The general aim was to explore factors influencing the normal variation and measurement of body temperature. Additional aims were to study morbidity, mortality and the clinical presentation of pneumonia and predictors for survival in elderly nursing-home residents. Two hundred and thirty seven non-febrile nursing home residents (aged 66-99 years) and 87 healthy adults (aged 19-59 years) were included. In elderly individuals, the morning ear and rectal body temperature was measured at baseline and pneumonia and survival was observed at one- two and three-year. In healthy adults the rectal, ear, oral and axillary temperature were measured simultaneously on one morning and repeated measurements were performed in three subjects. Overall, the range of normal body temperature was wider then traditionally stated. In elderly nursinghome residents, functional and cognitive impairment and BMI < 20 were related to a lower body temperature and medication with analgesics to a higher. Compared to adults < 60 years elderly persons had a higher average ear and a lower rectal temperature. Men and postmenopausal women < 60 years had lower body temperature than premenopausal women. The repeated measurements showed a wide individual variability irrespective of the site of measurement, and that replicated measurements do not improve accuracy. When comparing the rectal temperature with oral, ear and axillary readings the average difference was > 0.5°C with a wide individual variation. The yearly incidence of nursing-home acquired pneumonia varied between 6.9% and 13.7%. Functional impairment, chronic obstructive pulmonary disease (COPD) and male sex were related to a higher risk of acquiring pneumonia and presenting non-specific symptoms were common. Age and functional impairment predicted mortality, irrespective of gender, while cerebral vascular insult, a lower body mass index and malnutrition in women and heart disease, COPD, medication with sedatives and mortality rate index in men were gender specific predictors. Surviving women had a higher baseline body temperature than non-surviving, while no such difference was found in men. When assessing body temperature, it is important to consider the site of measurement, technical design, operator technique, age and gender and, in elderly nursing-home residents, physical and cognitive impairment, body constitution and medication with analgesics. The best approach is to use an unadjusted mode, without adjusting to another site. To prevent a delayed diagnosis of pneumonia, one should be aware of a low baseline body temperature and lack of specific clinical symptoms in elderly nursing-home residents. Preserving and/or improving functional, cognitive, nutritional status and preventing agitation and confusion would improve survival in nursing-home residents.

The goal of this thesis is to develop an algorithm to process infrared images and achieve automatic identification of moving subjects with fever. The identification is based on two main features: the distinction between the geometry of a human face and other objects in the field of view of the camera, and the temperature of the radiating object. Infrared thermography is a remote sensing technique used to measure temperatures based on emitted infrared radiation. Applications include fever screening in major public places such as airports and hospitals. Current accepted practice of screening requires people to stay in a line and temperature measurements are carried out for one person at a time. However in the case of mass screening of moving people the accuracy of the measurements is still under investigation. An algorithm constituting of image processing to threshold objects based on the temperature, template matching and hypothesis testing is proposed to achieve automatic identification of fever subjects. The algorithm was first tested on training data to obtain a threshold value (used to discriminate between face and non face shapes) corresponding to a false detection rate of 5%, which in turn corresponds to 85% probability of detection using Neyman-Pearson criterion. By testing the algorithm on several simulated and experimental images (which reflect relevant scenarios characterizing crowded places) it is observed that it can be beneficially implemented to introduce automation in the process of detecting moving subjects with fever.

The goal of this thesis is to develop an algorithm to process infrared images and achieve automatic identification of moving subjects with fever. The identification is based on two main features: the distinction between the geometry of a human face and other objects in the field of view of the camera, and the temperature of the radiating object. Infrared thermography is a remote sensing technique used to measure temperatures based on emitted infrared radiation. Applications include fever screening in major public places such as airports and hospitals. Current accepted practice of screening requires people to stay in a line and temperature measurements are carried out for one person at a time. However in the case of mass screening of moving people the accuracy of the measurements is still under investigation. An algorithm constituting of image processing to threshold objects based on the temperature, template matching and hypothesis testing is proposed to achieve automatic identification of fever subjects. The algorithm was first tested on training data to obtain a threshold value (used to discriminate between face and non face shapes) corresponding to a false detection rate of 5%, which in turn corresponds to 85% probability of detection using Neyman-Pearson criterion. By testing the algorithm on several simulated and experimental images (which reflect relevant scenarios characterizing crowded places) it is observed that it can be beneficially implemented to introduce automation in the process of detecting moving subjects with fever.

