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Severely burned patients suffer from both coagulopathy and hypothermia, with a lack of international consensus and appropriate treatment guidelines. This study examines recent developments and trends in coagulation and temperature management in European burn centers. A survey was sent to burn centers in Switzerland, Austria and Germany in 2016 and again in 2021. The analysis was performed using descriptive statistics, with categorical data reported in absolute numbers (n) and percentages (%) and numerical data reported as mean and standard deviation. The rate of completed questionnaires was 84 % (16 of 19 questionnaires) in 2016 and 91 % (21 of 22 questionnaires) in 2021. The number of global coagulation tests performed has decreased over the observation period in favor of single factor determination and bed-side point-of-care coagulation tests. This has also led to increased administration of single factor concentrates in therapy. Although many centers had a defined treatment protocol for hypothermia in 2016, coverage increased such that in 2021 all centers surveyed had such a protocol. The body temperature was measured more consistently in 2021; thus, hypothermia was more actively sought, detected and treated. A point-of-care guided, factor-based coagulation management and the maintenance of normothermia have gained importance in the care of burn patients in recent years. Severely burned patients are at particular risk of developing burn-induced coagulopathy or perioperative hypothermia. Clear guidelines regarding coagulation and temperature management are largely absent in the care of severely burned patients. In recent years, point-of-care guided, factor-based coagulation management has gained importance in European burn centers. The high rate of hypothermia management concepts in 2016 was further expanded in 2021. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of a warming care protocol (WCM) on temperature control and thermal comfort perception in hypothermia following major abdominal surgery. A prospective nonrandomized controlled trial. A total of 54 patients undergoing major abdominal surgery were assigned to receive routine care (control group, 27 patients) or the WCM (intervention group, 27 patients). The body temperature (core and peripheral) was measured, and physical symptoms were monitored every hour for 4 hours after arriving at the ward and then every 4 hours for up to 12 hours. The temperature gap, calculated as the difference between the core and skin temperatures, was similar between the control and intervention groups at the end of surgery. However, the temperature gap in the intervention group decreased within 3 hours after arrival at the ward and remained lower than that in the control group. The visual analog scale score for postoperative thermal discomfort was significantly lower in the intervention group than in the control group, indicating achievement of higher comfort with the warming intervention. Patients were warmed using active warming methods under the WCM, which in turn increased the thermal comfort perception with the body temperature. Postoperative patients often require warming care for thermal comfort, which may be improved by proper observation and management within 1 to 2 hours postoperatively. Our results indicate that nurses could effectively warm the patient to maintain normal body temperature following surgery not only to improve thermal comfort, but also to prevent shivering and possibly various postoperative complications. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest that volatile anaesthetics are safe, efficient, and reliable alternatives to the use of intravenous anaesthetics for out-of-hospital cardiac arrest (OHCA) patients admitted to the intensive care unit (ICU). We hypothesised that volatile anaesthetics may reduce the incidence of delirium rather than intravenous sedatives. This retrospective study aimed to investigate whether sevoflurane combined with higher targeted temperature management could decrease the incidence of delirium when compared with intravenous anaesthetics with lower targeted temperature management.Methods: Using a propensity score-matched analysis, we retrospectively compared a target temperature management (32-34 °C) method along with intravenous sedation (TTM-33/IV) and a modified target temperature management (34-36 °C) method along with sevoflurane sedation (mTTM-36/sevo). We used the confusion assessment method for the ICU to measure the incidence of delirium. We calculated the time-dependent risk on delirium using the multivariate Cox regression model.Results: The incidence of delirium was significantly lower (p = 0.001) in OHCA patients of the mTTM-36/sevo group (9/56, 16.1%) than in those of the TTM-33/IV group (25/67, 37.3%). Mechanical ventilation and lengths of stay in the ICU (p < 0.001) and hospital stay (p = 0.04) were shorter in the mTTM-36/sevo group. Patients in the TTM-33/IV group required more midazolam, propofol, and fentanyl. We observed no significant difference in mortality.Conclusion: A multimodal sevoflurane-based sedation regimen together with targeted temperature management resulted in a lower incidence of delirium and a shorter duration for mechanical ventilation and ICU length of stay than did the treatment with intravenous sedation combined with the classical cooling protocol. [ABSTRACT FROM AUTHOR]

