Measurement of Core Body Temperature Using Graphene-Inked Infrared Thermopile Sensor

Continuous Core Body Temperature Monitoring for Heatstroke Alert via a Wearable In-Ear Thermometer

Heatstroke, a global concern exacerbated by climate change, poses significant health risks, potentially leading to multiorgan damage and fatalities. Core body temperature (CBT) is a critical and precise indicator of heatstroke, and its continuous monitoring could serve as a pivotal tool for early detection. Traditional CBT measurements, often invasive (e.g., surgical intubation, rectal or oral placement), and disrupt daily activities, whereas existing wearable devices predominantly measure skin temperatures which is susceptible to ambient environment, thus unreliable for heatstroke alert. To overcome these limitations, this study introduces an innovative in-ear wearable device to measure CBT via the cochlea, which allows for accurate CBT monitoring and timely heatstroke alerts during activities in high-temperature and high-humidity environments. The device comprises a negative temperature coefficient (NTC) thermometer integrated into a flexible precision circuit (FPC), a compact Bluetooth module, an 8 mA h micro battery, and a biocompatible, low-stimulus silica gel casing. With dimensions of 27 mm × 18 mm and a maximum in-ear diameter of 5 mm, weighing just 1.3 g, the device offers high portability and comfort, with a continuous operational lifespan of at least 24 h postcharging. A complementary software system facilitates continuous CBT monitoring, heatstroke alerts, and device management. Preliminary human trials demonstrate the device's accuracy in CBT measurement, rivaling that of rectal thermometry, and superior to the performance of surface body temperature measurement at different body parts. Long-term experiments affirm the device's efficacy in detecting rapid CBT escalations, enabling timely preventive measures against heatstroke.

Earable Multimodal Sensing and Stimulation: A Prospective Towards Unobtrusive Closed-Loop Biofeedback

The human ear has emerged as a bidirectional gateway to the brain's and body's signals. Recent advances in around-the-ear and in-ear sensors have enabled the assessment of biomarkers and physiomarkers derived from brain and cardiac activity using ear-electroencephalography (ear-EEG), photoplethysmography (ear-PPG), and chemical sensing of analytes from the ear, with ear-EEG having been taken beyond-the-lab to outer space. Parallel advances in non-invasive and minimally invasive brain stimulation techniques have leveraged the ear's access to two cranial nerves to modulate brain and body activity. The vestibulocochlear nerve stimulates the auditory cortex and limbic system with sound, while the auricular branch of the vagus nerve indirectly but significantly couples to the autonomic nervous system and cardiac output. Acoustic and current mode stimuli delivered using discreet and unobtrusive earables are an active area of research, aiming to make biofeedback and bioelectronic medicine deliverable outside of the clinic, with remote and continuous monitoring of therapeutic responsivity and long-term adaptation. Leveraging recent advances in ear-EEG, transcutaneous auricular vagus nerve stimulation (taVNS), and unobtrusive acoustic stimulation, we review accumulating evidence that combines their potential into an integrated earable platform for closed-loop multimodal sensing and neuromodulation, towards personalized and holistic therapies that are near, in- and around-the-ear.

Recent Advances in Two-Dimensional Nanomaterials for Healthcare Monitoring

The development of advanced technologies for the fabrication of functional nanomaterials, nanostructures, and devices has facilitated the development of biosensors for analyses. Two-dimensional (2D) nanomaterials, with unique hierarchical structures, a high surface area, and the ability to be functionalized for target detection at the surface, exhibit high potential for biosensing applications. The electronic properties, mechanical flexibility, and optical, electrochemical, and physical properties of 2D nanomaterials can be easily modulated, enabling the construction of biosensing platforms for the detection of various analytes with targeted recognition, sensitivity, and selectivity. This review provides an overview of the recent advances in 2D nanomaterials and nanostructures used for biosensor and wearable-sensor development for healthcare and health-monitoring applications. Finally, the advantages of 2D-nanomaterial-based devices and several challenges in their optimal operation have been discussed to facilitate the development of smart high-performance biosensors in the future.