The goal of this thesis is to develop an algorithm to process infrared images and achieve automatic identification of moving subjects with fever. The identification is based on two main features: the distinction between the geometry of a human face and other objects in the field of view of the camera, and the temperature of the radiating object. Infrared thermography is a remote sensing technique used to measure temperatures based on emitted infrared radiation. Applications include fever screening in major public places such as airports and hospitals. Current accepted practice of screening requires people to stay in a line and temperature measurements are carried out for one person at a time. However in the case of mass screening of moving people the accuracy of the measurements is still under investigation. An algorithm constituting of image processing to threshold objects based on the temperature, template matching and hypothesis testing is proposed to achieve automatic identification of fever subjects. The algorithm was first tested on training data to obtain a threshold value (used to discriminate between face and non face shapes) corresponding to a false detection rate of 5%, which in turn corresponds to 85% probability of detection using Neyman-Pearson criterion. By testing the algorithm on several simulated and experimental images (which reflect relevant scenarios characterizing crowded places) it is observed that it can be beneficially implemented to introduce automation in the process of detecting moving subjects with fever.

The goal of this thesis is to develop an algorithm to process infrared images and achieve automatic identification of moving subjects with fever. The identification is based on two main features: the distinction between the geometry of a human face and other objects in the field of view of the camera, and the temperature of the radiating object. Infrared thermography is a remote sensing technique used to measure temperatures based on emitted infrared radiation. Applications include fever screening in major public places such as airports and hospitals. Current accepted practice of screening requires people to stay in a line and temperature measurements are carried out for one person at a time. However in the case of mass screening of moving people the accuracy of the measurements is still under investigation. An algorithm constituting of image processing to threshold objects based on the temperature, template matching and hypothesis testing is proposed to achieve automatic identification of fever subjects. The algorithm was first tested on training data to obtain a threshold value (used to discriminate between face and non face shapes) corresponding to a false detection rate of 5%, which in turn corresponds to 85% probability of detection using Neyman-Pearson criterion. By testing the algorithm on several simulated and experimental images (which reflect relevant scenarios characterizing crowded places) it is observed that it can be beneficially implemented to introduce automation in the process of detecting moving subjects with fever.

Numerical simulation is used to investigate the accuracy of a direct-contact device for measuring skin-surface temperature. A variation of thermal conductivity of the foam has greater effect on the error rather than a variation of the blood perfusion rate. For a thermal conductivity of zero, an error of 1.5 oC in temperature was identified. For foam pad conductivities of 0.03 and 0.06 W/m-oC, the errors are 0.5 and 0.15 oC. For the transient study, with k=0 W/m-oC, it takes 4,900 seconds for the temperature to reach steady state compared with k=0.03 W/m-oC and k=0.06 W/m-oC where it takes 3,000 seconds. The configuration without the foam and in presence of an air gap between the skin surface and the sensor gives the most uniform temperature profile.

The primary purpose of this doctoral dissertation was to investigate the effect of body temperature responses at physiologically relevant sites during an incremental exercise test on the phenomenon of exercise-induced hypoxemia (EIH). This phenomenon has been considered as an important limitation to physical performance with a prevalence of ~50 % in trained male athletes, but described in both sexes, across the range of both age and physical fitness in more recent literature. Previously this phenomenon has been described as a decrement in both arterial oxygen partial pressure (PaO₂) and oxy-haemoglobin saturation (SaO₂or SpO₂) with, particularly important for PaO₂, a lack of or inappropriate correction made for the change in body temperature during intense exercise. The initial study of this thesis determined the thermal response within the body at physiologically relevant sites measured simultaneously during an incremental exercise test. The results demonstrated the inadequacy of rectal temperature as an indicator of the acute temperature changes occurring during an incremental exercise test due to its slow response rate and relative thermal inertia. Radial arterial blood and oesophageal temperatures were shown to behave almost identically during the exercise test, albeit with an offset of approximately 1.3ºC, and were considered much more appropriate and relevant indicators of thermal changes during exercise. As an extension of the initial work active muscle temperature (vastus lateralis) was measured during the exercise test, demonstrating a significantly lower resting temperature than the oft-reported “core” temperatures (rectal and oesophageal) as well as a significantly greater increase in temperature in comparison to all other measurement sites. Overall, the results of this first study indicated that the physiologically relevant temperatures measured at the oesophageal and muscle sites differed markedly to the outdated rectal temperature measurement site and should be used as measures of thermal response when evaluating oxygen loading (oesophageal) or unloading (active muscle). Utilising the definition of EIH as a decrease in PaO₂ of ≥ 10 mmHg, the effect of temperature correcting PaO₂ was evaluated in the second study. Arterial blood gases measured simultaneously to the temperature measurements during the incremental exercise test were adjusted for the temperature changes at each site (every 1ºC increase in temperature will increase a PaO₂ value by ~5 mmHg). Whilst uncorrected PaO₂ values indicated an almost 100% prevalence of EIH in this group, oesophageal temperature corrected PaO₂ values decreased this prevalence to ~50% while muscle temperature corrections resolved all cases of EIH and demonstrated an HYPEROXAEMIA (i.e. the reverse of the well-established phenomenon) in the majority of subjects. Further investigation of arterial oxygen content during the exercise test indicates that there is no disruption in the delivery of oxygen to the active muscles and therefore any performance decrement should be attributed to another mechanism. Whilst the phenomenon of EIH is determined by the definition applied and the use of temperature corrections in the case of PaO₂, its reproducibility in a test-retest situation had not previously been determined. Utilising a subset of previously tested subjects, the reproducibility of both temperature and PaO₂ were determined with results indicating that the blood gas response was highly reproducible, especially the minimum PaO₂ value noted during each exercise test. However, comparing a more statistically relevant definition of a change in PaO₂ of ± 2 standard deviations from the mean resting PaO₂ to the previous delimiter of 10 mmHg indicated a lesser reproducibility of the prevalence of EIH. In summary, this thesis exposes the inadequacies of previous research into EIH with regard to the expected reproducibility of the phenomenon and the need to correctly adjust PaO₂ values for exercise-induce hyperthermia as well as demonstrating the difference in thermal responses to acute exercise in physiologically significant areas of the body. Furthermore, previously described correlations between the change in PaO₂ and VO₂ max were not evident in the subjects tested within this thesis, nor was there any indication of a diffusion limitation based on reduced pulmonary capillary transit time (by association with VO₂ max) or pulmonary oedema (rebuked by a rapid return of PaO₂ to above resting levels following exercise cessation). / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320633 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008

