, for women on hormone replacement therapy, and for pre or post menopausal women.

Breast thermography is specifically worthwhile during the early stages of fast tumor growth, which is not yet recognizable by mammography as thermography is a physiological test while mammography is an anatomical one. Often, physiological changes precede anatomical changes. This early detection of irregular tissue liveliness gives breast thermography the potential to be greatly useful and economical as an imaging program and provides the opportunity to apply non-invasive treatment to reform breast tissue activity. The non-radiating nature of thermography also permits repeated images. Thus, changes can be compared over time and the results of protective approaches can be observed to ensure utmost care of breast cells.

NEW STANDARDS FOR FEVER SCREENING WITH THERMAL IMAGING SYSTEMS

Infrared thermal imaging has in recent years become more accessible and affordable as a means of remote sensing for human body temperature such as in identifying a person with fever. The implementation and operational guidelines for identifying a febrile human using a screening thermograph as documented in the ISO/TR 13154:2009 ISO/TR 80600 has been deployed for the screening of a total of 402 children. It was found that there was a significant difference between the temperatures measured in non-fevered patients and those with known fever, with the thermal imaging of the eye region being the most rapid non-contact site for measurement.

Quantitative deconvolution of human thermal infrared emittance

The bioheat transfer models conventionally employed in etiology of human thermal infrared (TIR) emittance rely upon two assumptions; universal graybody emissivity and significant transmission of heat from subsurface tissue layers. In this work, a series of clinical and laboratory experiments were designed and carried out to conclusively evaluate the validity of the two assumptions. Results obtained from the objective analyses of TIR images of human facial and tibial regions demonstrated significant variations in spectral thermophysical properties at different anatomic locations on human body. The limited validity of the two assumptions signifies need for quantitative deconvolution of human TIR emittance in clinical, psychophysiological and critical applications. A novel approach to joint inversion of the bioheat transfer model is also introduced, levering the deterministic temperature-dependency of proton resonance frequency in low-lipid human soft tissue for characterizing the relationship between subsurface 3D tissue temperature profiles and corresponding TIR emittance.

Comparison of 3 infrared thermal detection systems and self-report for mass fever screening

In a hospital setting, the systems had reasonable utility for fever detection.

Despite limited evidence regarding their utility, infrared thermal detection systems (ITDS) are increasingly being used for mass fever detection. We compared temperature measurements for 3 ITDS (FLIR ThermoVision A20M [FLIR Systems Inc., Boston, MA, USA], OptoTherm Thermoscreen [OptoTherm Thermal Imaging Systems and Infrared Cameras Inc., Sewickley, PA, USA], and Wahl Fever Alert Imager HSI2000S [Wahl Instruments Inc., Asheville, NC, USA]) with oral temperatures (>100°F = confirmed fever) and self-reported fever. Of 2,873 patients enrolled, 476 (16.6%) reported a fever, and 64 (2.2%) had a confirmed fever. Self-reported fever had a sensitivity of 75.0%, specificity 84.7%, and positive predictive value 10.1%. At optimal cutoff values for detecting fever, temperature measurements by OptoTherm and FLIR had greater sensitivity (91.0% and 90.0%, respectively) and specificity (86.0% and 80.0%, respectively) than did self-reports. Correlations between ITDS and oral temperatures were similar for OptoTherm (ρ = 0.43) and FLIR (ρ = 0.42) but significantly lower for Wahl (ρ = 0.14; p<0.001). When compared with oral temperatures, 2 systems (OptoTherm and FLIR) were reasonably accurate for detecting fever and predicted fever better than self-reports.

Estimating the mutual information between bilateral breast in thermograms using nonparametric windows

Comparison between contra lateral breast images is one of the effective methods in breast cancer detection. Asymmetric temperature distribution can be an indicator of abnormality. The mutual information is a good measure of nonlinear correlation. It is a measure that captures linear and nonlinear dependencies, without requiring the specification of any kind of model of dependence. Therefore, it is suitable for our abnormality indicator. Although nonparametric windows is a numerically expensive technique but it is accurate. The reason is that nonparametric windows incorporate an interpolation model which enhances the resolution to a highly oversampled image. For our purposes we worked with sixty simulated breast thermal images. It is shown that the more similar the thermal image of right breast to the thermal image of left breast, the closer the normalized mutual information value to one.

An overview of recent application of medical infrared thermography in sports medicine in Austria

Medical infrared thermography (MIT) is used for analyzing physiological functions related to skin temperature. Technological advances have made MIT a reliable medical measurement tool. This paper provides an overview of MIT's technical requirements and usefulness in sports medicine, with a special focus on overuse and traumatic knee injuries. Case studies are used to illustrate the clinical applicability and limitations of MIT. It is concluded that MIT is a non-invasive, non-radiating, low cost detection tool which should be applied for pre-scanning athletes in sports medicine.

A novel screening method for influenza patients using a newly developed non-contact screening system

OBJECTIVES

In places of mass gathering, rapid infection screening prior to definite diagnosis is vital during the epidemic season of a novel influenza. In order to assess the possibility of clinical application of a newly developed non-contact infection screening system, we conducted screening for influenza patients.

MATERIALS AND METHODS

The system is operated by a screening program via a linear discriminant analysis using non-contact derived variables, i.e., palmar pulse derived from a laser Doppler blood-flow meter, respiration rate determined by a 10-GHz microwave radar, and average facial temperature measured by thermography. The system was tested on 57 seasonal influenza (2008-2009) patients (35.7 degrees C < or = body temperature < or = 38.3 degrees C, 19-40 years) and 35 normal control subjects (35.5 degrees C < or = body temperature < or = 36.9 degrees C, 21-35 years) at the Japan Self-defense Forces Central Hospital.

RESULTS

A significant linear discriminant function (p < 0.001) was determined to distinguish the influenza group from the control group (Mahalanobis D-square = 6.5, classification error rate > 10%). The system had a positive predictive value (PPV) of 93%, which is higher than the PPV value (PPV < or = 65.4%) reported in the recent summary of studies using only thermography performed mainly in hospitals.

CONCLUSIONS

The proposed system appears promising for application in accurate screening for influenza patients at places of mass gathering.