Development of a novel scheme for long-term body temperature monitoring: a review of benefits and applications

Body temperature is a health or disease marker that has been in clinical use for centuries. The threshold currently applied to define fever, with small variations, is 38 °C. However, current approaches do not provide a full picture of the thermoregulation process and its correlation with disease. This paper describes a new non-invasive body temperature device that improves the understanding of the pathophysiology of diseases by integrating a variety of temperature data from different body locations. This device enables to gain a deeper insight into fever, endogenous rhythms, subject activity and ambient temperature to provide anticipatory and more efficient treatments. Its clinical use would be a big step in the overcoming of the anachronistic febrile/afebrile dichotomy and walking towards a system medicine approach to certain diseases. This device has already been used in some clinical applications successfully. Other possible applications based on the device features and clinical requirements are also described in this paper.Cuesta Frau, D.; Varela Entrecanales, M.; Valor Pérez, R.; Vargas, B. (2015). Development of a novel scheme for long-term body temperature monitoring: a review of benefits and applications. Journal of Medical Systems. 39(4):1-7. doi:10.1007/s10916-015-0209-3S17394Gai, M., Merlo, I., Dellepiane, S., Cantaluppi, V., Leonardi, G., Fop, F., Guarena, C., Grassi, G., and Biancore, L., Glycemic pattern in diabetic patients on hemodialysis: Continuous Glucose Monitoring (CGM) analysis. Blood Purif. 38(1):68–73 , 2014.Kondziella, D., Friberg, C.K., Wellwood, I., Reiffurth, C., Fabricius, M., and Dreier, J.P.: Continuous EEG monitoring in aneurysmal subarachnoid hemorrhage: A systematic review. Neurocrit. Care (2014)Ciccone, A., Celani, M.G., Chiaramonte, R., Rossi, C., and Righetti, E., Continuous versus intermittent physiological monitoring for acute stroke. Cochrane Database Syst. Rev. 31, 2013.Kushimoto, S., Yamanouchi, S., Endo, T., Sato, T., Nomura, R., Fujita, M., Kudo, D., Omura, T., Miyagawa, N., and Sato, T., Body temperature abnormalities in non-neurological critically ill patients: A review of the literature. J. Intensive Care 2, 2014.Mc Callum, L., and Higgings, D., Measuring body temperature. Nursing Times 108:20–22, 2012.Varela, M., Ruiz-Esteban, R., Martinez-Nicolas, A., Cuervo-Arango, A., Barros, C., and Delgado, E.G., Catching the spike and tracking the flow: Holter-temperature monitoring in patients admitted in a general internal medicine ward. Int. J. Clin. Pract. 65(12):1283–1288, 2011.Lopes, F., Peres, D., Bross, A., Melot, C., and Vincent, J.L., Serial evaluation of the SOFA score to predict outcome in critically ill patients. J. Am. Med. Assoc. 286:1754–1758, 2001.Vincent, J.L., and Moreno, R., Clinical review: Scoring systems in the critically ill. Crit. Care, 14, 2010.Sund-Levander, M., and Grodzinsky, E., Time for a change to assess and evaluate body temperature in clinical practice. Int. J. Nurs. Pract. 15:241–249, 2009.Cuesta-Frau, D., Varela, M., Aboy, M., and Miro, P., Description of a portable wireless device for body temperature acquisition and analysis. Sensors 9(10):7648–7663, 2009.Varela, M., Cuesta-Frau, D., Madrid, J.A., Churruca, J., Miro-Matinez, P., Ruiz, R., and Marinez, C., Holter monitoring of central peripheral temperature: Possible uses and feasibility study in outpatient settings. J. Clin. Monit. Comput. 4(23):209–216, 2009.Jordan, J., Miro, P., Cuesta-Frau, D., Varela, M., and Vargas B.: Aplicacion de analisis multivariante para la deteccion de estados prefebriles en pacientes ingresados (in Spanish), XXXIV Congreso Nacional de Estadistica e Investigacion Operativa, Castellon (Spain) (2013)Richman, J., and Moorman, J.R., Physiological time-series analysis using approximate entropy and sample entropy. Am. J. Physiol. Heart Circ. Physiol. 278(6):H2039–2049, 2000.Young, P., Saxena, M., Eastwood, G.M., Bellomo, R., and Beasley, R., Fever and fever management among intensive care patients with known or suspected infection: A multicentre prospective cohort study. Crit. Care Resusc. 13:97–102 , 2011.Drewry, A.M., Fuller, B.M., Bailey, T.C., and Hotchkiss, R.S., Body temperature patterns as a predictor of hospital-acquired sepsis in afebrile adult intensive care unit patients: A case-control study. Crit. Care,17, 2013.Musher, D., Fainstein, V., Young, E., and Pruett, T., Fever patterns. Their lack of significance. Arch. Intern. Med. 139(11):1225–8, 1979.Varela, M., Calvo, M., Chana, M., Gomez-Mestre, I., Asensio, R., and Galdos, P., Clinical implications of temperature curve complexity in critically ill patients. Crit. Care Med. 33(12):2764–2771, 2005.Varela, M., Churruca, J., Gonzalez, A., Martin, A., Ode, J., and Galdos, P., Temperature curve complexity predicts survival in critically ill patients. Am. J. Respir. Crit. Care Med. 174(3):290–298, 2006.Cuesta-Frau, D., Varela, M., Miro, P., Galdos, P., Abasolo, D., Hornero, R., and Aboy, M., Predicting survival in critical patients by use of body temperature regularity measurement based on Approximate Entropy. Med. Biol. Eng. Computing 45:671–678, 2007.Mackiowak, P. Temperature regulation and the pathogenesis of fever, Principles and Practice of Infectious Diseases, pp. 765–778. New York: Churchill Livingston Elsevier, 2010.Cherbuin N., and Brinkman C., Cognition is cool: Can hemispheric activation be assessed by tympanic membrane thermometry? Brain Cogn. 54:228–231, 2004

