Tympanic Membrane Temperature Research Articles

Effect of eardrum perforation and chronic otitis media on the results of infrared tympanic thermometer in adults: A systematic review and meta-analysis.

This study was conducted to determine whether tympanic membrane perforation or chronic otitis media affects the results of an infrared tympanic membrane thermometer in adults. A literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar. Four nonrandomized studies were included in the analysis. The temperatures of the bilateral eardrums (one eardrum with normal condition [control group] and the other eardrum with perforation or chronic otitis media [experimental group]) were measured for the same subject in the studies. The mean and standard deviation of the bilateral tympanic membrane temperatures were used to calculate the mean difference (MD) with a corresponding 95% confidence interval (CI). The fixed-effect model was utilized based on the results of the heterogeneity measurement using the Chi2 test and I2 statistic. The results of a meta-analysis in the normal eardrum (control group) and perforated eardrum, chronic suppurative otitis media with tympanic membrane perforation, or chronic otitis media with cholesteatoma (experimental group) were 343 subjects (MD = 0.05; 95% CI = -0.00 to 0.11; P = .06). A meta-analysis of the normal eardrum (control group) and perforated eardrum or chronic suppurative otitis media with tympanic membrane perforation except for cholesteatoma (experimental group) found 296 subjects (MD = 0.05; 95% CI = -0.01 to 0.11; P = .10). When the temperatures of the bilateral eardrums were measured using an infrared tympanic membrane thermometer, no difference was observed between the eardrum with perforation or chronic otitis media and the normal eardrum.

Prospective comparative analysis of zero-heat-flux thermometer (SpotOn®) compared with tympanic thermometer and bladder thermometer in extremely aged patients undergoing lower extremity orthopedic surgery.

Thermoregulation is important for maintaining homeostasis in the body. It can be easily broken under anesthesia. An appropriate method for measuring core body temperature is needed, especially for elderly patients, because the efficiency of thermoregulation gradually decreases with age. Zero-heat-flux (ZHF) thermometry (SpotOn) is an alternative, noninvasive method for continuous temperature monitoring at the skin surface. The aim of this study was to examine the accuracy and feasibility of using the SpotOn sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn sensor with 2 other reliable minimally invasive methods: a tympanic membrane thermometer and a bladder thermometer. This study enrolled 45 patients aged over 80 years who were scheduled to undergo lower extremity surgery. Body temperature was measured using a SpotOn sensor, a tympanic membrane thermometer and a bladder thermometer. Agreements between the SpotOn sensor and the other 2 methods were assessed using Bland and Altman plots for repeated measures adjusted for unequal numbers of measurements per patient. Compared with bladder temperature, bias and limits of agreement for SpotOn temperature were 0.07°C ± 0.58°C. Compared with tympanic membrane temperature, bias and limits of agreement for SpotOn temperature were -0.28°C ± 0.61°C. The 3M SpotOn sensor using the ZHF method for patients aged over 80 years undergoing lower extremity surgery showed feasible measurement value and sensitivity.

Comparison of Preemptive Post-Intubation 15 Mg/KgBW Paracetamol to 0.35 Mg/KgBW Meperidine in Incidence of Post-Anesthetic Shivering

Post anesthesia shivering (PAS) is a repetitive involuntary movement of one or more muscle groups as a result of a decrease in core body temperature. Pharmacological therapy in preventing PAS may include meperidine and paracetamol. This study compared the effectiveness of paracetamol to meperidine in reducing the incidence of post-anesthesia shivering. This study used an experimental randomized double-blind comparative analytic design on patients underwent exploratory laparotomy surgery under general anesthesia at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from September 2021 to August 2022. Patients with 50 ASA 1-2 physical status were included and divided into two groups. One group received 15 mg/kg group paracetamol and the other received 0.35 mg/kg meperidine. Data on tympanic membrane temperature and hemodynamics before and after induction and after extubating were collected. Furthermore, data on the results of the assessment of the incidence and grade of shivering in each treatment group were also collected. The results of this study showed that there was a decrease in the frequency of PAS in patients receiving intravenous 15 mg/kg paracetamol (p<0.05), as well as less side effects in the form of nausea and vomiting (p < 0.05). The incidence and degree of shivering after general anesthesia using intravenous 15 mg/kg paracetamol was lower compared to the use of 0.35 mg/kg meperidine. In the meperidine group, the decrease in body temperature was lower than in the paracetamol group, while the incidence of nausea and vomiting in the paracetamol group was lower than in the meperidine group. In conclusion, paracetamol reduces the incidence of post-anesthesia shivering better than meperidine.