This paper presents high-performance Ni-YSZ tubular catalysts for CO 2 methanation prepared by the extrusion molding. We fabricated tubular-shaped Ni-YSZ catalysts with various Ni contents (25–100 wt% NiO) and investigated the effect of Ni content on CO 2 methanation performance under various temperatures and gas flow rates. Catalysts with Ni contents >75 wt% showed CH 4 yields >91% above 270 °C with high CH 4 selectivities (>99%). High CH 4 yields were also observed under high GHSVs at 300 °C: 93% and 92% at 8700 and 17,500 h−1, respectively. Investigation of methanation with the catalysts revealed that CO 2 methanation was accelerated by a localized hotspot at the reactor inlet arising from the interaction between reaction kinetics and heat generation. Using a numerical simulation, we considered the optimum arrangement of catalytic activity in the reactor to avoid hotspot generation and realize a stable high CO 2 methanation performance. We can simultaneously achieve high CH 4 production and prevent hotspot formation by properly arranging catalysts with different activities. • Ni content >75% gave CH 4 yields >91% above 270 °C with selectivities >99%. • Inlet hotspot arises from interaction of heat generation and reaction acceleration. • Increasing catalytic activity along reactor length can avoid hotspot formation. [ABSTRACT FROM AUTHOR]

• A temperature control system with controllable loop thermosyphon is designed. • Heat transfer and temperature management behaviours are examined. • Controllable loop thermosyphon provides heat transfer capability above 40 W in the long-term test. • Temperature control accuracy is significantly improved to 0.4 °C by shortening start-stop cycle. The loop thermosyphon with active heat transfer control capability is a promising solution for the temperature management of the fresh food compartment of cool-storage refrigerators or other precise temperature control devices. However, the frequently start-stop operating mode of the loop thermosyphon has not received enough attention, its active temperature management behaviours still requires further investigation. In this study, a controllable loop thermosyphon used in the temperature control of a fresh food compartment is developed and its start-stop is controlled by the temperature controller with the assistance of two magnetic valves. The performances of the controllable loop thermosyphon in long-term and start-stop operating modes are tested. The controllable loop thermosyphon with 35% filling ratio present highest heat transfer rate, reliable heat transfer capability, and good stability for the varying temperatures in the fresh food compartment. Based on this filling ratio, the heat transfer rate remains higher than 40 W during the long-term operating test. When the controllable loop thermosyphon operates in the start-stop mode, the start-stop cycle decreases from 39.4 min to 27.2 min and the operating ratio increases from 12.6% to 53.7% as the temperature of the fresh food compartment rises. Particularly, when the start-stop cycle reduces from 42.6 min to 18.1 min, the temperature control accuracy is improved from 2.0 °C to 0.4 °C. The results demonstrate that the controllable loop thermosyphon is promising as a novel precise temperature management device and is qualified for the use in cool-storage refrigerators. [ABSTRACT FROM AUTHOR]

Targeted temperature management (TTM) in comatose survivors of out-of-hospital cardiac arrest has been associated with improved neurological outcomes. However, the optimal temperature target for TTM remains unclear. To compare a TTM protocol targeted at 34–36°C with a protocol targeted at 32–34°C with reference to both clinical outcomes and acute complications. We analyzed a prospective registry of consecutive out-of-hospital cardiac arrest survivors who underwent TTM. We compared patients on a TTM protocol targeted at 34–36°C (n = 59) with a historical cohort of patients treated at 32–34°C (n = 116) according to the following parameters: six-month survival, cerebral performance category (CPC) scores, and acute complications. Survival and favorable neurological outcomes (CPC ≤ 2) at six months were 56% and 49%, respectively, in the higher target temperature group vs. 66% and 61%, respectively, in the lower target temperature group (p = 0.18 and 0.13). Acute clinical complications occurred in 1.5% vs. 12% of patients treated at the higher vs. the lower temperature range (p = 0.02). Patients treated with TTM at 34–36°C had similar mid-term survival and neurological outcomes as patients treated with TTM at 32–34°C. However, patients treated within the higher temperature range had fewer acute complications. [ABSTRACT FROM AUTHOR]

