Temperature Management Research Articles

Can Biomarkers Correctly Predict Ventilator-associated Pneumonia in Patients Treated With Targeted Temperature Management After Cardiac Arrest? An Exploratory Study of the Multicenter Randomized Antibiotic (ANTHARTIC) Study.

Ventilator-associated pneumonia (VAP) frequently occurs in patients with cardiac arrest. Diagnosis of VAP after cardiac arrest remains challenging, while the use of current biomarkers such as C-reactive protein (CRP) or procalcitonin (PCT) is debated. To evaluate biomarkers' impact in helping VAP diagnosis after cardiac arrest. This is a prospective ancillary study of the randomized, multicenter, double-blind placebo-controlled ANtibiotherapy during Therapeutic HypothermiA to pRevenT Infectious Complications (ANTHARTIC) trial evaluating the impact of antibiotic prophylaxis to prevent VAP in out-of-hospital patients with cardiac arrest secondary to shockable rhythm and treated with therapeutic hypothermia. An adjudication committee blindly evaluated VAP according to predefined clinical, radiologic, and microbiological criteria. All patients with available biomarker(s), sample(s), and consent approval were included. The main endpoint was to evaluate the ability of biomarkers to correctly diagnose and predict VAP within 48 hours after sampling. The secondary endpoint was to study the combination of two biomarkers in discriminating VAP. Blood samples were collected at baseline on day 3. Routine and exploratory panel of inflammatory biomarkers measurements were blindly performed. Analyses were adjusted on the randomization group. Among 161 patients of the ANTHARTIC trial with available biological sample(s), patients with VAP (n = 33) had higher body mass index and Acute Physiology and Chronic Health Evaluation II score, more unwitnessed cardiac arrest, more catecholamines, and experienced more prolonged therapeutic hypothermia duration than patients without VAP (n = 121). In univariate analyses, biomarkers significantly associated with VAP and showing an area under the curve (AUC) greater than 0.70 were CRP (AUC = 0.76), interleukin (IL) 17A and 17C (IL17C) (0.74), macrophage colony-stimulating factor 1 (0.73), PCT (0.72), and vascular endothelial growth factor A (VEGF-A) (0.71). Multivariate analysis combining novel biomarkers revealed several pairs with p value of less than 0.001 and odds ratio greater than 1: VEGF-A + IL12 subunit beta (IL12B), Fms-related tyrosine kinase 3 ligands (Flt3L) + C-C chemokine 20 (CCL20), Flt3L + IL17A, Flt3L + IL6, STAM-binding protein (STAMBP) + CCL20, STAMBP + IL6, CCL20 + 4EBP1, CCL20 + caspase-8 (CASP8), IL6 + 4EBP1, and IL6 + CASP8. Best AUCs were observed for CRP + IL6 (0.79), CRP + CCL20 (0.78), CRP + IL17A, and CRP + IL17C. Our exploratory study shows that specific biomarkers, especially CRP combined with IL6, could help to better diagnose or predict early VAP occurrence in cardiac arrest patients.

Wearable thermoelectric cooler encapsulated with low thermal conductivity filler and honeycomb structure for high cooling effect

Thermoelectric coolers (TEC) based on Peltier effect has been widely used in small scale cold storage because of its zero emission, and high efficiency, while wearable thermoelectric coolers (WTEC) for personal temperature management is garnered tremendous scientific attention. For out-of-plane structured WTEC using inorganic TE materials encapsuled in flexibility substrate, on the one hand, encapsulating materials are required to have low thermal conductivity, high reliability and high flexibility, and on the other hand, heat dissipation of devices is required to be lightweight, portable and efficient. For this reason, we propose a composite material synthesised from SiO2 aerogel, hollow glass beads (HGB) and polydimethylsiloxane (PDMS) as a filler, which takes advantage of the low thermal conductivity of (0.094 W/mK) to increase the temperature difference in the encapsulation layer of the device, and moreover performs the fabrication of honeycomb holes, which further reduces the thermal conductivity of the encapsulation layer and at the same time brings a certain degree of compression resistance to the device. Radiative cooling (RC) films synthesised using hexagonal boron nitride (HBN) and PDMS for lowering the temperature of the hot side in outdoor environments without additional energy consumption, providing heat dissipation at the hot side. Honeycomb wearable thermoelectric cooler (HWTEC) proposed in this work deliver high cooling temperature difference of 9.1 °C and 6.5 °C indoor and outdoor through human wear. Our work represents an important step in the development of flexible TE devices and is believed to have promising future applications in personal thermal management, e-skin and smart textiles.

