Emission from Human Skin in the Sub THz Frequency Band

Recently published Radiometric measurements of human subjects in the frequency range 480-700 GHz, demonstrate the emission of blackbody radiation from the body core, rather than the skin surface. We present a detailed electromagnetic simulation of the dermis and epidermis, taking into account the presence of the sweat duct. This complex structure can be considered as an electromagnetic bio-metamaterial, whereby the layered structure, along with the topology of the sweat duct, reveals a complex interference pattern in the skin. The model is capable of accurately representing the skin greyness factor as a function of frequency and this is confirmed by radiometry of living human skin.

Brain thermal kinetics at brain-eyelid thermal tunnels overcoming COVID-19 thermometry limitations for automated asymptomatic infection detection in concert with physical and biological principles

For centuries, temperature measurement deficiencies attributable to biological barriers and low thermo-conductivity (k) have precluded accurate surface-based fever assessment. At this stage of the pandemic, infection detection in children (who due to immature immune system may not effectively respond to vaccines) is critical because children can be readily infected and also become a large mutation reservoir. We reveal hitherto-unrecognized worldwide body temperature measurements (T°), in children and adults, over tissue typified by low-k similar to wood that may reach 6.8°C in thermal variability, hampering thereby COVID-19 control. Brain-eyelid thermal tunnels’ (BTT) integration of low-k and high-k regions creating a thermal pathway for undisturbed heat transmission from hypothalamus to high-k skin eliminates current shortcomings and makes the brain indispensable for defeating COVID-19 given that brain thermoregulatory signals are not limited by mutations. Anatomo-histologic, emissive, physiologic, and thermometric bench-to-bedside studies characterized and overcome biophysical limitations of thermometry through high-k eyelid-enabled brain temperature measurements in children and adults. BTT eyelid features fat-free skin (~900 µm) and unique light emission through a blood/fat configuration in the underlying tunnel. Contrarily, forehead features variable and thick dermis (2000–2500 µm) and variable fat layers (1100–2800 µm) resulting in variable low-k as well as temperatures 1.97 °C lower than BTT temperature (BTT°). Highest emission present in only ~3.1% of forehead averaged 1.08±0.49 °C (mean±SD) less than BTT° (p=0.008). Environmental and biological impacts during fanning revealed thermal imaging limitations for COVID-19 screening. Comparison of paired measurements for 100 pediatric patients showed that in the children subgroup above 37°C, BTT° exceeded body core temperature (Core°) in 60/72 patients; the average difference in the 72 patients was 0.62±0.7°C (p<0.001 by unpaired t-test); and in the subgroup beyond 37.5°C, BTT° exceeded Core° in 30/32 patients. Delineating hypothalamic activity in children facilitates early infection detection, which is essential because children’s immunogenicity prevents effective vaccination and causes accelerated viral evolution. Capturing hypothalamic thermal signals from BTT was further supported by brain thermal kinetics via BTT using wearables during anesthesia, sedation, sleep, brain injury, exercise, and asymptomatic infection, which revealed brain/core discordance and enabled automated noninvasive afebrile infection detection for interrupting asymptomatic human-to-human transmission. BTT-based spot-check thermometry can be harmlessly implemented for children worldwide without undue burden and costs; meanwhile, continuous brain-eyelid T° in concert with biological and physical principles affords a new dimension for combating pandemics. The “detection–vaccination” pair solution presented is required to mitigate COVID-19 from spreading indefinitely through mutations and vaccine evasion while opening a viable path for eradicating COVID-19.

Core Temperature Measurement—Principles of Correct Measurement, Problems, and Complications

Core temperature reflects the temperature of the internal organs. Proper temperature measurement is essential to diagnose and treat temperature impairment in patients. However, an accurate approach has yet to be established. Depending on the method used, the obtained values may vary and differ from the actual core temperature. There is an ongoing debate regarding the most appropriate anatomical site for core temperature measurement. Although the measurement of body core temperature through a pulmonary artery catheter is commonly cited as the gold standard, the esophageal temperature measurement appears to be a reasonable and functional alternative in the clinical setting. This article provides an integrative review of invasive and noninvasive body temperature measurements and their relations to core temperature.

The Impact of Elevated Body Core Temperature on Critical Power as Determined by a 3-min All-Out Test

Critical power (CP) delineates the heavy and severe exercise intensity domains, and sustained work rates above CP result in an inexorable progression of oxygen uptake to a maximal value and, subsequently, the limit of exercise tolerance. The finite work capacity above CP, W′, is defined by the curvature constant of the power-duration relationship. Heavy or severe exercise in a hot environment generates additional challenges related to the rise in body core temperature (Tc) that may impact CP and W′. The purpose of this study was to determine the effect of elevated Tc on CP and W′. CP and W′ were estimated by end-test power (EP; mean of final 30s) and work above end-test power (WEP), respectively, from 3-min "all-out" tests performed on a cycle ergometer. Volunteers (n = 8, 4 female) performed the 3-min tests during a familiarization visit and two experimental visits (Thermoneutral vs Hot, randomized crossover design). Before experimental 3-min tests, subjects were immersed in water (Thermoneutral: 36°C for 30 min; Hot: 40.5°C until Tc was ≥ 38.5°C). Mean Tc was significantly greater in Hot compared to Thermoneutral (38.5±0.0°C vs. 37.4±0.2°C; mean±SD, P<0.01). All 3-min tests were performed in an environmental chamber (Thermoneutral: 18°C, 45% RH; Hot: 38°C, 40% RH). EP was similar between Thermoneutral (239 ± 57W) and Hot (234 ± 66W; P = 0.55). WEP was similar between Thermoneutral (10.9 ± 3.0 kJ) and Hot (9.3 ± 3.6; P = 0.19). These results suggest that elevated Tc has no significant impact on EP or WEP.