Cholecystokinin in the central nervous system of the sea lamprey Petromyzon marinus: precursor identification and neuroanatomical relationships with other neuronal signalling systems

Cholecystokinin (CCK) is a neuropeptide that modulates processes such as digestion, satiety, and anxiety. CCK-type peptides have been characterized in jawed vertebrates and invertebrates, but little is known about CCK-type signalling in the most ancient group of vertebrates, the agnathans. Here, we have cloned and sequenced a cDNA encoding a sea lamprey (Petromyzon marinus L.) CCK-type precursor (PmCCK), which contains a CCK-type octapeptide sequence (PmCCK-8) that is highly similar to gnathostome CCKs. Using mRNA in situ hybridization, the distribution of PmCCK-expressing neurons was mapped in the CNS of P. marinus. This revealed PmCCK-expressing neurons in the hypothalamus, posterior tubercle, prethalamus, nucleus of the medial longitudinal fasciculus, midbrain tegmentum, isthmus, rhombencephalic reticular formation, and the putative nucleus of the solitary tract. Some PmCCK-expressing neuronal populations were only observed in adults, revealing important differences with larvae. We generated an antiserum to PmCCK-8 to enable immunohistochemical analysis of CCK expression, which revealed that GABA or glutamate, but not serotonin, tyrosine hydroxylase or neuropeptide Y, is co-expressed in some PmCCK-8-immunoreactive (ir) neurons. Importantly, this is the first demonstration of co-localization of GABA and CCK in neurons of a non-mammalian vertebrate. We also characterized extensive cholecystokinergic fibre systems of the CNS, including innervation of habenular subnuclei. A conspicuous PmCCK-8-ir tract ascending in the lateral rhombencephalon selectively innervates a glutamatergic population in the dorsal isthmic grey. Interestingly, this tract is reminiscent of the secondary gustatory/visceral tract of teleosts. In conclusion, this study provides important new information on the evolution of the cholecystokinergic system in vertebrates.</p

The Goal Programming as a Tool for Measuring the Sustainability of Agricultural Production Chains of Rice

Agricultural activity is characterized by an intensive use of capital and a considerable dependence on external financing. Access to credit is often limited by the scarcity of resources and lack of guarantees, seriously affecting the productivity and economic performance of agricultural exploitations. The objective of this paper is to assess the sustainability of agricultural production chain of rice in Latin America using multi-criteria analysis tools to facilitate decision-making through a benchmarking process to contribute to their economic sustainability. The implementation of the model in an exploitation typy depending on financing sources (conservative, intermediate, and innovative) has revealed the conflict between the goals, being the intermediate exploitation, which gets the best results. The conclusions show that the flexibilization of financing options positively affects the economic performance