Abstract Forced-air precooling of strawberries is rarely ideal due to the non-uniform cooling rate inside precooling facilities and the simple heuristics used to select precooling duration. The aim of this work was to investigate the product temperature distribution during commercial forced-air precooling of strawberries, quantify the relationship between the ambient and product temperature and assess precooling durations. Our field studies showed that the half-cooling time (HCT) on the inside of precooling tunnels is approximately twice the HCT on the outside, facing the incoming air, but is relatively constant along the length of the tunnel and vertically within pallets. The HCT on the outside of the tunnel is strongly correlated to the HCT on the inside, enabling temperature predictions from a limited number of sensors. Temperature variations of up to 7 °C were observed at the end of precooling, suggesting that precooling should be extended in some instances to improve uniformity. Highlights • The temperature was monitored at different locations during forced-air precooling. • Differences of up to 8 °C in initial temperature can be observed within the same tunnel. • The temperature distribution in the tunnel can potentially be mapped from a few sensors. • In many instances, precooling duration should be extended to improve uniformity. [ABSTRACT FROM AUTHOR]

Abstract Tablet computers (PCs) are continuously moving towards light, thin, and small shape factors to achieve an eye appealing design while providing extreme mobility. The increased integration of electronic components with high power density, smaller size, and more compact layout is leading to exceptionally high operating temperatures for tablet PCs. This research focuses on development of an inexpensive and practical solution for thermal management for tablet PCs using phase change materials (PCMs) encapsulated in thin aluminized laminated film. In this paper, the performance of the tablet PC with this PCM thermal energy storage (TES) unit under continuous operation was investigated. PT-37, a commercial PCM from PureTemp, and n -eicosane were used as PCMs, as they have been shown to be safe and relatively inexpensive, and have melting temperatures in the range suitable for thermal management of portable electronics such as tablet PCs. It was found that the insertion of the thin PCM-based TES system within that tablet PC resulted in a reduction of the rate of temperature increase, for both the electronics and the tablet cover, during the transient start-up phase of operation; leading ultimately, to lower operating temperature of the entire tablet. Findings from this research confirm that the implementation of PCM–based TES unit is a viable option for thermal management of tablet PCs. Highlights • Evaluated a novel PCM-based TES unit to control temperature of today's slim Tablet PCs. • The PCMs used have melting temperatures in the range of 36–37 °C: n -eicosane and PT37. • Experiments show reduction of the electronic temperatures during 60-minutes of continuous operation. • Also resulted in a temperature reduction after 60 min of operation of the cover of the tablet PC. • Influence of orientation mostly negligible, as the slight variation in thermal conductivity between the two PCMs. [ABSTRACT FROM AUTHOR]

The guidelines on temperature control for comatose cardiac arrest survivors were recently changed from recommending targeted temperature management (32–36 °C) to fever control (≤37.7 °C). We investigated the effect of implementing a strict fever control strategy on prevalence of fever, protocol adherence, and patient outcome in a Finnish tertiary academic hospital. Comatose cardiac arrest survivors treated with either mild device-controlled therapeutic hypothermia (≤36 °C, years 2020–2021) or strict fever control (≤37 °C, year 2022) for the first 36 h were included in this before-after cohort study. Good neurological outcome was defined as a cerebral performance category score of 1–2. The cohort consisted of 120 patients (≤36 °C group n = 77, ≤37 °C group n = 43). Cardiac arrest characteristics, severity of illness scores, and intensive care management including oxygenation, ventilation, blood pressure management and lactate remained similar between the groups. The median highest temperatures for the 36 h sedation period were 36.3 °C (≤36 °C group) vs. 37.2 °C (≤37 °C group) (p < 0.001). Time of the 36 h sedation period spent >37.7 °C was 0.90% vs. 1.1% (p = 0.496). External cooling devices were used in 90% vs. 44% of the patients (p < 0.001). Good neurological outcome at 30 days was similar between the groups (47% vs. 44%, p = 0.787). In multivariable model the ≤37 °C strategy was not associated with any change in outcome (OR 0.88, 95% CI 0.33–2.3). The implementation strict fever control strategy was feasible and did not result in increased prevalence of fever, poorer protocol adherence, or worse patient outcomes. Most patients in the fever control group did not require external cooling. [ABSTRACT FROM AUTHOR]