Prevalence of Postoperative Hypothermia in the Post-anesthesia Care Unit.

Unwanted postoperative hypothermia is an unpleasant event that can cause various complications. As this serious complication and its provoking causes have not been investigated sufficiently, this study was designed and conducted to determine the prevalence of hypothermia and its associated factors in the post-anesthesia care unit after elective surgery. Four hundred patients undergoing elective surgeries were enrolled in the present cross-sectional research after termination of surgery and at the time of arrival at the post-anesthesia care unit of Poursina Public University Hospital. The tympanic membrane temperature was measured and recorded at the time of arrival at the post-anesthesia care unit and every 30 minutes after arrival. The required data were collected in a researcher-made checklist and analyzed after entering the SPSS software version 25. Considering the 5% error, it can be said that the prevalence of hypothermia in patients undergoing elective surgery ranges from 20 to 28% at the time of arrival at the post-anesthesia care unit and 18.5 to 26% 30 minutes after arrival. More than a quarter of patients experienced hypothermia following elective surgery. Therefore, appropriate treatment and control measures are necessary to manage this complication, particularly in patients with predisposing risk factors and comorbidities.

Body Temperature Manipulation Increases Salivary Cortisol Independent of Exercise

The vast majority of circulating cortisol in the blood is bound and inactivated by binding proteins like corticosteroid-binding globulin (CBG) and albumin. The cortisol that is free of these binding proteins is secreted via saliva and other body fluids. Ex-vivo studies have shown that CBG binding to cortisol is temperature-dependent within the physiological range of human core body temperatures. Exercise is a standard experimental paradigm for inducing cortisol responses. However, these studies rarely consider that exercise-induced changes in core body temperature might increase free cortisol independent of psychological stress or physical exertion. We tested the effect of heat exposure without exertion or other stressors on saliva cortisol. 26 Participants (18 healthy and 8 with Major Depression MDD) sat motionless in a dry infrared sauna set to 65.5 degrees C (150 F). They had their tympanic membrane temperature and salivary cortisol measured as their body temperature increased. Exposure to exogenous heat significantly increased core body temperature from 36.93 C/98.48 F (95% CI 36.79-37.07 C, 98.23-98.73 F) to 38.42 C /101.16 F (95% CI 38.24-38.6 C, 100.83-101.48 F) after 45 minutes of heat exposure, F(15,42.33)=43.509, p<0.001. Concurrently saliva cortisol also increased significantly from 4.00 nmol/l (95%CI 1.89-6.11) to 9.87 nmol/l (95% CI 5.58-14.17), F(1,33.17)=6.64, p=0.015. Elevations in core body temperature can significantly increase free cortisol levels even in the absence of exercise or overt psychological stressors.

Non-Invasive Intracranial Pressure Monitoring.

(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients in intensive care units, as well as during long-term surgeries and interventions. The gold standard is invasive measurement and monitoring via ventricular drainage or a parenchymal probe. In recent decades, numerous methods for non-invasive measurement have been evaluated but none have become established in routine clinical practice. The aim of this study was to reflect on the current state of research and shed light on relevant techniques for future clinical application. (2) Methods: We performed a PubMed search for "non-invasive AND ICP AND (measurement OR monitoring)" and identified 306 results. On the basis of these search results, we conducted an in-depth source analysis to identify additional methods. Studies were analyzed for design, patient type (e.g., infants, adults, and shunt patients), statistical evaluation (correlation, accuracy, and reliability), number of included measurements, and statistical assessment of accuracy and reliability. (3) Results: MRI-ICP and two-depth Doppler showed the most potential (and were the most complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, and retinal vein approaches were also promising. (4) Conclusions: To date, no convincing evidence supports the use of a particular method for non-invasive intracranial pressure measurement. However, many new approaches are under development.