Effect of Auricular Position on Body Temperature Measurement with Tympanic Thermometers: A Quasi Experimental Study

BACKGROUND

With the COVID-19 pandemic, body temperature measurement has begun to be widely used in the diagnosis of the coronavirus disease. When measuring body temperature, it is important to obtain the core temperature measurement. This study compared the results of body temperature obtained with the tympanic membrane thermometer-which is one of the methods that best reflect the body temperature-with or without positioning the auricle.

AIMS

The aim of this study was to investigate the effect of auricle position on body temperature measurements made with tympanic membrane thermometer in adult patients.

MATERIALS AND METHODS

A quasi-experimental design that employed a pre-test and a post-test was used in this study. A total of 143 patients who fit the inclusion criteria of the study were included in the sample. For analysis of the data, frequencies, percentages, means and standard deviations were calculated, and the significance of the difference between paired values was tested in order to investigate the effects of auricle position on measurement values. Statistical Package for the Social Sciences (SPSS) 22.0 was used in analyzing the data obtained in this study.

RESULTS

The difference between the values of measurement taken in these two separate positions was found to be 0.31 0C, and the Bland-Altman plot showed that the differences were distributed systematically around the value 0.31.

CONCLUSIONS

It was found in the comparison of two positions that there was a significant difference between the tympanic thermometer measurements made by positioning the auricle and those without positioning.

Video-Based Elevated Skin Temperature Detection

In this work, we propose a non-contact video-based approach that detects when an individual's skin temperature is elevated beyond the normal range. The detection of elevated skin temperature is critical as a diagnostic tool to infer the presence of an infection or an abnormal health condition. Detection of elevated skin temperature is typically achieved using contact thermometers or non-contact infrared-based sensors. The ubiquity of video data acquisition devices such as mobile phones and computers motivates the development of a binary classification approach, the Video-based TEMPerature (V-TEMP) to classify subjects with non-elevated/elevated skin temperature. We leverage the correlation between the skin temperature and the angular reflectance distribution of light, to empirically differentiate between skin at non-elevated temperature and skin at elevated temperature. We demonstrate the uniqueness of this correlation by 1) revealing the existence of a difference in the angular reflectance distribution of light from skin-like and non-skin like material and 2) exploring the consistency of the angular reflectance distribution of light in materials exhibiting optical properties similar to human skin. Finally, we demonstrate the robustness of V-TEMP by evaluating the efficacy of elevated skin temperature detection on subject videos recorded in 1) laboratory controlled environments and 2) outside-the-lab environments. V-TEMP is beneficial in two ways; 1) it is non-contact-based, reducing the possibility of infection due to contact and 2) it is scalable, given the ubiquity of video-recording devices.

Evaluation of newly developed wearable ear canal thermometer, mimicking the application to activities on sports and labor fields

We evaluated the reliability of a newly developed wearable ear canal thermometer based on three different experiments, in which ear canal and rectal temperature (Tear and Trec, respectively) were simultaneously monitored. In Experiment 1, participants sat at 28 °C and 50% relative humidity (RH), during which fanning or 41 °C lower legs water immersion was conducted. In Experiment 2, participants conducted a 70-min treadmill exercise (4 km/h, 0.5% slope) at 35 °C and 50% RH with intermittent fanning. In Experiment 3, participants completed a 20 min treadmill exercise (6 km/h, 5% slope) at 35 °C and 65% RH. Bland-Altman analysis for Tear and Trec showed the difference of - 0.2-0.3 °C and the limit of agreement of the mean ± 0.3-0.6 °C. The intraclass correlation coefficient was 0.44-0.83. The results may suggest that the ear canal thermometer is useful to assess core body temperature in sports and/or labor fields.

Health-Related Indicators Measured Using Earable Devices: Systematic Review

BACKGROUND

Earable devices are novel, wearable Internet of Things devices that are user-friendly and have potential applications in mobile health care. The position of the ear is advantageous for assessing vital status and detecting diseases through reliable and comfortable sensing devices.

OBJECTIVE

Our study aimed to review the utility of health-related indicators derived from earable devices and propose an improved definition of disease prevention. We also proposed future directions for research on the health care applications of earable devices.