Real-Time Implementable Integrated Energy and Cabin Temperature Management for Battery Life Extension in Electric Vehicles

Among many emerging technologies, battery electric vehicles (BEVs) have emerged as a prominent and highly supported solution to stringent emissions regulations. However, despite their increasing popularity, key challenges that might jeopardize their further spread are the lack of charging infrastructure, battery life degradation, and the discrepancy between the actual and promised all-electric driving range. The primary focus of this paper is to formulate an integrated energy and thermal comfort management (IETM) strategy. This strategy optimally manages the electrical energy required by the heating, ventilation, and air conditioning (HVAC) unit, the most impacting auxiliary in terms of battery load, to minimize battery life degradation over any specific drive cycle while ensuring the actual cabin temperature hovers within the permissible tolerance limit from the reference cabin temperature and the driver-requested traction power is always satisfied. This work incorporates a state-of-health (SOH) estimation model, a high-fidelity cabin thermodynamics model, and an HVAC model into the forward-approach simulation model of a commercially available BEV to showcase the impact and efficacy of the proposed IETM strategy for enhancing battery longevity. The instantaneous optimization problem of IETM is solved by the golden-section search method leveraging the convexity of the objective function. Simulated results under different driving scenarios show that the improvement brought by the proposed ITEM controller can minimize battery health degradation by up to 4.5% and energy consumption by up to 2.8% while maintaining the cabin temperature deviation within permissible limits from the reference temperature.

Decreasing incidence of admission neonatal hypothermia in Gandhi Memorial Hospital, Addis Ababa, Ethiopia: quality improvement project

BackgroundWHO reported that neonatal hypothermia accounts for about 27% of newborn deaths worldwide. It is a serious concern in Ethiopia and other parts of sub-Saharan Africa; it poses a serious...

Goal-oriented temperature management in severely traumatized children in the emergency department: an evidence-based practice project.

Hypothermia commonly occurs in trauma patients. Evidence-based practices for hypothermia prevention are not strictly followed by all medical staff in the emergency department. This study aimed to assess compliance with evidence-based practices regarding goal-oriented temperature management for severely traumatized children in a Chinese hospital. This project used the JBI Evidence Implementation Framework to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. A goal-oriented temperature management strategy for trauma patients was developed based on the identified barriers, along with a simulation training module, and the supply of warming materials. Field observation, review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices. Twelve criteria were audited in the baseline and follow-up audits, with 11 and 37 trauma patients, respectively. In the follow-up audit, compliance with all criteria increased, with a reduction in shivering and cold discomfort scores. Except for two patients who died, hypothermia did not occur in any of the patients. The JBI Evidence Implementation Framework was used to successfully improve compliance with best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff. http://links.lww.com/IJEBH/A234.

Normal value of neuron-specific enolase for predicting good neurological outcomes in comatose out-of-hospital cardiac arrest survivors.

