A novel method for measuring sublingual temperature using conventional non-contact forehead thermometer

Background: Sublingual temperature measurement is a quick and accurate representation of oral temperature and corresponds closely with core temperature. Sub-lingual temperature measurement using non-contact infrared thermometers has not been studied for this purpose and if accurate they would be a reliable and convenient way of recording temperature of a patient very quickly. The aim of the study was to evaluate the utility of recording sublingual temperature using an infrared non-contact thermometer and establish its accuracy by comparing the readings with tympanic thermometer recordings. Methods: This cross-sectional study was carried out in 29 patients (328 paired recordings from sublingual and tympanic sites simultaneously). Subjects were requested to keep their mouth closed for five minutes before recording the temperature. Sublingual recordings were performed for each patient at different times of the day using an infrared thermometer. The infrared thermometer was quickly brought 1cm away from the sublingual part of the tongue and the recordings were then done immediately. Readings were compared with the corresponding tympanic temperature. Results: The non-contact sublingual temperature correlated very closely with tympanic temperature (r=0.86, p<0.001). The mean difference between the infrared sublingual and tympanic temperature was 0.21°C (standard deviation [SD]:0.48°C, 95% confidence interval [CI] of 0.16-0.27). The intra-class correlation co-efficient (ICC) between core and sublingual temperatures was 0.830 (95% CI: 0.794 to 0.861) p<0.001. The sensitivity of sublingual IR (infrared) temperature of 37.65°C was 90% and specificity was 89% for core temperature >38°C. Conclusions: This innovative modification of using the forehead infrared thermometer to measure the sublingual temperature offers an accurate, rapid and non-contact estimation of core temperature.

Development of an observational - perceptual heat strain risk assessment (OPHSRA) index and its validation

Background The thermal strain can be measured using subjective methods without the use of sensitive equipment. The purpose of the present study was the development and validation of an observational - perceptual heat strain risk assessment (OPHSRA) method. Methods This cross-sectional study, in 2019, was performed. At first, an observational-perceptual questionnaire was designed using effective items in producing heat strain. Then, the reliability and validity of the questionnaire were examined. Later, 201 male workers were asked to perform the routine tasks for 90 min under various climatic conditions after resting in a cool room. At the end of the activity, the tympanic temperature of the subjects was accurately measured. Also, the designed questionnaire was completed by researchers and participants. Then, the effect coefficients of the items were calculated and used for developing the novel index. At final, the index validity was investigated. Results The values of the content validity ratio (CVR), content validity index (CVI), and Cronbach’s coefficient alpha (α) of the designed questionnaire with 16 questions were equal to 0.793, 0.913, and 0.910, respectively. The results indicated that environmental, job, administrative, and clothing items assessed by the questionnaire with the coefficients of 0.860, 0.658, 0.783, and 0.566 had significant effects on the thermal strain, respectively. These coefficients were exploited to develop the index. The result revealed that the OPHSRA index justified 69% of the variations of the tympanic temperature (R2 = 0.69). Conclusion The novel index developed by the questionnaire had an acceptable validity. Therefore, this index can be used for estimating the risk of thermal strain in a variety of thermal conditions.

Measuring temperature in children, conveniently and accurately: a comparative study on different modalities of thermometry

Background: Fever is one of the most common complaints in children in day-to-day practice. The pattern and grade of fever provide some evidence in determining the etiology of fever. Equally important is the identification and documentation of hypothermia in neonates. Hence there is need for an accurate thermometry mode, which should also be convenient to use in children.Methods: This was a cross-sectional observation study on all the neonates and children satisfying the inclusion criteria. Infrared forehead thermometer and digital axillary thermometer were used to record temperature and compared with Infrared tympanic temperature which was taken as gold standard.Results: A total of 240 neonates and children were evaluated. Strong positive correlation was observed between Means of Forehead Thermometer (FT) and Ear Thermometer (ET) with correlation coefficient of 0.777 and p value <0.001. Similar correlation was also observed with Axillary Temperature (AT) with correlation coefficient of 0.944 and p<0.001.Conclusions: Non-contact Infrared thermometer may be used in neonates and children without causing discomfort. It gives instant and comparable readings which are especially significant in the current coronavirus disease (COVID) pandemic setting.