Outcomes of extracorporeal membrane oxygenation and cardiopulmonary bypass in children after drowning-related resuscitation

Drowning is one of the leading causes of accidental deaths in children worldwide. However, the use of long-term extracorporeal life support (ECLS) in this setting is not widely established, and rewarming is often achieved by short-term cardiopulmonary bypass (CPB) treatment. Thus, we sought to add our experience with this means of support as a bridge-to-recovery or to-decision. This retrospective single-center study analyzes the outcome of 11 children (median 23 months, minimum–maximum 3 months–6.5 years) who experienced drowning and subsequent cardiopulmonary resuscitation (CPR) between 2005 and 2016 and who were supported by veno-arterial extracorporeal membrane oxygenation (ECMO), CPB, or first CPB then ECMO. All but one incident took place in sweet water. Submersion time ranged between 10 and 50 minutes (median 23 minutes), water temperature between 2°C and 28°C (median 14°C), and body core temperature upon arrival in the emergency department between 20°C and 34°C (median 25°C). Nine patients underwent ongoing CPR from the scene until ECMO or CPB initiation in the operating room. The duration of ECMO or CPB before successful weaning/therapy withdrawal ranged between 2 and 322 hours (median 19 hours). A total of four patients (36%) survived neurologically mildly or not affected after 4 years of follow-up. The data indicate that survival is likely related to a shorter submersion time and lower water temperature. Resuscitation of pediatric patients after drowning has a poor outcome. However, ECMO or CPB might promote recovery in selected cases or serve as a bridge-to-decision tool.

An Exploration into Vection During Virtual Helicopter Flight Using Varying Levels of Active Control and Passive Control

The illusory perception of self-motion, which is called vection, is a phenomenon that is traditionally measured in passive participants. Eliciting a compelling vection experience enhances the immersiveness of, and presence in, virtual environments. The investigation of vection during active control has mostly been done through subjective reports using single intensity stimuli for virtual locomotion or driving tasks, however, a vection study on virtual flight with varying difficulty levels appears to be missing from literature. Herein, we aimed to investigate how varying difficulty levels of active control as well as passive control of a virtual aircraft affects subjective vection intensity and objective physiological signals. Participants were visually and audibly immersed in a virtual environment in which either they or an AI controlled a virtual helicopter. Active control was facilitated by means of a stationary helicopter simulator. Galvanic skin response (GSR) and accelerations of the body core were recorded during flight and upon completion of each condition participants rated the intensity of vection and object-motion for 3 sensory modalities separately. Marginally higher vection intensity ratings compared to object-motion ratings were found and vection ratings were lightly affected by control difficulty due to weather conditions. Furthermore, participants reporting higher vection intensity ratings showed elevated changes in GSR compared to participants reporting lower vection intensity ratings. Our results show that vection can be elicited and modulated through active control with varying difficulty levels and including objective measures could elevate our understanding vection during active control tasks.

A Comparative Study on the Effectiveness of Evaporative and Phase Change Material Cooling Vests for People With Paraplegia

Personal cooling vests to alleviate thermal strain in persons with thoracic spinal cord injury (SCI), named paraplegia, were tested. Mainly, phase change material (PCM) cooling vests were the most frequent type applied at different exercises and ambient conditions. Published results of PCM cooling vests indicated its significant effect in reducing body core temperature for persons having more than 50% of their trunk skin as sensate. Nevertheless, preferences of persons with SCI obtained from subjective voting during experimental studies revealed that the use of PCM cooling vests caused additional burden weight on the body and sometimes restricted the movement. It is of interest to investigate the effect of an alternative personal evaporative cooling vest (ECV), characterized by light weight and practical use without hindering body movement of persons with SCI. In this study, it is aimed to compare the effect of ECV on the physiological and psychological responses of persons with SCI compared to that of PCM cooling vests under the same ambient conditions and metabolic rates. The research methodology included human subject experiments for persons with mid-thoracic (T4-T8) and low-thoracic (T9-T12) injury where the sensate skin of the trunk is at least 50% of its area. Thirteen participants were recruited to perform an arm-crank exercise at a constant load of 30 W for 30-min while using ECV inside a controlled climatic chamber of hot conditions (30°C, 4 0% RH). Measurements of body core and skin temperatures as well as thermal comfort and sensation, perceived exertion and skin wettedness were done. Furthermore, Multi-way ANOVA test was conducted to analyse the results of three tests: no vest (NV), with ECV, and with PCM. Findings of mid- and low-thoracic groups showed similar effectiveness of ECV compared to PCM cooling vest in reducing core temperature, yet the change in perceived exertion was better with the use of ECV due to its light weight.