METHODS

A systematic review was conducted of the PubMed, Embase, and Web of Science databases. Keywords were used to identify studies on earable devices published between 2015 and 2020. The earable devices were described in terms of target health outcomes, biomarkers, sensor types and positions, and their utility for disease prevention.

RESULTS

A total of 51 articles met the inclusion criteria and were reviewed, and the frequency of 5 health-related characteristics of earable devices was described. The most frequent target health outcomes were diet-related outcomes (9/51, 18%), brain status (7/51, 14%), and cardiovascular disease (CVD) and central nervous system disease (5/51, 10% each). The most frequent biomarkers were electroencephalography (11/51, 22%), body movements (6/51, 12%), and body temperature (5/51, 10%). As for sensor types and sensor positions, electrical sensors (19/51, 37%) and the ear canal (26/51, 51%) were the most common, respectively. Moreover, the most frequent prevention stages were secondary prevention (35/51, 69%), primary prevention (12/51, 24%), and tertiary prevention (4/51, 8%). Combinations of ≥2 target health outcomes were the most frequent in secondary prevention (8/35, 23%) followed by brain status and CVD (5/35, 14% each) and by central nervous system disease and head injury (4/35, 11% each).

CONCLUSIONS

Earable devices can provide biomarkers for various health outcomes. Brain status, healthy diet status, and CVDs were the most frequently targeted outcomes among the studies. Earable devices were mostly used for secondary prevention via monitoring of health or disease status. The potential utility of earable devices for primary and tertiary prevention needs to be investigated further. Earable devices connected to smartphones or tablets through cloud servers will guarantee user access to personal health information and facilitate comfortable wearing.

Towards real-time thermal stress prediction systems for workers

Exposure to extreme temperatures in workplaces implies serious physical hazards to workers. In addition, a poorly acclimatized worker can have reduced performance and alertness. It may therefore be more vulnerable to the risk of accidents and injuries. Due to the incompatibility of standards and regulations with some work environments and a lack of thermal exchange in many personal protective equipment, heat stress remains among the most common physical risks in many industrial sectors. Furthermore, conventional methods of measuring physiological parameters in order to calculate personal thermophysiological constraints are not practical to use during work tasks. However, the emergence of wearable technologies can contribute to real-time measurement of body temperature and the biometric signals needed to assess thermophysiological constraints while actively working. Thus, the present study was carried out in order to scrutinize the current knowledge of these types of technologies by analyzing the available systems and the advances made in previous studies, as well as to discuss the efforts required to develop devices for the prevention of the occurrence of heat stress in real time.

Agreement of infrared ear temperature with nasopharyngeal temperature and diagnostic performance on hypothermia in general anesthetized patients

BACKGROUND

Infrared ear thermometry is widely used in clinical practice due to its noninvasive, convenient, and quick sampling. However, its accuracy and feasibility in anesthetized patients have not yet been established.

METHODS

We conducted this cross-sectional study to evaluate the agreement between infrared ear temperature and nasopharyngeal temperature in general anesthetized patients and its performance in intraoperative hypothermia, defined as nasopharyngeal temperature <36°C. Adult female patients who underwent gynecological surgery under general anesthesia were enrolled in this study. Infrared ear temperature by Braun ThermoScan PRO 4000 (Braun GmbH, Kronberg, Germany) and nasopharyngeal temperature were measured simultaneously before, during, and after surgery. The agreement between the two temperatures was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The diagnostic performance of the infrared ear thermometer for hypothermia was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Fifty-six patients with 168 pairs of simultaneous infrared ear and nasopharyngeal temperatures were included in this analysis. The mean infrared ear temperature was consistently higher than the nasopharyngeal temperature throughout surgery, but the differences were small (0.22, 0.13, and 0.06°C before, during, and after surgery, respectively). The ICC between the two temperatures before, during, and after surgery was 0.70, 0.75, and 0.80, respectively, and 93.5% of the differences fell within the 95% limits of agreement of ±0.5°C. An infrared ear thermometer had high diagnostic accuracy for hypothermia, with an area under the ROC curve of 0.95 (95% confidence interval [CI], 0.92-0.98). The cutoff of infrared ear temperature for hypothermia was 36.2°C with a sensitivity of 0.89 (95% CI, 0.71-0.98) and a specificity of 0.87 (95% CI, 0.81-0.92).