Dilution Method of Menthol Solutions Affects Subsequent Perceptual Thermal Responses during Passive Heat Exposure in Non-Heat Acclimated Participants

Due to its volatility, the qualitative experience of menthol may be modulated by its preparation and combination with other compounds. One such method of preparation is dilution, with two dilution methods existing within the sport and exercise science literature, where menthol is used to impart feelings of oral cooling and improve thermal comfort and sensation during heat exposure. This study compared these two dilution methods; one using a solvent the other using temperature, via a randomized counterbalanced repeated measures design (n = 12; Height: 174.0 ± 8.5 cm Mass: 73.4 ± 13.3 kg Age: 28.7 ± 8.4 y; two exposures to each solution) to assess the effect of solution and heat exposure, upon thermal comfort, thermal sensation and associated physiological parameters in non-heat acclimated participants. Thermal comfort was significantly affected by solution (p = 0.041; η2 = 0.017) and time (p < 0.001; η2 = 0.228), whereas thermal sensation was significantly affected by time only (p = 0.012; η2 = 0.133), as was tympanic temperature (p < 0.001; η2 = 0.277). Small to moderate clear differences between solutions at matched time points were also observed. These trends and effects suggest that, depending upon the dilution method employed, the resultant perceptual effects are likely impacted; this also likely depends upon the timing of menthol administration within a heat exposure session.

Impact of Personal Cooling on Performance, Comfort and Heat Strain of Healthcare Workers in PPE, a Study From West Africa

Background: Personal protective equipment (PPE) is an essential component of safely treating suspected or confirmed SARS-CoV-2 patients. PPE acts as a barrier to heat loss, therefore increasing the risk of thermal strain which may impact on cognitive function. Healthcare workers (HCWs) need to be able to prioritize and execute complex tasks effectively to ensure patient safety. This study evaluated pre-cooling and per-cooling methods on thermal strain, thermal comfort and cognitive function during simulated emergency management of an acutely unwell patient.Methods: This randomized controlled crossover trial was run at the Clinical Services Department of the Medical Research Unit The Gambia. Each participant attended two sessions (Cool and Control) in standard PPE. Cool involved pre-cooling with an ice slurry ingestion and per-cooling by wearing an ice-vest external to PPE.Results: Twelve participants completed both sessions. There was a significant increase in tympanic temperature in Control sessions at both 1 and 2 h in PPE (p = 0.01). No significant increase was seen during Cool. Effect estimate of Cool was −0.2°C (95% CI −0.43; 0.01, p = 0.06) post 1 h and −0.28°C (95% CI −0.57; 0.02, p = 0.06) post 2 h on tympanic temperature. Cool improved thermal comfort (p &lt; 0.001), thermal sensation (p &lt; 0.001), and thirst (p = 0.04). No difference on cognitive function was demonstrated using multilevel modeling.Discussion: Thermal strain in HCWs wearing PPE can be safely reduced using pre- and per-cooling methods external to PPE.

Effect of a single dose of oral azithromycin on malaria parasitaemia in children: a randomized controlled trial

Background Azithromycin has recently been shown to reduce all-cause childhood mortality in sub-Saharan Africa. One potential mechanism of this effect is via the anti-malarial effect of azithromycin, which may help treat or prevent malaria infection. This study evaluated short- and longer-term effects of azithromycin on malaria outcomes in children. Methods Children aged 8 days to 59 months were randomized in a 1:1 fashion to a single oral dose of azithromycin (20 mg/kg) or matching placebo. Children were evaluated for malaria via thin and thick smear and rapid diagnostic test (for those with tympanic temperature ≥ 37.5 °C) at baseline and 14 days and 6 months after treatment. Malaria outcomes in children receiving azithromycin versus placebo were compared at each follow-up timepoint separately. Results Of 450 children enrolled, 230 were randomized to azithromycin and 220 to placebo. Children were a median of 26 months and 51% were female, and 17% were positive for malaria parasitaemia at baseline. There was no evidence of a difference in malaria parasitaemia at 14 days or 6 months after treatment. In the azithromycin arm, 20% of children were positive for parasitaemia at 14 days compared to 17% in the placebo arm (P = 0.43) and 7.6% vs. 5.6% in the azithromycin compared to placebo arms at 6 months (P = 0.47). Conclusions Azithromycin did not affect malaria outcomes in this study, possibly due to the individually randomized nature of the trial. Trial registration This study is registered at clinicaltrials.gov (NCT03676751; registered 19 September 2018).