Associations among serum VEGF and CGRP levels with the peripheral vascular blood flow of the skin of the hands in women with Fibromyalgia

BackgroundFibromyalgia (FM) is a long-term condition of unknown physiopathology, whose hallmark symptoms are diffuse musculoskeletal chronic pain and fatigue. ObjectivesWe aimed to analyze the associations among serum vascular endothelial growth factor (VEGF) and calcitonin gene-related peptide (CGRP) levels with the peripheral temperature of the skin of both hands and the core body temperature in patients with FM and healthy controls. MethodsWe conducted a case-control observational study with fifty-three women diagnosed with FM and twenty-four healthy women. VEGF and CGRP levels were spectrophotometrically analyzed in serum by enzyme-linked immunosorbent assay. We used an infrared thermography camera to assess the peripheral temperature of the skin of the dorsal thumb, index, middle, ring, and pinkie fingertips and dorsal centre as well as the palm thumb, index, middle, ring, and pinkie fingertips, palm centre and thenar and hypothenar eminences of both hands and an infrared thermographic scanner to record the tympanic membrane and axillary temperature. ResultsLinear regression analysis adjusting for age, menopause status, and body mass index showed that serum VEGF levels were positively associated with the maximum (β = 65.942, 95% CI [4.100,127.784], p = 0.037), minimum (β = 59.216, 95% CI [1.455,116.976], p = 0.045), and mean (β = 66.923, 95% CI [3.142,130.705], p = 0.040) temperature of the thenar eminence of the non-dominant hand, as well as with the maximum temperature of the hypothenar eminence of the non-dominant hand (β = 63.607, 95% CI [3.468,123.747], p = 0.039) in women diagnosed with FM. ConclusionsMild associations were observed between serum VEGF levels and the peripheral temperature of the skin in hand areas in patients with FM; therefore, it is not possible to establish a clear relationship between this vasoactive molecule and vasodilation of the hands in these patients.

Effect of different masses, ages, and coats on the thermoregulation of dogs before and after exercise across different seasons.

Domestic dogs demonstrate a positive correlation between body mass and whole-animal metabolism but a negative relationship between body mass and lifespan in dogs. Additionally, essential physiological mechanisms in domestic dogs, such as the relationships between thermal relations and body size and age, remain poorly understood. In this study, we looked at thermoregulation in dogs of different sizes, ages, coat types, and head morphologies across three different seasons. We used tympanic membrane temperatures (Tear) and infrared thermography to observe temperature regulation in pet dogs before and after a 45-min moderate walking exercise trial. We hypothesized that Tear and heat dissipation is positively correlated with body mass. Using network analysis, we found that body mass was among the most central features for spring and summer trials, but not for the winter trials. Similarly, leg length, snout length, and paw width were the central predictors in two of the three seasons. Mediation analysis demonstrated that nose and snout length act as significant mediators of the effects of body mass on mouth temperatures in the spring. For the summer trials, nose length and paw width significantly mediated the effect of body mass on mouth temperatures. Age, however, does not seem to be a major determinant of thermoregulation in dogs according to best subset models. A cross-seasonal examination of repeated measurements showed that mouth temperature heat dissipation rates decreased with increasing temperature and humidity. Overall, our findings support our hypothesis that Tear and heat dissipation rates are positively correlated with body mass in dogs, thus, negatively correlated with mass-specific metabolism. This finding suggests that small dogs allocate a bigger proportion of their metabolism to "inefficiencies" of heat production to offset greater heat loss.

Comparison of bilateral eardrum temperatures measured using an infrared tympanic thermometer before and after surgery in patients with chronic otitis media.

This study aimed to investigate the effect of chronic otitis media (COM) and COM surgery on infrared tympanic thermometer measurements. We retrospectively reviewed the medical records of 192 patients (192 surgery cases) who underwent surgery for COM and whose bilateral tympanic membrane temperature was measured with an infrared tympanic thermometer the day before surgery and at 2, 3, 4, and 6 months after surgery. Patients underwent surgery for COM in 1 ear, the other eardrum was intact. Patients who underwent tympanoplasty, simple mastoidectomy, and canal wall up mastoidectomy, surgeries performed to preserve the ear canal, were included in group A, and patients who underwent canal wall down mastoidectomy, a surgery to remove the ear canal, were included in group B. There were 115 and 77 patients in groups A and B, respectively. The mean temperature on the side with COM measured the day before surgery was 37.09°C ± 0.325°C and the mean temperature on the opposite normal side was 37.03°C ± 0.330°C (P = .000). In group A, the eardrum temperature on the surgical and contralateral side was not statistically different after surgery (P = .439). The temperature difference between both sides of the eardrums (dTemp) changed from 0.056°C before surgery to 0.014°C after surgery (P = .008). However, in group B, which canal wall down mastoidectomy was performed, the eardrum temperature of the surgical side was higher than that on the other side (P = .001). The dTemp increased up to 0.15°C after surgery (P = .000). The temperature of the eardrum was slightly increased by COM. The COM surgeries, which preserve the ear canal, brought the temperature of the eardrum close to that of the normal eardrum, and the surgery to remove the ear canal raised the temperature of the eardrum.