CONCLUSION

The infrared ear temperature is in good agreement with the nasopharyngeal temperature in general anesthetized patients without hyperthermia and has high performance for detecting hypothermia. An infrared ear thermometer can be a diagnostic tool for intraoperative hypothermia.

A Novel Non-Invasive Thermometer for Continuous Core Body Temperature: Comparison with Tympanic Temperature in an Acute Stroke Clinical Setting

There is a growing research interest in wireless non-invasive solutions for core temperature estimation and their application in clinical settings. This study aimed to investigate the use of a novel wireless non-invasive heat flux-based thermometer in acute stroke patients admitted to a stroke unit and compare the measurements with the currently used infrared (IR) tympanic temperature readings. The study encompassed 30 acute ischemic stroke patients who underwent continuous measurement (Tcore) with the novel wearable non-invasive CORE device. Paired measurements of Tcore and tympanic temperature (Ttym) by using a standard IR-device were performed 3−5 times/day, yielding a total of 305 measurements. The predicted core temperatures (Tcore) were significantly correlated with Ttym (r = 0.89, p < 0.001). The comparison of the Tcore and Ttym measurements by Bland−Altman analysis showed a good agreement between them, with a low mean difference of 0.11 ± 0.34 °C, and no proportional bias was observed (B = −0.003, p = 0.923). The Tcore measurements correctly predicted the presence or absence of Ttym hyperthermia or fever in 94.1% and 97.4% of cases, respectively. Temperature monitoring with a novel wireless non-invasive heat flux-based thermometer could be a reliable alternative to the Ttym method for assessing core temperature in acute ischemic stroke patients.

Wireless Technologies for Social Distancing in the Time of COVID-19: Literature Review, Open Issues, and Limitations

This research aims to provide a comprehensive background on social distancing as well as effective technologies that can be used to facilitate the social distancing practice. Scenarios of enabling wireless and emerging technologies are presented, which are especially effective in monitoring and keeping distance amongst people. In addition, detailed taxonomy is proposed summarizing the essential elements such as implementation type, scenarios, and technology being used. This research reviews and analyzes existing social distancing studies that focus on employing different kinds of technologies to fight the Coronavirus disease (COVID-19) pandemic. This study main goal is to identify and discuss the issues, challenges, weaknesses and limitations found in the existing models and/or systems to provide a clear understanding of the area. Articles were systematically collected and filtered based on certain criteria and within ten years span. The findings of this study will support future researchers and developers to solve specific issues and challenges, fill research gaps, and improve social distancing systems to fight pandemics similar to COVID-19.

Are Non-Contact Thermometers an Option in Anaesthesia? A Narrative Review on Thermometry for Perioperative Medicine

Measurement of core body temperature—clinical thermometry—provides critical information to anaesthetists during perioperative care. The value of this information is determined by the accuracy of the measurement device used. This accuracy must be maintained despite external influences such as the operating room temperature and the patient’s thermoregulatory defence. Presently, perioperative thermometers utilise invasive measurement sites. The public health challenge of the COVID-19 pandemic, however, has highlighted the use of non-invasive, non-contact infrared thermometers. The aim of this article is to review common existing thermometers used in perioperative care, their mechanisms of action, accuracy, and practicality in comparison to infrared non-contact thermometry used for population screening during a pandemic. Evidence currently shows that contact thermometry varies in accuracy and practicality depending on the site of measurements and the method of sterilisation or disposal between uses. Despite the benefits of being a non-invasive and non-contact device, infrared thermometry used for population temperature screening lacks the accuracy required in perioperative medicine. Inaccuracy may be a consequence of uncontrolled external temperatures, the patient’s actions prior to measurement, distance between the patient and the thermometer, and the different sites of measurement. A re-evaluation of non-contact thermometry is recommended, requiring new studies in more controlled environments.