The negative consequence of recent climate change on the Earth’s biodiversity has become more evident in recent years. Some animals, due to insularity or habitat fragmentation, are unable to shift their ranges altitudinally and latitudinally. Vulnerable species need to rely on behavioural and, more importantly, physiological responses in order to persist through present climatic changes. It has therefore become more obvious that physiological responses of individuals need to be incorporated into predictive models of the responses of mammals to accelerated climate change. The primary purpose of this study was to test the ‘Hyperthermic Daily Torpor’ hypothesis proposed recently by Lovegrove et al., (in press). The hypothesis suggests that, based on albeit limited evidence, some small mammals may be capable of hyperthermia induced hypometabolism equivalent to that experienced during torpor and hibernation in response to cold temperatures. These authors argue that such hyperthermic hypometabolism should reduce the risk of entry into pathological hyperthermia and also reduce the rate of water loss driven by heat-induced evaporative cooling. The reaction norms of desert mammals have been selected to be adaptive over a wide range of climatic conditions due to the unpredictability of their habitat. Thus, they are good models for testing the reaction norms that may be expressed in response to accelerated climate change. We therefore tested our hypothesis using two presumably heat-adapted desert rodents; the Namaqua rock mouse, Aethomys namaquensis, and the pygmy rock mouse, Petromyscus collinus, as model species. We used indirect respirometry to measure metabolic rate at high ambient temperatures. We progressively exposed the animals to high temperatures to induce thermal tolerance and thus minimize the risks of lethal hyperthermia. We also measured subcutaneous and core temperatures, using temperature-sensitive PIT tags (BioTherm Identipet) and modified iButtons (Maxim Integrated), respectively. A. namaquensis displayed the capacity for hyperthermia-induced hypometabolism (Q10 79 = 1.27 ± 1.61) whereas the P. collinus did not (Q10 = 2.45 ± 1.41). The implications of such a physiological response in A. namaquensis are crucial in terms of its capacity to minimize the risks of lethal, pathological hyperthermia. Recent models of endothermic responses to global warming based on ectothermic models predict a dichotomy in the thermoregulatory responses of mammals to high temperatures. This study, to our knowledge, provides some of the first data on these interspecific variations in the thermoregulatory responses of mammals to high temperatures. However, the different physiological responses to hyperthermia between these two species cannot be meaningfully interpreted without phylogenetically independent comparisons with other species, that is, a more expansive interspecific analysis. Nonetheless, we provide some autecological sketches to assist in future multivariate interspecific analyses. Physiological differences between captive or captive-bred and free-ranging mammals preclude the extrapolation of our findings to free-ranging mammals. It is almost impossible to collect MR data in the field, although a few authors have successfully done so, and it is often not feasible to collect Tb data in small free-ranging mammals. Most studies have therefore made use of externally-mounted temperature-sensitive data loggers in order to collect Tskin data as a proxy for Tcore data in free-ranging mammals. However, misleading gradients between Tskin and Tcore can occur if data loggers are placed too close to major-heat producing tissues and the effects of the external environment on these data loggers may result in large Tskin – Tcore gradients. The second objective of this thesis therefore was to test the validity of using subcutaneous temperatures (Tsub) from subcutaneously injected temperature-sensitive PIT tags as a proxy for Tcore using the Namaqua rock mouse, Aethomys namaquensis. We found that the difference between Tcore and Tsub was minimal (~ 0.34˚C) within the thermoneutral zone (TNZ) with slight, non-significant, differences outside the TNZ. There was a tendency for Tsub to underestimate Tcore below thermoneutrality and overestimate it above thermoneutrality. We attributed these differences to the various heat loss and heat gain mechanisms activated in response to heat and cold stress in order to maintain a setpoint Tb. Nevertheless, we found that the Tcore – Tskin differential never exceeded 1.59˚C above the wide 108 range of Tas (5˚ – 41˚C) measured. Thus, we can conclude that subcutaneous temperatures provide a reasonably reliable proxy for core temperature in small mammals. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