[Display omitted] • Composite yarn with photo-thermoelectric and antibacterial properties is prepared. • Composite antimicrobial agent (Ketoconazole/nano ZnO) is used. • Photo-thermoelectric effect can heat our body and enhance antibacterial ability. Antibacterial textiles play an important role in preventing the spread of infectious diseases. However, the development of their application is limited due to the lack of controlled release of antibacterial agents, low antibacterial efficiency and poor antibacterial durability under high temperature environment. The preparation of antimicrobial nanofibers by heating-controlled release and electrospinning may be an effective solution. In this paper, we prepared twisted composite yarns with high abrasion resistance, excellent electrothermal properties, light properties, antibacterial properties and slow-release properties using the technique of conjugate electrospinning combined with the conventional twisting process. With an applied voltage of 2 V, the temperature of the composite twisted fabric can reach 45 ℃, which obviously promotes the release of antibacterial agent in the nanofiber compared with the normal temperature. The photo thermoelectric properties of the yarn also enable body temperature management, with heating to high temperatures at low voltages. In addition, the twisted composite yarn inhibited S. aureus , E. coli and C. albicans up to 99.6 %, 95.7 % and 72.5 %, respectively, and the inhibition rate was almost unchanged after 20 times of water washing. The twisted composite yarn reported in the present article would provide a new methodology for to multi-functional textiles. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial.Methods: The TTM trial randomized 939 patients to TTM at 33 or 36°C for 24h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed.Results: OHCA patients having a temperature ≤34.0°C on arrival at hospital had a significantly higher mortality compared to the OHCA patients with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation (ROSC) and duration of transport time to hospital. Patients who were actively cooled or passively rewarmed during the first 4h had similar mortality. In a multivariate logistic regression model mortality was significantly related to time from OHCA to ROSC, time from OHCA to advanced life support (ALS), age, sex and first registered rhythm. None of the temperature related variables (included the TTM-groups) were significantly related to mortality.Conclusion: OHCA patients with a temperature ≤34.0°C on arrival have a higher mortality than patients with a temperature ≥34.1°C on arrival. A low temperature on arrival is associated with a long time to ROSC. Temperature changes and TTM-groups were not associated with mortality in a regression model. [ABSTRACT FROM AUTHOR]

The use of therapeutic hypothermia (TH) and targeted temperature management (TTM) for severe traumatic brain injury (TBI) has been tested in a variety of preclinical and clinical situations. Early preclinical studies showed that mild reductions in brain temperature after moderate to severe TBI improved histopathological outcomes and reduced neurological deficits. Investigative studies have also reported that reductions in post-traumatic temperature attenuated multiple secondary injury mechanisms including excitotoxicity, free radical generation, apoptotic cell death, and inflammation. In addition, while elevations in post-traumatic temperature heightened secondary injury mechanisms, the successful implementation of TTM strategies in injured patients to reduce fever burden appear to be beneficial. While TH has been successfully tested in a number of single institutional clinical TBI studies, larger randomized multicenter trials have failed to demonstrate the benefits of therapeutic hypothermia. The use of TH and TTM for treating TBI continues to evolve and a number of factors including patient selection and the timing of the TH appear to be critical in successful trial design. Based on available data, it is apparent that TH and TTM strategies for treating severely injured patients is an important therapeutic consideration that requires more basic and clinical research. Current research involves the evaluation of alternative cooling strategies including pharmacologically-induced hypothermia and the combination of TH or TTM approaches with more selective neuroprotective or reparative treatments. This manuscript summarizes the preclinical and clinical literature emphasizing the importance of brain temperature in modifying secondary injury mechanisms and in improving traumatic outcomes in severely injured patients. This article is part of a Special Issue entitled SI:Brain injury and recovery . [ABSTRACT FROM AUTHOR]