Intravenous magnesium sulfate &lt;em&gt;versus&lt;/em&gt; intravenous meperidine to prevent shivering during spinal anesthesia

BACKGROUND Shivering is a frequent event during neuraxial anesthesia due to impaired central and peripheral thermoregulation control. Meperidine and MgSO4 are effective in lowering the shivering threshold. Hence, this study aimed to compare the efficacy of MgSO4 and meperidine to prevent shivering in patients undergoing spinal anesthesia.&#x0D; METHODS This was a double-blind randomized clinical trial of 100 patients divided into 2 groups. One group had MgSO4 30 mg/kg, and the other group had meperidine 0.5 mg/kg intravenously in 100 ml of 0.9% NaCl before undergoing spinal anesthesia. Participants were non-pregnant patients aged 18–65 years and had physical status I or II (based on the American Society of Anesthesiologist). Shivering was considered significant if it occurred in grade 3 or 4. Patient characteristics, shivering degree, tympanic membrane temperature, and side effects were recorded.&#x0D; RESULTS Shivering occurred 10% in the MgSO4 group and 19% in the meperidine group, with p = 0.23. Both groups had similar side effects of nausea, vomiting, and hypotension.&#x0D; CONCLUSIONS MgSO4 30 mg/kg was not superior to meperidine 0.5 mg/kg intravenously in preventing shivering in patients undergoing spinal anesthesia.

Incidence of inadvertent perioperative hypothermia in pediatric laparoscopic surgery: a prospective observational single-center study.

Abstract&#x0D; Objective&#x0D; The pediatric age group is in the risk group for Inadvertent perioperative hypothermia (IPH) due to insufficient subcutaneous adipose tissue and underdeveloped thermoregulatory responses.&#x0D; We aimed to determine the frequency of IPH in the pediatric age group undergoing laparoscopic surgery.&#x0D; Methods&#x0D; The study is prospective observational.&#x0D; Pediatric patients (1-18 years old) who underwent laparoscopic surgery under general anaesthesia were evelueted. The tympanic membrane temperature measurements of the patients (°C) were recorded before anaesthesia induction (T0) and then every 15 minutes during the surgery.&#x0D; Results&#x0D; A total of 100 patients were evaluated. The frequency of inadvertent perioperative hypothermia was detected 13 (13%). Frequency of IPH on elective surgery patients was higher than emergency surgery (

Invention of a non-invasive intracranial pressure (ICP) monitoring system – an enlightenment from a hydrocephalus study

Background Mechanical obstruction is the most common cause of shunt failure for hydrocephalic patients. However, the diagnosis is extremely challenging and often requires invasive testing methods. Thus, a simple and non-invasive technique is in urgent need to predict the intracranial pressure (ICP) of hydrocephalic patients during their post-surgical follow-up, which could help neurosurgeons to determine the conditions of the shunt system. Materials and methods Two groups of patients were enrolled in the current study. In group I, patients were enrolled as they were diagnosed with high ICP hydrocephalus and received shunt surgery. The shunt valve pressures were taken for their post-surgical ICP. Meanwhile, the participants of group II exhibited abnormally increased lumbar puncture opening pressure (LPOP; from 180 to 400 mmH2O). Both the ICP and LPOP were used to match with their corresponding tympanic membrane temperature (TMT). Results When patients’ ICP were in the normal range (group I, from 50 to 180 mmH2O), the TMT correlated with ICP in a linear regression model (R 2 = 0.59, p < 0.001). Interestingly, when patients exhibited above-normal ICP (LPOP was from 180 to 400 mmH2O), their TMT fit well with the ICP in a third-order polynomial regression (R 2 = 0.88). When the ICP was 287.98 mmH2O, the TMT approached the vertex, which was 38.54 °C. Based on this TMT-ICP algorithm, we invented a non-invasive ICP monitor system. Interestingly, a tight linear correlation was detected between the ICP data drawn from the non-invasive device and Codman ICP monitoring system (R 2 = 0.93, p < 0.01). Conclusions We believe the TMT-ICP algorithm (the Y-Jiang model) could be used for preliminary prediction of shunt malfunction as well as monitoring ICP changes.