Digestion of Raw and Roasted Almonds in Simulated Gastric Environment

Knowledge of digestion kinetics of solid foods in human stomach, as affected by food processing methods, is critical in establishing processing conditions at the manufacturing stage to achieve desirable release of nutrients in the gastrointestinal tract. The objective of this study was to investigate how roasting affected disintegration and solid release properties of almond in simulated gastric environment. In vitro trials were performed for raw and roasted almonds by using static soaking method and a model stomach system. The changes in sample weight, dry mass, and moisture during the trials were determined. Both compression and penetration tests were used to investigate the texture of almonds with a focus on the influence of absorption of gastric juice. Light microscopy and transmission electronic microscopy were used to study the change in microstructure of the raw and roasted almonds after simulated digestion. The results suggested that the slow disintegration rate and the high amount of swelling of the almonds in the stomach may contribute to their high satiety property. Roasting significantly improved the disintegration rates of almonds and increased loss of solids during simulated digestion, which is well correlated with the decrease in the rigidity of almond samples after absorbing gastric juice. Microstructure of digested almonds showed breakage and breach of cell walls due to acid hydrolysis. Intercellular and intracellular channels formed in almonds during roasting are important for penetration of gastric juice that may facilitate an effective digestion

Characterizing global evolutions of complex systems via intermediate network representations

Recent developments in measurement techniques have enabled us to observe the time series of many components simultaneously. Thus, it is important to understand not only the dynamics of individual time series but also their interactions. Although there are many methods for analysing the interaction between two or more time series, there are very few methods that describe global changes of the interactions over time. Here, we propose an approach to visualise time evolution for the global changes of the interactions in complex systems. This approach consists of two steps. In the first step, we construct a meta-time series of networks. In the second step, we analyse and visualise this meta-time series by using distance and recurrence plots. Our two-step approach involving intermediate network representations elucidates the half-a-day periodicity of foreign exchange markets and a singular functional network in the brain related to perceptual alternations

500 ml of blood loss does not decrease non-invasive tissue oxygen saturation (StO2) as measured by near infrared spectroscopy - A hypothesis generating pilot study in healthy adult women

BACKGROUND: The goal when resuscitating trauma patients is to achieve adequate tissue perfusion. One parameter of tissue perfusion is tissue oxygen saturation (StO2), as measured by near infrared spectroscopy. Using a commercially available device, we investigated whether clinically relevant blood loss of 500 ml in healthy volunteers can be detected by changes in StO2 after a standardized ischemic event. METHODS: We performed occlusion of the brachial artery for 3 minutes in 20 healthy female blood donors before and after blood donation. StO2 and total oxygenated tissue hemoglobin (O2Hb) were measured continuously at the thenar eminence. 10 healthy volunteers were assessed in the same way, to examine whether repeated vascular occlusion without blood donation exhibits time dependent effects. RESULTS: Blood donation caused a substantial decrease in systolic blood pressure, but did not affect resting StO2 and O2Hb values. No changes were measured in the blood donor group in the reaction to the vascular occlusion test, but in the control group there was an increase in the O2Hb rate of recovery during the reperfusion phase. CONCLUSION: StO2 measured at the thenar eminence seems to be insensitive to blood loss of 500 ml in this setting. Probably blood loss greater than this might lead to detectable changes guiding the treating physician. The exact cut off for detectable changes and the time effect on repeated vascular occlusion tests should be explored further. Until now no such data exist

Intraspecific Combinations of Flower and Leaf Volatiles Act Together in Attracting Hawkmoth Pollinators

Insects pinpoint mates, food and oviposition sites by olfactory cues. Recognizing and localizing a suitable target by olfaction is demanding. Odor sources emit characteristic blends of compounds that have to be identified against an environmentally derived olfactory background. This background, however, does not necessarily disturb the localization of a source. Rather, the contrary. Sex pheromones become more attractive to male moths when being presented against a relevant plant background. Here we asked whether such olfactory coaction also characterizes foraging cues. The tobacco hornworm Manduca sexta feeds on nectar from wild tobacco Nicotiana attenuata and sacred datura Datura wrightii flowers. We tested how leaf-derived volatile blends as a background affect the moths' approach to flower blends. We found coaction when a flower blend was presented against a conspecific leaf volatile background but not when the blend was presented against volatiles emitted by the other host plant or by a non-host plant. Hence, our results reveal a species-specific coaction between flower blend and leaf volatile background. The ability to integrate information from different odor sources on one plant might provide the moth with a fine-grained analysis of food site quality