Background: The importance of acute-phase brain temperature management is widely accepted for prevention of exacerbation of brain damage by a high body temperature.Methods: In this study, we investigated the influence of body temperature in the early postoperative period on the outcomes of 62 patients with subarachnoid hemorrhage who were admitted to our department. Body temperature was measured from day 4 to day 14 after onset. The patients were divided into those treated with surgical clipping (clip group) and coil embolization (coil group), those graded I-III (mild) and IV-V (severe) based on the Hunt & Hess classification on admission, those with and without development of delayed cerebral ischemia (DCI), and those with favorable and poor outcomes. Body temperatures throughout the hospital stay were compared in each group.Results: There was no significant difference in body temperature between the clip and coil groups or between the mild and severe groups, but body temperature was significantly higher in patients with DCI compared to those without DCI, and in patients with a poor outcome compared to those with a favorable outcome.Conclusions: Fever in the early postoperative period of subarachnoid hemorrhage is associated with development of DCI and a poor outcome. [ABSTRACT FROM AUTHOR]

For more than a decade, mild induced hypothermia (32 °C-34 °C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurological benefit with mild induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33 °C or 36 °C. In response to these new data, the International Liaison Committee on Resuscitation Advanced Life Support Task Force performed a systematic review to evaluate 3 key questions: (1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients? (2) If used, what is the ideal timing of the intervention? (3) If used, what is the ideal duration of the intervention? The task force used Grading of Recommendations Assessment, Development and Evaluation methodology to assess and summarize the evidence and to provide a consensus on science statement and treatment recommendations. The task force recommends targeted temperature management for adults with out-of-hospital cardiac arrest with an initial shockable rhythm at a constant temperature between 32 °C and 36 °C for at least 24 hours. Similar suggestions are made for out-of-hospital cardiac arrest with a nonshockable rhythm and in-hospital cardiac arrest. The task force recommends against prehospital cooling with rapid infusion of large volumes of cold intravenous fluid. Additional and specific recommendations are provided in the document. [ABSTRACT FROM AUTHOR]

Background Timing of coronary angiography (CAG) is still controversial in the out-of-hospital cardiac arrest survivors who present without ST-segment elevation. Methods and results We analysed a prospective registry of 158 comatose survivors of out-of-hospital cardiac arrest. For further analysis, we included 99 patients without ST-segment elevation on the initial electrocardiogram. All patients underwent temperature management. Urgent CAG (<2 h from admission) was performed in 25% of the patients. A definite cause of the cardiac arrest could be identified during the index hospitalization in 82 patients: 36 had a non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and 46 had a non-ACS diagnosis. Eighty-seven patients (88%) survived the index hospitalization and 65 (66%) were alive at six months. A favourable neurological status (cerebral performance category ≤2) was observed in 56% of the patients at discharge and in 56% after six months of follow-up. Neither the survival nor the neurological outcome differed between the patients in whom the CAG was performed urgently upon the admission and the patients in whom the CAG was initially not performed, regardless of the aetiology of the cardiac arrest. On the other hand, performing an urgent CAG was safe and it did not prolong the average time to achieve an effective hypothermia. Conclusions Performing an urgent CAG in comatose cardiac arrest survivors without ST-segment elevation was not associated with better clinical and neurological outcome as compared to the initially conservative approach. [ABSTRACT FROM AUTHOR]