Effect of cooperative care training on physiological parameters and compliance in dogs undergoing a veterinary examination – A pilot study

One way to reduce fear and lack of compliance during veterinary procedures is ‘cooperative care training’, training animals to voluntarily participate in husbandry and medical care. Here we assessed the effects of cooperative care training on heart rate (HR), heart rate variability (HRV), tympanic membrane temperature (TMT) and compliance (i.e., all steps of the examination completed) of dogs during a veterinary examination. A blinded controlled trial with 47 dogs (training group (TG): 26; control group (CG): 21) was carried out. Forty dogs completed the study (TG: 22, CG:18). Dogs and their owners took part in a standardized veterinary visit twice (visit interval: 140 ± 23 days). In between, the TG took part in cooperative care training (10 ± 2 group training sessions, additional training at home). Linear mixed models were calculated (fixed effects HR/HRV: group* visit* period, TMT: group* visit; random effect: dogID). Compliance (completed steps of exam) was analyzed using McNemar tests. HR/HRV was higher/lower during the veterinary examination compared to the waiting room (period: p < 0.001), indicating that the examination was more stressful. No significant differences in HR/HRV regarding group*visit were found. TMT, taken at the end of each examination, resulted in a significant group*visit interaction (p = 0.008); stress appeared increased during visit 2 in the CG whereas in the TG a heterogeneous pattern, with 42% of dogs with reduced rightward bias, was observed. Compliance was lower in the TG during the second visit (p = 0.04). Trainer and owners claimed observable improvement of behavior during training and a decrease in HR between visits correlated significantly with trainer perception of high training success (rs = −0.52, p = 0.049). Overall, transfer of trained skills to the veterinary examination performed by a team blinded to the group allocation was poor. TMT analyses and HR/HRV data within the training group, suggest that the training had differing effects on the dogs based on their previous tolerance of handling and their progress made during training. Further research how to optimize training programs, including desensitization and counterconditioning, and their outcomes is needed.

Effect of Upper Limb Warming Blanket on Body Temperature Control During Total Hip Arthroplasty and Total Knee Arthroplasty

Background: At our research facility, the body temperature is constantly monitored using a continuous-measuring ear thermometer, i.e., Nipro CE Thermo (hereafter CE Thermo). However, this temperature control assumes that the CE Thermo itself does not get affected, thus warranting the identification of influencing factors for temperature control based on their influence on the CE Thermo. We aimed to evaluate the tympanic membrane temperature of patients undergoing lower limb surgery under general anesthesia, and to explore body temperature fluctuations during anesthesia based on the tympanic membrane temperature. Methods: We selected patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) for lower extremities at the Department of Orthopedic Surgery, Okinawa Tokushukai Kamagaya General Hospital between January 2017 and March 2020. We conducted a retrospective observational study of 173 patients undergoing THA and TKA for lower extremities at a single institution. Results: We calculated and compared the tympanic temperature measurements at 5, 10, 15, 20, 25, 30, 35, and 40 min between the groups to predict the factors of temperature variation. The results of tympanic temperature measurements were analyzed using two-way analysis of variance. At the beginning of the measurement, the THA group demonstrated significantly lower values than the TKA group (P = 0.001). Conclusions: The above results necessitate further clarification of the effect of temperature fluctuation, including surgical factors, on prognosis. J Curr Surg. 2022;12(1):7-14 doi: https://doi.org/10.14740/jcs456

Introduction of a Novel, Continuous, Noninvasive Estimation of Intracranial Pressure and Cerebral Perfusion Pressure Based on Tympanic Membrane Temperature