Research on prognostic factors for good outcomes in out-of-hospital cardiac arrest (OHCA) survivors is lacking. We assessed whether normal levels of normal neuron-specific enolase (NSE) value would be useful for predicting good neurological outcomes in comatose OHCA survivors treated with targeted temperature management (TTM). This registry-based observational study with consecutive adult (≥18 years) OHCA survivors with TTM who underwent NSE measurement 48 hours after cardiac arrest was conducted from October 2015 to November 2022. Normal NSE values defined as the upper limit of the normal range by the manufacturer (NSE <16.3 μg/L) and guideline-suggested (NSE < 60 μg/L) were examined for good neurologic outcomes, defined as Cerebral Performance Categories ≤2, at 6 months post-survival. Among 226 OHCA survivors with TTM, 200 patients who underwent NSE measurement were enrolled. The manufacturer-suggested normal NSE values (<16.3 μg/L) had a specificity of 99.17% for good neurological outcomes with a very low sensitivity of 12.66%. NSE <60 μg/L predicted good outcomes with a sensitivity of 87.34% and specificity of 72.73%. However, excluding 14 poor-outcome patients who died from multi-organ dysfunction excluding hypoxic brain injury, the sensitivity and specificity of normal NSE values were 12.66% and 99.07% of NSE < 16.3 μg/L, and 87.34% and 82.24% of NSE < 60 μg/L. The manufacturer-suggested normal NSE had high specificity with low sensitivity, but the guideline-suggested normal NSE value had a comparatively low specificity for good outcome prediction in OHCA survivors. Our data demonstrate normal NSE levels can be useful as a tool for multimodal appropriation of good outcome prediction.

Establishment and risk factor assessment of the abnormal body temperature probability prediction model (ABTP) for dairy cattle

The study aims to develop an abnormal body temperature probability (ABTP) model for dairy cattle, utilizing environmental and physiological data. This model is designed to enhance the management of heat stress impacts, providing an early warning system for farm managers to improve dairy cattle welfare and farm productivity in response to climate change. The study employs the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to analyze environmental and physiological data from 320 dairy cattle, identifying key factors influencing body temperature anomalies. This method supports the development of various models, including the Lyman Kutcher-Burman (LKB), Logistic, Schultheiss, and Poisson models, which are evaluated for their ability to predict abnormal body temperatures in dairy cattle effectively. The study successfully validated multiple models to predict abnormal body temperatures in dairy cattle, with a focus on the temperature-humidity index (THI) as a critical determinant. These models, including LKB, Logistic, Schultheiss, and Poisson, demonstrated high accuracy, as measured by the AUC and other performance metrics such as the Brier score and Hosmer–Lemeshow (HL) test. The results highlight the robustness of the models in capturing the nuances of heat stress impacts on dairy cattle. The research develops innovative models for managing heat stress in dairy cattle, effectively enhancing detection and intervention strategies. By integrating advanced technologies and novel predictive models, the study offers effective measures for early detection and management of abnormal body temperatures, improving cattle welfare and farm productivity in changing climatic conditions. This approach highlights the importance of using multiple models to accurately predict and address heat stress in livestock, making significant contributions to enhancing farm management practices.

Automatic Temperature Management in Brooder and Its Effects on Chicken Growth and Body Weight

Automatic Temperature Management in Brooder and Its Effects on Chicken Growth and Body Weight

Enhanced Thermal Modeling of Electric Vehicle Motors Using a Multihead Attention Mechanism

The rapid advancement of electric vehicles (EVs) accentuates the criticality of efficient thermal management systems for electric motors, which are pivotal for performance, reliability, and longevity. Traditional thermal modeling techniques often struggle with the dynamic and complex nature of EV operations, leading to inaccuracies in temperature prediction and management. This study introduces a novel thermal modeling approach that utilizes a multihead attention mechanism, aiming to significantly enhance the prediction accuracy of motor temperature under varying operational conditions. Through meticulous feature engineering and the deployment of advanced data handling techniques, we developed a model that adeptly navigates the intricacies of temperature fluctuations, thereby contributing to the optimization of EV performance and reliability. Our evaluation using a comprehensive dataset encompassing temperature data from 100 electric vehicles illustrates our model’s superior predictive performance, notably improving temperature prediction accuracy.

Empowering Aquarists a Comprehensive Study On IOT-Enabled Smart Aquarium Systems For Remote Monitoring And Control

owadays, a lot of people keep fish as pets at home and the aquarium keeper has been feeding the fish in the tanks, therefore appropriate setup and upkeep are required. Taking care of the aquarium appears to be somewhat tough for aquarists. The fish's quality of life depends on the aquarium being kept up properly. Changes in water quality, fish feeding, temperature management, light control, and the challenge of physically inspecting aquarium conditions are these problems are experienced.. As such, it is important to monitor the physical characteristics regularly and to improve the quality of the water. It has water quality management, which levels the aquarium to the perfect conditions by keeping an eye on the physical variations in the tank. Thus, the system that this model suggests is capable of real-time operation and is fitted with sensors. It carries out turbidity system, water renewal, temperature monitoring, and pH level detection in water and all these things are carried out in the ESP32 controller which contains an inbuit WiFi module. For large-scale aquaculture, an embedded system with a wireless network technology and a water quality testing unit was proposed. The aquarium's state is tracked and sent to the user's mobile application via Thingspeak IoT platfrom.