Contactless temperature and distance measuring device: A low-cost, novel infrared -based

<abstract> <p>This work eases the feasibility of infrared thermometer application and reliability to introduce a novel design with upgraded applications &amp; functions. The custom-designed compact device "Badge" structured comprises the operative methods through the electronic packages of an optimal level. The physical and social distance measured by the ToF (Time of Flight) infrared laser sensor within 1 m from the subject and the measuring equipment (MLX90632 SMD QFN and VL530LX ToF). When the distance is not maintained, or the physical distance condition is not met, the flashing LED, or vibration should trigger an indication (warning for physical distancing and alteration for pyrexia warning, respectively). Statistical analysis and simulation-based studies criticized the accuracy of ±0.5°F and relational model of the independent and dependent variable for this device with significant R² = 0.99 and P &lt; = 1; values with the lowest accuracy error of ±0.2°F and least residual sum of squares 0.01462 values. The portable, lightweight, and dynamic body temperature monitoring altered the application from static to continuous, complete structural design. This alternative provides the best technique to combine worn (personnel) medical devices with primary healthcare instruments to help body temperature measurements that are not contactable, fast, and accurate. It builds a way of processing through the protocol Covid-19.</p> </abstract>

A Thermopile Detector Based on Micro-Bridges for Heat Transfer

A thermopile detector with their thermocouples distributed in micro-bridges is designed and investigated in this work. The thermopile detector consists of 16 pairs of n-poly-Si/p-poly-Si thermocouples, which are fabricated using a low-cost, high-throughput CMOS process. The micro-bridges are realized by forming micro trenches at the front side first and then releasing the silicon substrate at the back side. Compared with a thermopile device using a continuous membrane, the micro-bridge-based one can achieve an improvement of the output voltage by 13.8% due to a higher temperature difference between the hot and cold junctions as there is a decrease in thermal conduction loss in the partially hollowed structure. This technique provides an effective way for developing high-performance thermopile detectors and other thermal devices.

Advanced Functional Materials for Intelligent Thermoregulation in Personal Protective Equipment

The exposure to extreme temperatures in workplaces involves physical hazards for workers. A poorly acclimated worker may have lower performance and vigilance and therefore may be more exposed to accidents and injuries. Due to the incompatibility of the existing standards implemented in some workplaces and the lack of thermoregulation in many types of protective equipment that are commonly fabricated using various types of polymeric materials, thermal stress remains one of the most frequent physical hazards in many work sectors. However, many of these problems can be overcome with the use of smart textile technologies that enable intelligent thermoregulation in personal protective equipment. Being based on conductive and functional polymeric materials, smart textiles can detect many external stimuli and react to them. Interconnected sensors and actuators that interact and react to existing risks can provide the wearer with increased safety, protection, and comfort. Thus, the skills of smart protective equipment can contribute to the reduction of errors and the number and severity of accidents in the workplace and thus promote improved performance, efficiency, and productivity. This review provides an overview and opinions of authors on the current state of knowledge on these types of technologies by reviewing and discussing the state of the art of commercially available systems and the advances made in previous research works.

Estimation of core body temperature by near-infrared imaging of vein diameter change in the dorsal hand

Core body temperature (T_core ) is a key indicator of personal thermal comfort and serves as a monitor of thermal strain. Multi-parametric sensors are not practical for estimating core temperature because they require long data collection times and a wide variety of settings. This study introduces dorsal hand vein dynamics as a novel indicator along with heart rate (HR) and dorsal hand skin temperature (T_hand ) for predicting T_core during rest following T_core elevation. Twelve healthy males aged 27 ± 9 years old participated in the experiment. The experimental procedure consisted of a 10-min rest followed by 60 min of passive heat stress induced by leg immersion in hot water at 42°C and a 40-min thermal relaxation period after the legs were removed from the water. A near-infrared (NIR) imaging system was configured to monitor the dorsal hand veins during the entire experimental session. The values of HR, T_hand , and T_core were continuously monitored while the ambient temperature and relative humidity (RH) were maintained in a climate chamber at 20°C and 50%, respectively. Our selected predictor parameters demonstrated similar patterns in the T_core such that the value increased as a result of passive heat stress and decreased in the thermal relaxation phase. The experimental data were divided into two phases: thermal stress and relaxation. At the resting condition, inclusion of the hand vein diameter (VD) improved the multiple linear regression value (R² ) about 26%. At the relaxation phase, however, training regressions R²  = 0.68 and R²  = 0.94 were observed in the regression model with and without considering VD, respectively. The test regression value of R²  = 0.88 and the root mean square error (RMSE) of 0.18°C showed good agreement with the predicted values. These findings demonstrate acceptable validity of the non-invasive T_core estimation at the resting condition. In particular, the inclusion of VD as a predictor in the regression analysis increases the prediction accuracy with a lower RMSE value.