Hydrocephalus is a common but potentially life-threatening condition. However, valve malfunction makes further diagnosis difficult. Thus, we tried to develop a noninvasive method to detect the hydrocephalus intracranial pressure (ICP) during routine follow-up. In group I, the patient was recruited because a spinal tap test was necessary for either disease diagnosis or treatment. In group II, patients were diagnosed with high ICP hydrocephalus and received shunt surgery. The tympanic membrane temperatures (TMTs) were recorded and plotted against the spinal tap pressure (STP) and shunt valve pressures. All patients in group I showed an above-normal STP (from 180 to 400 mm H2O). The STP presents with an inverted U-shaped curve when it is plotted against TMT (R2= 0.9). When the STP was 286.1 mm H2O, the TMT approached its peak value, which was 38.61°C (101.5°F). However, when ICP was in the normal range (50-200 mm H2O), the TMT correlated with ICP in a linear regression model (R2= 0.69; P < 0.001). In addition, the cerebral perfusion pressure (CPP) was calculated and plotted against TMT. The TMT-CPP was also shown as a parabola (R2= 0.74). Based on the TMT-ICP algorithm, we invented a noninvasive ICP monitor system, which performs in a manner comparable to the Codman ICP Transducer (R2= 0.9; P < 0.01). Both Y-Jiang TMT-ICP and TMT-CPP algorithms are useful to monitor the shunt outcomes and identify potential shunt failure. More importantly, these algorithms open the possibility for the rational acquisition of ICP and CPP noninvasively.

Design and application of a cooling device based on the phase-change material for heat stroke

Heat stroke is a critical and health-threatening disease, triggered by thermal stimulus and progressing rapidly. It can give rise to multiple organ dysfunction syndrome (MODS), resulting in a high mortality rate. Nearly 30% of survivors will suffer with different sequelae, for instance, the neurological sequelae. Currently, the early rapid cooling is the focus of therapy for heat stroke. Therefore, it is imperative to design a cooling module suitable for the treatment of heat stroke in the field and in the hospital to realize the goal of early rapid cooling and the effective targeted temperature management (TTM). The cooling device is composed of a cooling blanket and a cooling cap. The blanket and cap are made by temperature changeable fabric. The cooling blanket comprises a backing layer, a buffer layer, a flexible heat conduction capsule body, a temperature changing component, a fixed part and a temperature sensor. The cooling cap includes a main body and two side ears, in which the main body is worn on the top of the patient's head, and the front is equipped with a flexible display screen, which is convenient for real-time monitoring the temperature of the temperature change component of the cooling blanket. The lateral ear can wrap the patient's ears and neck, and the tympanic membrane thermometer is designed to monitor the tympanic membrane temperature in real time. The tympanic membrane thermometer is also designed at the ear to monitor the tympanic auditory canal temperatures in real time.Continuous dynamic temperature monitoring can guide the duration of cooling treatment and stop cooling in time. The cooling component is portable, easy to operate, real-time temperature monitoring, excellent cooling effect and reusable. It is used for on-site first aid, transportation and continuous cooling for patients with heat stroke in the ward.

Are Operating Rooms With Laminar Airflow a Risk for Inadvertent Perioperative Hypothermia During Ureterorenoscopic Lithotripsy Under Spinal Anesthesia? A Prospective Randomized Clinical Trial.

Inadvertent perioperative hypothermia (IPH), defined as a core temperature &lt;36°C, is common during a surgical procedure and is associated with high morbidity and mortality. Laminar (LAS) and conventional airflow systems (CAS) are used frequently for clean microenvironmental surgical areas in operating rooms. In LAS, the cold airflow is directed toward the patient, unlike CAS. Does this airflow in LAS cause heat loss from the patient by convection more than CAS? We aimed to compare the IPH frequencies of these airflow systems on patients who underwent ureterorenoscopic lithotripsy (ureterorenoscopic surgery) under spinal anesthesia. The study was a prospective, parallel-group, randomized trial. A total of 246 volunteers were included in the study and divided into group LAS (n = 123) and group CAS (n = 123). Randomization of patients was performed using the closed-envelope method (as 1:1).The tympanic membrane temperature of patients was measured before spinal anesthesia ( T0 ) and then every 15 minutes ( T n ) during the procedure. The IPH ratio and the change of the tympanic temperatures (Δ T ) were recorded (clinical trial number: IRCT20180324039145N5). In total, there were no statistical differences between the IPH ratios of group LAS and group CAS (61.2% [71 of 116] versus 49.6% [57 of 115], respectively; P = 0.075). The IPH ratio was 55.4% (128 of 231). The tympanic temperatures of patients decreased about 0.64°C (0.45°C) at the 30th minute. In both groups, Δ 30 was similar (0.62; 95% confidence interval, 0.52-0.72 [ P = 0.65]; 95% confidence interval, 0.55-0.74 [ P = 0.236], respectively). The risk for IPH of both LAS and CAS in the operating room is similar during ureterorenoscopic surgery.