Effects of Acacia Honey Drink after Exercise-Induced Dehydration on Selected Physiological Parameters and Subsequent Running Performance

This study examined the effect of honey supplementation on exercise performance and biochemical markers in comparison to plain water and sports drink in the heat. Ten recreational athletes (Age: 22.2 ± 2.0 years, weight: 65.7 ± 5.3 kg; height: 170.4 ± 3.5 cm; VO2max: 51.5 ± 3.7 mL.kg−1.min−1) participated in this study. Participants ran at 70% of their VO2max for 1 h in a pre-load phase (Run-1), followed by a rehydration phase for 2 h and then a 20 min self-paced time trial (Run-2). After Run-1, participants drank either Acacia honey, sports drink or plain water with an amount equivalent to 150% of body weight loss. Subsequently, the participants performed the 20 min self-paced time trial. Acacia honey elicited an improved running time trial performance with a significantly (p<0.05) longer distance ran compared to plain water trial, but it was not different from the sports drink trial. In addition, there was no significant difference in running performance between sports drink and plain water trials. Plasma glucose, insulin and free fatty acids were significantly (p<0.05) higher in H and sports drink compared to the W trial during the rehydration phase. There were no significant differences in body weight changes, oxygen uptake, heart rate, rate of perceived exertion, tympanic temperature, plasma volume changes, plasma cortisol, urine osmolality, volume, and specific gravity among the three trials. Thus, Acacia honey can be recommended to be used as a rehydration drink for individuals who train and compete in the heat.

Effect of Wearing Different Types of Face Mask to Heat Strain During Physical Activities

There is a concern to use masks during physical activities when exercising and working. Wearing masks during physical activity will pose a risk to physiological changes in the body and human heat strain by the principle of a mask can block the respiratory tract. This study aims to determine how much the human physiological changes quantitatively and qualitatively when using different types of medical masks, cloths and N95. There were 10 respondents as a sample of this study. The results obtained show that the different types of masks to the physiological response of the human body, cloth masks can affect the physiological changes the highest compared to medical masks and N95. The subjective response in the form of thermal comfort, mask sensation, and thermal sensation shows that of the 3 types of masks, the N95 mask is the mask that is the most uncomfortable when worn. The recommendations of the 3 types of masks are medical masks because they affect the slightest increase in the risk of heat stress while the cloth masks have the highest increase in tympanic temperature and Physiological Strain Index.

The Effects of Caffeine on Jumping Performance and Maximal Strength in Female Collegiate Athletes

Caffeine is often used in a variety of forms to enhance athletic performance; however, research regarding caffeine’s effects on strength and power in female athletes is lacking. Therefore, the purpose of this study was to analyze the acute effects of caffeine anhydrous (6 mg/kg of body mass) on jumping performance and maximal strength in female collegiate athletes. Eleven athletes (19.7 ± 0.9 yrs; 166.4 ± 10.2 cm, 67.7 ± 9.4 kg) performed two testing sessions separated by one week, and randomly received caffeine or placebo using a double-blind approach. Heart rate, blood pressure, and tympanic temperature were recorded before athletes received each condition, following 60 min of quiet sitting, and directly after performance testing. Athletes were assessed on unweighted and weighted squat jump height (SJH0, SJH20) and countermovement jump height (CMJH0, CMJH20), isometric mid-thigh pull peak force (IPF), and rate of force development from 0–200 ms (RFD200). Resting systolic blood pressure was significantly greater following caffeine administration compared to a placebo (p = 0.017). There were small, significant differences in SJH0 (p = 0.035, g = 0.35), SJH20 (p = 0.002, g = 0.49), CMJH0 (p = 0.015, g = 0.19), and CMJH20 (p < 0.001, g = 0.37) in favor of caffeine over placebo. However, there was no significant difference in IPF (p = 0.369, g = 0.12) and RFD200 (p = 0.235, g = 0.32) between conditions. Therefore, caffeine appears to enhance jumping performance, but not maximal strength in female collegiate athletes.