Peripheral thermometry: Agreement between non-touch infrared versus traditional modes in an adult population

AIM

To test whether infrared non-touch forehead thermometry (FNTT) obtains comparable temperature readings in adults compared with common, non-invasive thermometry methods such as axillary (DAT), oral (DOT) and infrared tympanic (ITT).

DESIGN

A prospective, repeated-measures comparative diagnostic test study design was used for this study.

METHODS

Data were collected from a convenience sample of 169 nursing students over 3 months (March 2019 to May 2019). Participants had their temperature measured once with each of the four thermometers. Agreement between thermometers was assessed using repeated-measures analysis of variance with Bonferroni post hoc testing.

RESULTS/FINDINGS

One hundred and sixty-one participants were included in the final analysis. A repeated-measures ANOVA showed statistically significant differences between the four thermometer temperature readings. Post hoc pairwise comparisons with Bonferroni adjustment revealed infrared non-touch forehead thermometry demonstrated statistically significant higher mean temperatures compared with digital oral thermometry MD = 0.466℃ (95% CI, 0.357-0.576, p < .001) and digital axillary thermometry MD = 0.897℃ (95% CI, 0.752-1.043, p < .001), but not with infrared tympanic MD = 0.069℃ (95% CI, -0.025-0.162, p = .307).

CONCLUSIONS

This study found that infrared non-touch forehead thermometry consistently produced higher temperature readings in adults compared with other common forms of peripheral thermometry. Caution should be taken when using forehead non-touch thermometer readings interchangeably with digital oral and digital axillary readings unless corrections for bias are made. More research is needed into whether infrared non-touch forehead thermometry and infrared tympanic could be used interchangeably.

IMPACT STATEMENT

This study aimed to address whether non-touch forehead could be used interchangeably with other common forms of non-invasive thermometry. Our result revealed inconsistencies in temperature readings between the different thermometers. Consequently, healthcare professionals should exercise caution when monitoring temperature trends where readings have been taken by different types of peripheral thermometers. This study could impact healthcare clinicians responsible for the monitoring and recording of peripheral temperatures.

Evaluation of a Wearable Non-Invasive Thermometer for Monitoring Ear Canal Temperature during Physically Demanding (Outdoor) Work

Aimed at preventing heat strain, health problems, and absenteeism among workers with physically demanding occupations, a continuous, accurate, non-invasive measuring system may help such workers monitor their body (core) temperature. The aim of this study is to evaluate the accuracy and explore the usability of the wearable non-invasive Cosinuss° °Temp thermometer. Ear canal temperature was monitored in 49 workers in real-life working conditions. After individual correction, the results of the laboratory and field study revealed high correlations compared to ear canal infrared thermometry for hospital use. After performance of the real-life working tasks, this correlation was found to be moderate. It was also observed that the ambient environmental outdoor conditions and personal protective clothing influenced the accuracy and resulted in unrealistic ear canal temperature outliers. It was found that the Cosinuss° °Temp thermometer did not result in significant interference during work. Therefore, it was concluded that, without a correction factor, the Cosinuss° °Temp thermometer is inaccurate. Nevertheless, with a correction factor, the reliability of this wearable ear canal thermometer was confirmed at rest, but not in outdoor working conditions or while wearing a helmet or hearing protection equipment.

Consequences of police-related personal protective equipment and physical training status on thermoregulation and exercise energy expenditure

BACKGROUND

The aim was to examine the impact of personal protective equipment (PPE) on human thermoregulation and its alteration in groups of different training status.

