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A new noninvasive core-thermometry technique, based on the use of two heat flux sensors with different very low thermal resistances, is proposed. Thermodynamically derived equations, using a pair of skin temperatures and heat fluxes detected from the sensors, can give the estimated deep body temperature (DBT) together with thermal resistance of the skin tissue itself. The validity and accuracy of this method are firstly investigated through in vitro experiments using a tissue phantom model and, secondly, as in vivo comparisons with sublingual (T sub ) or rectal temperature (T rec ) measurements in 9 volunteers, attaching the sensors around the upper sternum or the nape. Model experiments showed a good agreement between the measured and estimated temperatures, ranging from approximately 36 to 42 ℃. In vivo experiments demonstrated linear correlations between the estimated DBT and both T sub and T rec values, though the estimated DBT was 0.13 ℃ higher than T sub and 0.42 ℃ lower than T rec on average. The results also strongly suggested the possibility to estimate the tissue thermal resistance; this is discussed herein. Although further in vivo experiments under various environmental conditions are necessary, this method appears highly promising as an accurate, useful and convenient core-thermometry system for medical and healthcare settings., (© 2023. International Federation for Medical and Biological Engineering.)

Aim: The study aimed to determine the current status of face mask use, deep body temperature measurement, and active cooling in patients suffering from heat stroke and heat exhaustion in Japan., Methods: This was a prospective, observational, multicenter study using data from the Heatstroke STUDY 2020-2021, a nationwide periodical registry of heat stroke and heat exhaustion patients. Based on the Bouchama heatstroke criteria, we classified the patients into two groups: severe and mild-to-moderate. We compared the outcomes between the two groups and reclassified them into two subgroups according to the severity of the illness, deep body temperature measurements, and face mask use. Cramer's V was used to determine the effect sizes for a comparison between groups., Results: Almost all patients in this study were categorized as having degree III based on the Japanese Association for Acute Medicine heatstroke criteria (JAAM-HS). However, the severe group was significantly worse than the mild-to-moderate group in outcomes like in-hospital death and modified Rankin Scale scores, when discharged. Heat strokes had significantly higher rates of active cooling and lower mortality rates than heat stroke-like illnesses. Patients using face masks often use them during labor, sports, and other exertions, had less severe conditions, and were less likely to be young male individuals., Conclusions: It is suggested that severe cases require a more detailed classification of degree III in the JAAM-HS criteria, and not measuring deep body temperature could have been a factor in the nonperformance of active cooling and worse outcomes., (© 2023 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.)

Heatstroke is a concern during sudden heat waves. We designed and prototyped an Internet of Things system for heatstroke prevention, which integrates physiological information, including deep body temperature (DBT), based on the dual-heat-flux method. A dual-heat-flux thermometer developed to monitor DBT in real-time was also evaluated. Real-time readings from the thermometer are stored on a cloud platform and processed by a decision rule, which can alert the user to heatstroke. Although the validation of the system is ongoing, its feasibility is demonstrated in a preliminary experiment.

There is a need to rapidly screen individuals for heat strain and fever using skin temperature (T sk ) as an index of deep body temperature (T b ). This study's aim was to assess whether T sk could serve as an accurate and valid index of T b during a simulated heatwave. Seven participants maintained a continuous schedule over 9-days, in 3-day parts; pre-/post-HW (25.4 °C), simulated-HW (35.4 °C). Contact thermistors measured T sk (T forehead , T finger ); radio pills measured gastrointestinal temperature (T gi ). Proximal-distal temperature gradients (ΔT forehead-finger ) were also measured. Measurements were grouped into ambient conditions: 22, 25, and 35 °C. T gi and T forehead only displayed a significant relationship in 22 °C (r: 0.591; p < 0.001) and 25 °C (r: 0.408; p < 0.001) conditions. A linear regression of all conditions identified T forehead and ΔT forehead-finger as significant predictors of T gi (r 2 : 0.588; F: 125.771; p < 0.001), producing a root mean square error of 0.26 °C. Additional residual analysis identified T forehead to be responsible for a plateau in T gi prediction above 37 °C. Contact T forehead was shown to be a statistically suitable indicator of T gi in non-HW conditions; however, an error of ~1 °C makes this physiologically redundant. The measurement of multiple sites may improve T b prediction, though it is still physiologically unsuitable, especially at higher ambient temperatures.