Integrating 3D Printed Grinding Tools and Closed‐Loop Temperature Management for Optimal Surgical Outcomes

AbstractGrinding is a commonly employed surgical technique for the partial removal of bone. However, the grinding process often generates excessive heat at the interface, leading to localized temperature raise. This can result in irreversible damage to not only the bone but also surrounding tissues, such as nerves. Existing devices rely on the continuous application of coolant to mitigate temperature rise. With the rate and location of coolant deposition being primarily empirical, the current process brings potential risks to patients. In this study, a novel grinding device capable of continuously monitoring grinding temperatures and applying coolant precisely when needed is designed. Utilizing additive manufacturing techniques, a customized grinding tool head equipped with embedded temperature sensors and coolant channels is successfully created. This innovation has enabled the development of an intelligent closed‐loop device that provides precise temperature control during surgery. The device effectively maintains the grinding surface temperature within the user‐defined range, with a latency of less than 1 s. Furthermore, the design ensures that the coolant spray outlets remain unobstructed by debris during grinding and effectively removes debris at the interface, reducing the risk of potential complications, such as bone hyperplasia.

Identifying neonatal transport research priorities: a modified Delphi consensus

ObjectivesWith increasing advances in neonatal transport, a focused research strategy is required to increase the evidence base towards providing optimal care. We aimed to identify the most important neonatal transport...

Advanced age and neurological recovery in elderly patients with out-of-hospital cardiac arrest treated with targeted temperature management: a nationwide population‑based registry study 2016–2020

Advanced age and neurological recovery in elderly patients with out-of-hospital cardiac arrest treated with targeted temperature management: a nationwide population‑based registry study 2016–2020

Numerical simulation for the slip impacts on the radiative nanofluid flow over a stretched surface with nonuniform heat generation and viscous dissipation

Abstract The growing fascination with nanofluid flow is motivated by its potential applications in a variety of industries. Therefore, the objective of this research article is to conduct a numerical simulation of the Darcy porous medium flow of Newtonian nanofluids over a vertically permeable stretched surface, considering magnetohydrodynamic mixed convection. Various attributes, such as the impacts of slip, thermal radiation, viscous dissipation, and nonuniform heat sources, are integrated to explore the behavior of the flow. The utilization of the boundary layer theory helps to describe the physical problem as a system of partial differential equations (PDEs). These derived PDEs are then converted to a system of ordinary differential equations (ODEs) through the application of suitable conversions. The outcomes are obtained using the finite difference method, and the effects of parameters on nanofluid flow are compared and visualized through both tabular and graphical representations. The outcomes have been computed and subjected to a comparative analysis with previously published research, revealing a remarkable degree of agreement and consistency. Consequently, these innovative discoveries in heat transfer could prove beneficial in addressing energy storage challenges within the contemporary technological landscape. The noteworthy main findings indicate that when the porous parameter, magnetic number, velocity slip parameter, viscosity parameter, and Brownian motion parameter are assigned higher values, there is an observable expansion in the temperature field. Due to these discoveries, we can enhance the management of temperature in diverse settings by effectively modulating the heat flow.

A metabolic profile of xenon and metabolite associations with 6-month mortality after out-of-hospital cardiac arrest: A post-hoc study of the randomised Xe-Hypotheca trial.