Abstract: In this study, new temperature monitoring method for solid oxide fuel cells (SOFCs) was proposed, and the demonstration using micro-tubular SOFCs has done. The fabricated micro-tubular SOFCs were operated under the two different conditions, and polarization during the power generation was measured. The cell resistance as a function temperature was also measured. Based on the temperature dependence of cell resistance and the measured ohmic drop during the power generation, the cell temperature was estimated. The estimated cell temperature clearly depended on operation condition and increased with increasing of the current density. The estimated cell temperature was also in nearly proportion to the temperature which was measured by a thermocouple, and it was conformed that this temperature monitoring method by electrochemical technique certainly functioned. [Copyright &y& Elsevier]

Prevention and treatment of homeostatic disorders after central neurosurgical procedures requires a coordinated effort by the entire medical team caring for the patient. The goal of management is to optimize physiologic and metabolic variables so that patient outcome is improved. This chapter reviews current knowledge and clinical approaches to prevention and treatment of general homeostatic disorders that commonly complicate the postoperative course of neurosurgical patients after general anesthesia. Practice recommendations based on current clinical trials and experience will be made on the following topics: therapeutic approaches to optimal hemoglobin, cerebral blood flow and hemorrheology; prophylaxis and treatment of thrombosis; temperature management including rewarming and the control of shivering; use and side effects of anticonvulsants and corticosteroids; and therapeutic approaches to optimal serum glucose levels. [Copyright &y& Elsevier]

[Display omitted] • A field-scale demonstration setup was used to investigate particle growth and removal. • Particle size in actual flue gas was analyzed. • 80.05% particle removal efficiency could be achieved by heat exchanger. • The strategy of temperature management to control the pollutants was obtained. Flue gas generated from coal combustion is the primary source of air pollution. Temperature is an essential parameter for the treatment process of flue gas pollutants. In this study, a field-scale demonstration setup was used to investigate the effect of temperature on particle growth and removal by using actual flue gas. The ionic migration in heat exchanger was also studied, and a temperature management method was established. Results showed that the temperature had a substantial influence on particle growth and removal, the outlet particle median diameter increased from 0.116 µm to 0.155 µm, and the outlet particle mass concentration decreased from 7.05 mg/Nm3 to 4.49 mg/Nm3 when the flue gas temperature difference was 2.9–4.6 K. Changing the boiler load from 100% to 65% led to the increase in the particle removal efficiency from 78.06% to 80.33%. This increment was mainly related to the changes in temperature. In addition, when the temperature difference increased from 2.9 K to 4.6 K, the concentration of the ions in the sample significantly increased, and the removal amount of mercury was enhanced by 2.57 times. The pollutant in the flue gas was effectively removed by the temperature management installation between the wet flue gas desulfurization and wet electrostatic precipitator. [ABSTRACT FROM AUTHOR]

In this study, the electronic board temperature management using heat sinks containing pure and microencapsulated phase change materials (PCMs) was investigated experimentally. PCMs were selected based on the board critical temperature (80 °C). Effect of heat sink configurations, pure and microencapsulated PCMs, volume fractions of PCMs, and a wide range of electric power (5-18 W) in two states of fixed and pulsed power was examined on the board temperature behavior. Results showed that the square 7fins heat sink has the best performance compared to square 3fins and circular 12fins heat sinks. Duration times to reach the critical temperature for stearic acid, lauric acid, paraffin as pure PCMs, and PX52 and GR42 as commercial microencapsulated PCMs were 33, 31, 36, 32, and 26 min, respectively. It reveals that PX52 could be a comparable candidate to pure PCMs. Results showed that the operating time increases with volume fraction of PX52, proportionally. Consecutive heating-cooling cycles presented that the peak temperature for PX52 after heating range was lower than that for pure PCMs in the same conditions due to the higher heat transfer rate, although PX52 had less latent heat. Microencapsulated PCMs with many advantages can be good options to control the temperature of electronic components. [ABSTRACT FROM AUTHOR]