METHODS

45 men performed a maximum voluntary contraction test in an upright pull position to determine lower body strength and a graded treadmill test to determine maximum oxygen uptake (VO2max). Body composition was estimated via bioelectric impedance analysis. According to specific cutoff values, participants were assigned to a group of endurance-trained, strength-trained, endurance- and strength-trained, or untrained individuals. Subsequently, they completed two graded exercise tests until volitional exhaustion, once wearing sports wear (SPW) and once wearing PPE (20.9 kg). Participants were weighed before and afterward to investigate sweat loss and sweat rate. Body temperature was measured continuously from the tympanic membrane. Energy expenditure was derived from breathing gas analysis.

RESULTS

Sweat rate was 91% higher in PPE than in SPW but not significantly differnt between groups (p > 0.05). Body temperature was significantly higher in PPE during submaximal (+1.14 ± 0.45 °C) and maximal exercise intensity (+0.68 ± 0.57 °C) and was poorely related to VO2max and body composition. Energy expenditure significantly differed between both garments (+37% in PPE) and groups (p < 0.05). Additionally, energy expenditure significantly correlated with body weight (r = 0.84 in SPW and r = 0.68 in PPE).

CONCLUSIONS

Strength training alone does not seem to have any or negligible effects on thermoregulation. Endurance training and weight management might lead to rather small improvements in heat tolerance.

Hearables: New Perspectives and Pitfalls of In-Ear Devices for Physiological Monitoring. A Scoping Review

Technological advancements are opening the possibility of prolonged monitoring of physiological parameters under daily-life conditions, with potential applications in sport science and medicine, and in extreme environments. Among emerging wearable technologies, in-ear devices or hearables possess technical advantages for long-term monitoring, such as non-invasivity, unobtrusivity, good fixing, and reduced motion artifacts, as well as physiological advantages related to the proximity of the ear to the body trunk and the shared vasculature between the ear and the brain. The present scoping review was aimed at identifying and synthesizing the available evidence on the use and performance of in-ear monitoring of physiological parameters, with focus on applications in sport science, sport medicine, occupational medicine, and extreme environment settings. Pubmed, Scopus, and Web of Science electronic databases were systematically searched to identify studies conducted in the last 10 years and addressing the measurement of three main physiological parameters (temperature, heart rate, and oxygen saturation) in healthy subjects. Thirty-nine studies were identified, 24 performing temperature measurement, 12 studies on heart/pulse rate, and three studies on oxygen saturation. The collected evidence supports the premise of in-ear sensors as an innovative and unobtrusive way for physiological monitoring during daily-life and physical activity, but further research and technological advancement are necessary to ameliorate measurement accuracy especially in more challenging scenarios.

Emplacement of screen-printed graphene oxide coating for building thermal comfort discernment

This study demonstrates the development of flexible graphene oxide coatings (GOCs) by the screen-printed technique and further its implementation as a thermal absorber for buildings’ thermal comfort purpose. The basic concept consists the integration of the GOC as a flat absorber on the top of a low iron glass or aluminium-based substrate (5 × 5 cm²) connecting through a phase change material channel in contact with direct sun exposure. The function of GOC as an outdoor cover of the prototype chamber is to maintain the high indoor temperature while the outdoor temperature is low. Using the GOC, it has been observed that the indoor temperature (at the substrate) of the prototype chamber always remains higher as compared to the outdoor temperature (at the GOC) as measured under 1 SUN 1.5 AM condition. The temperature difference between outdoor and indoor exterior surface significantly increases during the light exposure time, whereas the difference drastically approaches to zero during the cooling period. The variation of different crucial environmental factors such as high temperature, moisture, flexibility and water resistivity has been investigated on the developed GOCs to understand the stability of the coating further.

Remote Patient Monitoring Technologies for Predicting Chronic Obstructive Pulmonary Disease Exacerbations: Review and Comparison

Background

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death by disease worldwide and has a 30-day readmission rate of 22.6%. In 2015, COPD was added to the Medicare Hospital Readmission Reductions Program.

Objective

The objective of this paper was to survey the current medical technologies for remote patient monitoring (RPM) tools that forecast COPD exacerbations in order to reduce COPD readmissions.

Methods

We searched literature and digital health news to find commercially available RPM devices focused on predicting COPD exacerbations. These technologies were reviewed and compared according to four criteria: forecasting ability, cost, ease of use, and appearance. A rating system was developed to facilitate the evaluation process.