Out-of-hospital cardiac arrest (OHCA) carries a relatively poor prognosis and requires multimodal prognostication to guide clinical decisions. Identification of previously unrecognized metabolic routes associated with patient outcome may contribute to future biomarker discovery. In OHCA, inhaled xenon elicits neuro- and cardioprotection. However, the metabolic effects remain unknown. In this post-hoc study of the randomised, 2-group, single-blind, phase 2 Xe-Hypotheca trial, 110 OHCA survivors were randomised 1:1 to receive targeted temperature management (TTM) at 33°C with or without inhaled xenon during 24 h. Blood samples for nuclear magnetic resonance spectroscopy metabolic profiling were drawn upon admission, at 24 and 72 h. At 24 h, increased lactate, adjusted hazard-ratio 2.25, 95% CI [1.53; 3.30], p<0.001, and decreased branched-chain amino acids (BCAA) leucine 0.64 [0.5; 0.82], p = 0.007, and valine 0.37 [0.22; 0.63], p = 0.003, associated with 6-month mortality. At 72 h, increased lactate 2.77 [1.76; 4.36], p<0.001, and alanine 2.43 [1.56; 3.78], p = 0.001, and decreased small HDL cholesterol ester content (S-HDL-CE) 0.36 [0.19; 0.68], p = 0.021, associated with mortality. No difference was observed between xenon and control groups. In OHCA patients receiving TTM with or without xenon, high lactate and alanine and decreased BCAAs and S-HDL-CE associated with increased mortality. It remains to be established whether current observations on BCAAs, and possibly alanine and lactate, could reflect neural damage via their roles in the metabolism of the neurotransmitter glutamate. Xenon did not significantly alter the measured metabolic profile, a potentially beneficial attribute in the context of compromised ICU patients. Trial Registry number: ClinicalTrials.gov Identifier: NCT00879892.

Tunable thermoresponsive hydrogels for temperature regulation and warning in fruit and vegetables preservation

Fresh fruit and vegetables usually suffer from quality deterioration when exposed to inappropriate temperatures. Common energy-input temperature regulation is widely applied but there remain challenges of increasing energy consumption. Passive temperature management regulates the heat transfer without energy consumption, showing a sustainable strategy for food preservation. Here, thermoresponsive hydrogels were constructed by incorporating NaCl and sodium dodecyl sulfate (SDS) micelles into a poly(N-isopropylacrylamide-co-acrylamide) (P(NIPAM-co-AM)) network. Due to the excellent mechanical properties and reversible thermochromism at 14 °C and 37 °C, Gel-8 wt%-NaCl could inhibit temperature rise and avoid sunburn damage to peppers under direct sunlight by blocking the input of solar energy and accelerating moisture evaporation. Additionally, hydrogels could act as a feasible sensor by providing real-time visual warnings for inappropriate temperatures during banana storage. Based on the self-adaptive thermoresponsive behaviour, the prepared hydrogels showed effective performance of temperature regulation and quality preservation of fruit and vegetables.

A comparative analysis of the biochemical constituents and nutritional role of the Wild Sour Plum (Ximeniacaffra) nut with commercial nuts for potential commercialisation

The Sustainable Development Goals (SDGs) promote universal access to safe, nutritious food. Thus, the “Zero Hunger” campaign's sustainable efforts to eliminate hunger, by encouraging the cultivation and use of underutilised crops and their value-added products, can improve food systems and community development. Wild sour plum (Ximeniacaffra subs caffra) nuts, an Oleaceae fruit crop native to the Lowveld of Southern Africa, are an underappreciated value-added commodity. In large or small amounts, nuts provide vital nutrients for human consumption. The biochemical components profile of wild sour plum nuts was compared to different commercial nuts to determine their potential role in human nutrition. Wild sour plum, pecan, and macadamia nuts were sampled, each having 24 samples. These samples were tested for various biochemical constituents including total fat and calcium. The study found that pecan nuts and macadamia nuts were superior compared to other nuts, with regards to total fat and calcium content, pecan nuts containing a total fat content of 11.7 g per 100 g dry weight (g/100 g DW), and macadamia nuts containing a total calcium content of 70.5 mg per hundred gram dry weight (mg/100 g DW). The study found that wild sour plum nuts could potentially provide enough nutrients to fulfill the nutritional recommended daily intake for humans. Thus, wild sour plum nuts may be important in human diets, provided crop production is done properly, which includes irrigation, fertilisation, and temperature management of the crop.