The effect of strategy game types on inhibition

Past studies have shown evidence of transfer of learning in action video games, less so in other types, e.g. strategy games. Further, the transfer of learning from games to inhibitory control has yet to be examined from the perspectives of time constraint and logic contradiction. We examined the effect of strategy games (puzzle, turn-based strategy ‘TBS’, and real-time strategy ‘RTS’) on inhibition (response inhibition and distractor inhibition) and cerebral hemispheric activation over 4 weeks. We predicted that compared to RTS, puzzle and TBS games would (1) improve response and distractor inhibition, and (2) increase cerebral hemispheric activation demonstrating increased inhibitory control. A total of 67 non-habitual video game players (Mage = 21.63 years old, SD = 2.12) played one of three games: puzzle (n = 19), TBS (n = 24) or RTS (n = 24) for 4 weeks on their smartphones. Participants completed three inhibition tasks, working memory (WM), and had their tympanic membrane temperature (TMT) taken from each ear before and after playing the games. Results showed that only the puzzle game group showed an improved response inhibition while controlling for WM. There were no significant changes in the distractor inhibition tasks. We also found that there was an increase in left TMT while playing RTS, suggesting the presence of increased impulsivity in RTS. Our findings suggest that puzzle games involving logical contradiction could improve response inhibition, showing potential as a tool for inhibition training.

Psychological, Physical, and Heat Stress Indicators Prior to and after a 15-Minute Structural Firefighting Task.

Simple SummaryFirefighters must endure extreme environments. Such exposure increases their body temperature, which can induce fatigue, reduce motivation, and impair their decision-making. This study set out to investigate the relationship between these factors. Nine firefighters were required to complete simulated firefighting tasks in a controlled structural fire for 15 min. Logical reasoning, speed and accuracy, memory recall, general motivation and fatigue, and physical and mental effort were recorded prior to, immediately after, and 20 min after the simulation. Results of this study identified that alongside a significant increase in firefighter tympanic membrane temperature post-task; (1) body weight loss was poorly correlated with post-task motivation and fatigue scores; (2) pre-task logical reasoning scores were predictive of change in tympanic membrane temperature. Firefighters work in strenuous conditions for prolonged periods wearing up to 20 kg of personal protective equipment. This often contributes to significant heat and cardiovascular strain. This study examined the relationships between psychological and physical measures taken prior to undertaking a 15 min firefighting task, and the occurrence of heat stress and high levels of fatigue following the task. Nine qualified firefighters completed a 15 min “live burn” scenario designed to mimic a fire started by a two-seater couch in a lounge room and completed simulated tasks throughout the duration. Logical reasoning, speed and accuracy, general motivation and fatigue, and physical and mental effort were recorded pre-scenario, and at 0- and 20-min post-scenario. General motivation and fatigue scores at 0- and 20-min post-scenario were highly correlated with each other (rs = 0.90; p = 0.001). The general motivation and fatigue scores, at 0- and 20-min post-scenario, were also strongly related to pre-task logic/reasoning test scores (Post 0 rs = −0.77, p = 0.016; Post 20 rs = −0.87, p = 0.002). Firefighters with lower logical reasoning and speed and accuracy scores were more susceptible to fatigue and impaired cognition when exposed to rises in core temperature and heat stress.

Emergency preservation and resuscitation for cardiac arrest from trauma

Patients who suffer a cardiac arrest from trauma rarely survive. Surgical control of hemorrhage cannot be obtained in time to prevent irreversible organ damage. Emergency preservation and resuscitation (EPR) was developed to utilize hypothermia to buy time to achieve hemostasis and allow delayed resuscitation. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10 °C during exsanguination cardiac arrest can allow up to 2 h of circulatory arrest and repair of simulated injuries with normal neurologic recovery. The Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) trial is testing the feasibility and safety of initiating EPR. Study subjects include patients with penetrating trauma who lose a pulse within 5minutes of hospital arrival and remain pulseless despite standard care. EPR is initiated via an intra-aortic flush of ice-cold saline solution. Following hemostasis, delayed resuscitation and rewarming are accomplished with cardiopulmonary bypass. The primary outcome is survival to hospital discharge without significant neurologic deficits. If trained team members are available, subjects can undergo EPR. If not, subjects can be enrolled as concurrent controls. Ten EPR and 10 control subjects will be enrolled. If successful, EPR could save the lives of trauma patients who are currently dying from exsanguinating hemorrhage.