Results

As of June 2019, a list of handheld and hands-free devices was compiled. We compared features and found substantial variations. Devices that ranked higher on all criteria tended to have a high or unlisted price. Commonly mass-marketed devices like the pulse oximeter and spirometer surprisingly fulfilled the least criteria.

Conclusions

The COPD RPM technologies with most technological promise and compatibility with daily living appear to have high or unlisted prices. Consumers and providers need better access to product information to make informed decisions.

Investigation of the Impact of Infrared Sensors on Core Body Temperature Monitoring by Comparing Measurement Sites

Many types of thermometers have been developed to measure body temperature. Infrared thermometers (IRT) are fast, convenient and ease to use. Two types of infrared thermometers are uses to measure body temperature: tympanic and forehead. With the spread of COVID-19 coronavirus, forehead temperature measurement is used widely to screen people for the illness. The performance of this type of device and the criteria for screening are worth studying. This study evaluated the performance of two types of tympanic infrared thermometers and an industrial infrared thermometer. The results showed that these infrared thermometers provide good precision. A fixed offset between tympanic and forehead temperature were found. The measurement values for wrist temperature show significant offsets with the tympanic temperature and cannot be used to screen fevers. The standard operating procedure (SOP) for the measurement of body temperature using an infrared thermometer was proposed. The suggestion threshold for the forehead temperature is 36 °C for screening of fever. The body temperature of a person who is possibly ill is then measured using a tympanic infrared thermometer for the purpose of a double check.

Monitoring core temperature of firefighters to validate a wearable non-invasive core thermometer in different types of protective clothing: Concurrent in-vivo validation

This study aims (1) to test the validity of a new non-invasive core thermometer, Cosinuss°, in rest and (2) during firefighting simulation tasks, against invasive temperature pill and inner-ear temperature and (3) to compare the change in core temperature of firefighters when working in two types of protective clothing (traditional turnout gear versus new concept). 11 active firefighters performed twice a selection of tasks during their periodic preventive medical examination and a fire-extinguishing task. Without correction no correlation between the Cosinuss° and thermometer pill (ICC≤0.09, p ≥ 0.154, LoA≥1.37) and a moderate correlation between Cosinuss° and inner-ear infrared (ICC = 0.40, p = 0.044, LoA±1.20) was observed. With individual correction both correlations were excellent (ICC≥0.84, p = 0.000, LoA≤0.30). However, during and after working all correlations were poor and non-significant (ICC≤0.38, p ≥ 0.091, LoA≥1.71). During firefighting tasks, the Cosinuss° is invalid for measuring the core temperature. No differences in heat development in the two types of protective clothing was proven.

Towards The Internet-of-Smart-Clothing: A Review on IoT Wearables and Garments for Creating Intelligent Connected E-Textiles

Technology has become ubiquitous, it is all around us and is becoming part of us. Together with the rise of the Internet-of-Things (IoT) paradigm and enabling technologies (e.g., Augmented Reality (AR), Cyber-Physical Systems, Artificial Intelligence (AI), blockchain or edge computing), smart wearables and IoT-based garments can potentially have a lot of influence by harmonizing functionality and the delight created by fashion. Thus, smart clothes look for a balance among fashion, engineering, interaction, user experience, cybersecurity, design and science to reinvent technologies that can anticipate needs and desires. Nowadays, the rapid convergence of textile and electronics is enabling the seamless and massive integration of sensors into textiles and the development of conductive yarn. The potential of smart fabrics, which can communicate with smartphones to process biometric information such as heart rate, temperature, breathing, stress, movement, acceleration, or even hormone levels, promises a new era for retail. This article reviews the main requirements for developing smart IoT-enabled garments and shows smart clothing potential impact on business models in the medium-term. Specifically, a global IoT architecture is proposed, the main types and components of smart IoT wearables and garments are presented, their main requirements are analyzed and some of the most recent smart clothing applications are studied. In this way, this article reviews the past and present of smart garments in order to provide guidelines for the future developers of a network where garments will be connected like other IoT objects: the Internet-of-Smart-Clothing.