The Effect of Targeted Temperature Therapy on Antioxidant Levels in Patients With Spontaneous Circulation After Cardiac Arrest.

Introduction In this study, we aimed to measure the change in total antioxidant status (TAS), total oxidant stress (TOS), oxidative stress index (OSI), and nuclear factor erythroid 2 (Nrf-2) levels during the treatment period in patients who restored spontaneous circulation return after cardiac arrest with targeted temperature management (TTM) therapy in our hospital. Methods The study included 36 patients who were hospitalized in the anesthesia intensive care unit and coronary intensive care unit of our hospital and were treated withTTM therapy after cardiac arrest. TAS, TOS, OSI, and Nrf-2 levels were measured at 0 (beginning), 12, 24, and 48 (end) hours ofTTM therapy. Results The mean age of the patients participating in the study was 54.25±17.10. TAS and TOS levels decreased gradually duringTTM therapy, but statistically significant decrease was observed at the end of the hour. When Nrf-2 and OSI levels wereevaluated, it was found that no statistically significant difference was observed during the TTM therapy. Conclusion In our study, the oxidant-antioxidant balance was preserved in patients who received TTM therapy after cardiac arrest. We predict TTM therapy is effective on oxidative stress after cardiac arrest and should be applied for at least 48 hours.

Study on Real‐Time Temperature of a 35 kW Vanadium Stack and Its Influences on the Performance of a Vanadium Redox Flow Battery

AbstractThe temperature is a very important parameter for an operating vanadium redox flow battery (VRFB). During charging and discharging, the temperature of VRFB is constantly changing. In this paper, a self‐made 35 kW vanadium stack was charged &amp; discharged at the current density of 100 and 120 mA cm−2 to investigate the change trend of real‐time operating temperature. The results show that the temperature decreases during charging and increases during discharging. And the average temperature of each cycle increases with continuous charge‐discharge cycles. The influences of real‐time temperature on performance of columbic efficiency (CE), voltage efficient (VE), over‐potential, capacity, energy, state of charge (SOC), and pressure loss were further investigated. The results show that the temperature fluctuation largely affects the electrochemical properties of VRFB. With the real‐time average temperature increased from 16.02 °C to 29.91 °C, the VE, capacity, energy and the SOC range of the battery increased, while the CE, the over‐potential and the average pressure loss decreased. This work not only gives data support to temperature management of VFB, but also provides direction to the engineering application of all flow batteries.

Perfusion Measures and Outcomes (PERForm) registry: First annual report.

The Perfusion Measures and Outcomes (PERForm) registry was established in 2010 to advance cardiopulmonary bypass (CPB) practices and outcomes. The registry is maintained through the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative and is the official registry of the American Society of Extracorporeal Technology. This first annual PERForm registry report summarizes patient characteristics as well as CPB-related practice patterns in adult (≥18 years of age) patients between 2019 and 2022 from 42 participating hospitals. Data from PERForm are probabilistically matched to institutional surgical registry data. Trends in myocardial protection, glucose, anticoagulation, temperature, anemia (hematocrit), and fluid management are summarized. Additionally, trends in equipment (hardware/disposables) utilization and employed patient safety practices are reported. A total of 40,777 adult patients undergoing CPB were matched to institutional surgical registry data from 42 hospitals. Among these patients, 54.9% underwent a CABG procedure, 71.6% were male, and the median (IQR) age was 66.0 [58.0, 73.0] years. Overall, 33.1% of the CPB procedures utilized a roller pump for the arterial pump device, and a perfusion checklist was employed 99.6% of the time. The use of conventional ultrafiltration decreased over the study period (2019 vs. 2022; 27.1% vs. 24.9%) while the median (IQR) last hematocrit on CPB has remained stable [27.0 (24.0, 30.0) vs. 27.0 (24.0, 30.0)]. Pump sucker termination before protamine administration increased over the study period: (54.8% vs. 75.9%). Few robust clinical registries exist to collect data regarding the practice of CPB. Although data submitted to the PERForm registry demonstrate overall compliance with published perfusion evidence-based guidelines, noted opportunities to advance patient safety and outcomes remain.