The primary purpose of this doctoral dissertation was to investigate the effect of body temperature responses at physiologically relevant sites during an incremental exercise test on the phenomenon of exercise-induced hypoxemia (EIH). This phenomenon has been considered as an important limitation to physical performance with a prevalence of ~50 % in trained male athletes, but described in both sexes, across the range of both age and physical fitness in more recent literature. Previously this phenomenon has been described as a decrement in both arterial oxygen partial pressure (PaO₂) and oxy-haemoglobin saturation (SaO₂or SpO₂) with, particularly important for PaO₂, a lack of or inappropriate correction made for the change in body temperature during intense exercise. The initial study of this thesis determined the thermal response within the body at physiologically relevant sites measured simultaneously during an incremental exercise test. The results demonstrated the inadequacy of rectal temperature as an indicator of the acute temperature changes occurring during an incremental exercise test due to its slow response rate and relative thermal inertia. Radial arterial blood and oesophageal temperatures were shown to behave almost identically during the exercise test, albeit with an offset of approximately 1.3ºC, and were considered much more appropriate and relevant indicators of thermal changes during exercise. As an extension of the initial work active muscle temperature (vastus lateralis) was measured during the exercise test, demonstrating a significantly lower resting temperature than the oft-reported “core” temperatures (rectal and oesophageal) as well as a significantly greater increase in temperature in comparison to all other measurement sites. Overall, the results of this first study indicated that the physiologically relevant temperatures measured at the oesophageal and muscle sites differed markedly to the outdated rectal temperature measurement site and should be used as measures of thermal response when evaluating oxygen loading (oesophageal) or unloading (active muscle). Utilising the definition of EIH as a decrease in PaO₂ of ≥ 10 mmHg, the effect of temperature correcting PaO₂ was evaluated in the second study. Arterial blood gases measured simultaneously to the temperature measurements during the incremental exercise test were adjusted for the temperature changes at each site (every 1ºC increase in temperature will increase a PaO₂ value by ~5 mmHg). Whilst uncorrected PaO₂ values indicated an almost 100% prevalence of EIH in this group, oesophageal temperature corrected PaO₂ values decreased this prevalence to ~50% while muscle temperature corrections resolved all cases of EIH and demonstrated an HYPEROXAEMIA (i.e. the reverse of the well-established phenomenon) in the majority of subjects. Further investigation of arterial oxygen content during the exercise test indicates that there is no disruption in the delivery of oxygen to the active muscles and therefore any performance decrement should be attributed to another mechanism. Whilst the phenomenon of EIH is determined by the definition applied and the use of temperature corrections in the case of PaO₂, its reproducibility in a test-retest situation had not previously been determined. Utilising a subset of previously tested subjects, the reproducibility of both temperature and PaO₂ were determined with results indicating that the blood gas response was highly reproducible, especially the minimum PaO₂ value noted during each exercise test. However, comparing a more statistically relevant definition of a change in PaO₂ of ± 2 standard deviations from the mean resting PaO₂ to the previous delimiter of 10 mmHg indicated a lesser reproducibility of the prevalence of EIH. In summary, this thesis exposes the inadequacies of previous research into EIH with regard to the expected reproducibility of the phenomenon and the need to correctly adjust PaO₂ values for exercise-induce hyperthermia as well as demonstrating the difference in thermal responses to acute exercise in physiologically significant areas of the body. Furthermore, previously described correlations between the change in PaO₂ and VO₂ max were not evident in the subjects tested within this thesis, nor was there any indication of a diffusion limitation based on reduced pulmonary capillary transit time (by association with VO₂ max) or pulmonary oedema (rebuked by a rapid return of PaO₂ to above resting levels following exercise cessation). / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320633 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008