Hydrogen sulfide (H 2 S) is classically known for its toxic effects. More recently H 2 S has been documented as a neuromodulator. Here we investigated the central effects of aminooxyacetate (AOA; inhibitor of the H 2 S-synthesizing enzyme cystathionine β-synthase, CBS) on cardiovascular, respiratory and thermoregulatory responses to hypercapnia in spontaneously hypertensive rats (SHR). To attain this goal we measured mean arterial pressure (MAP), heart rate (HR), ventilation (V E ), and deep body temperature (Tb) of SHR and (normotensive) Wistar Kyoto (WKY) rats before and after microinjection of AOA (9 nmol/μL) or saline into the fourth ventricle immediately followed by 30-min hypercapnia exposure (7% inspired CO 2 ). In saline-treated WKY rats, hypercapnia caused an increase in MAP accompanied by bradycardia, an increase in V E , and a drop in Tb. In AOA-treated WKY rats exposed to hypercapnia, the drug did not affect the increased MAP, potentiated the bradycardic response, attenuated the increased V E , and potentiated the drop in Tb. In saline-treated SHR, in comparison to the saline-treated WKY rats, hypercapnia elicited a minor, shorter-lasting increase in MAP with no changes in HR, evoked a greater increase in V E , and did not induce a drop in Tb. In AOA-treated SHR exposed to hypercapnia, the drug did not change the hypercapnia-induced cardiovascular and ventilatory responses while permitted a drop in Tb. Our findings indicate that AOA, an inhibitor of H 2 S production, modulates cardiorespiratory and thermoregulatory responses to hypercapnia in normotensive rats, whereas hypertension development in SHR is accompanied by suppression of the AOA effect on the cardiovascular and respiratory responses., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Cardiovascular (CV) and thermal responses to metabolically demanding multi-day military operations in extreme cold-weather environments are not well described. Characterization of these operations will provide greater insights into possible performance capabilities and cold injury risk., Methods: Soldiers from two cold-weather field training exercises (FTX) were studied during 3-day (study 1, n  = 18, age: 20 ± 1 year, height: 182 ± 7 cm, mass: 82 ± 9 kg) and 4-day (study 2, n  = 10, age: 20 ± 1 year, height: 182 ± 6 cm, mass: 80.7 ± 8.3 kg) ski marches in the Arctic. Ambient temperature ranged from -18 to -4 °C during both studies. Total daily energy expenditure (TDEE, from doubly labeled water), heart rate (HR), deep body ( T pill ), and torso ( T torso ) skin temperature (obtained in studies 1 and 2) as well as finger ( T fing ), toe ( T toe ), wrist, and calf temperatures (study 2) were measured., Results: TDEE was 6821 ± 578 kcal day -1 and 6394 ± 544 for study 1 and study 2, respectively. Mean HR ranged from 120 to 140 bpm and mean T pill ranged between 37.5 and 38.0 °C during skiing in both studies. At rest, mean T pill ranged from 36.0 to 36.5 °C, (lowest value recorded was 35.5 °C). Mean T fing ranged from 32 to 35 °C during exercise and dropped to 15 °C during rest, with some T fing values as low as 6-10 °C. T toe was above 30 °C during skiing but dropped to 15-20 °C during rest., Conclusions: Daily energy expenditures were among the highest observed for a military training exercise, with moderate exercise intensity levels (~65% age-predicted maximal HR) observed. The short-term cold-weather training did not elicit high CV and T pill strain. T fing and T toe were also well maintained while skiing, but decreased to values associated with thermal discomfort at rest.

Purpose: "Ice-mile" swimming presents significant physiological challenges and potential safety issues, but few data are available. This study examined deep body temperature (BT), respiratory rate (RR), and swim performance in 2 swimmers completing an ice-mile swim of 1 mile (1600 m) in water less than 5°C., Methods: Two male cold-water-habituated swimmers completed a 1-mile lake swim in 3.9°C water. For comparative purposes, they completed an indoor 1-mile swim in 28.1°C water. The Equivital physiological monitoring system was used to record BT and RR before, during, and after each swim. Total time to complete the swims and 400-m splits were recorded., Results: One swimmer became hypothermic after 27 min while swimming, reaching BT of 33.7°C at swim's end. On exiting the water the swimmers experienced large BT after-drops of -3.6°C and -2.4°C, reaching low points of 33.2°C and 31.3°C 38 and 23 min postswim, respectively. Respiratory rate and swim pace decreased over the course of the ice-mile swim for both swimmers. Swim pace for 1 swimmer declined sharply in the final 400-m lap of the ice mile when he was hypothermic. Both swimmers remained hypothermic 60 min postswim (34.2°C and 33.4°C)., Conclusion: Ice-mile swimmers may become hypothermic while swimming, and the postswim BT after drop may expose them to dangerous levels of hypothermia. Pace and RR should be monitored as proxies for a swimmer's physiological state. Postswim recovery should also be monitored for hypothermia for at least 1 h.

The aims of the present work were to investigate the relationships between radiant heat load, air velocity and body temperatures with or without coincidental exercise to determine the physiological mechanisms that drive thermal comfort and thermoregulatory behaviour. Seven male volunteers wearing swimming trunks in 18°C, 22°C or 26°C air were exposed to increasing air velocities up to 3 m s(-1) and self-adjusted the intensity of the direct radiant heat received on the front of the body to just maintain overall thermal comfort, at rest or when cycling (60 W, 60 rpm). During the 30 min of the experiments, skin and rectal temperatures were continuously recorded. We hypothesized that mean body temperature should be maintained stable and the intensity of the radiant heat and the mean skin temperatures would be lower when cycling. In all conditions, mean body temperature was lower when facing winds of 3 m s(-1) than during the first 5 min, without wind. When facing winds, in all but the 26°C air, the radiant heat was statistically higher at rest than when exercising. In 26°C air mean skin temperature was lower at rest than when exercising. No other significant difference was observed. In all air temperatures, high correlation coefficients were observed between the air velocity and the radiant heat load. Other factors that we did not measure may have contributed to the constant overall thermal comfort status despite dropping mean skin and body temperatures. It is suggested that the allowance to behaviourally adjust the thermal environment increases the tolerance of cold discomfort., (Copyright © 2014 Elsevier Inc. All rights reserved.)

To help pave a path toward the practical use of continuous unconstrained noninvasive deep body temperature measurement, this study aims to evaluate the structural and thermophysical effects on measurement accuracy for the dual-heat-flux method (DHFM). By considering the thermometer's height, radius, conductivity, density and specific heat as variables affecting the accuracy of DHFM measurement, we investigated the relationship between those variables and accuracy using 3-D models based on finite element method. The results of our simulation study show that accuracy is proportional to the radius but inversely proportional to the thickness of the thermometer when the radius is less than 30.0mm, and is also inversely proportional to the heat conductivity of the heat insulator inside the thermometer. The insights from this study would help to build a guideline for design, fabrication and optimization of DHFM-based thermometers, as well as their practical use., (Copyright © 2014 Elsevier Ltd. All rights reserved.)