Name: using an ingestible telemetric temperature pill to assess gastrointestinal temperature during exercise
Uploaded: 2015-10-07T15:00:00.000+00:00
Duration: 8 min 22 s
Description: Watch this Scientific Journal Video about Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise at JoVE.com

This work was supported by STW (12864, C.C.W.G.B) and the Netherlands Organization for Scientific Research (Rubicon Grant 825.12.016, T.M.H.E).

The steps described in the following section are in line with and accepted by the medical ethical committee of the Radboud University Medical Center in Nijmegen, The Netherlands. To our knowledge, 3 different commercial systems of ingestible temperature pills are currently available for researchers. The user manual of the ingestible temperature pills is brand-specific (Table of Specific Materials), but all systems are suitable for measurements during exercise and under resting conditions.
1. Exclusion Criteria and Subject Instruction
<ol>
	<li>Ask subjects in written or verbal form for the exclusion criteria for using the telemetric temperature pill: 1) body weight below 36.5 kg, 2) obstructive gastro-intestinal disease, 3) history of gastrointestinal surgery, 4) an implanted medical device, and 5) a scheduled MRI scan during the experimental period.</li>
	<li>Write down the serial and calibration number of the temperature pill.</li>
	<li>Instruct the subjects how to use the temperature pill (see section 2).</li>
	<li>Give the pill to the subject together with a short instruction manual, which contains the information shown in section 2. If subjects receive the temperature pill well ahead of the experiment, remind the subject the day preceding the experiment to ingest the temperature pill.</li>
</ol>
2. Temperature Pill Instructions
<ol>
	<li>Instruct the subject to ingest the temperature pill at least 6 hr&#160;prior to the experiment, to avoid any interaction with fluid ingestion. Follow the subsequent steps to ingest the temperature pill correctly.</li>
	<li>Instruct the subject to remove the magnetic strip from the pill, to activate the battery and enable measuring.</li>
	<li>Instruct the subject to ingest the temperature pill preferably with a glass of water to enhance pill ingestion.</li>
	<li>Ask the subject to return the pill wrapping material to the research team, so they can check serial and calibration numbers prior to the start of the experiment.</li>
	<li>Instruct the subject that the temperature pill will leave the body through its natural way (faeces) and it can be flushed through the toilet.</li>
</ol>
3. Experimental Protocol I: Cross Sectional Mode
Note: In the cross sectional mode it is possible to measure up to 99 subjects simultaneously.
<ol>
	<li>Adjust the recorder to the desired settings for the cross sectional measurement prior to the measurement.
	<ol>
		<li>Turn on the recorder, connect the recorder with the computer with a transfer cable and push the &#8216;F2-PC Link&#8217; button to enable the recorder to connect with the computer.</li>
		<li>Open the Tc software on the computer, which can be used to define the right settings. Note: The software is supplied by the company with the order of the temperature pill and recorder.</li>
		<li>To adjust the settings, click on &#8216;Program&#8217; in the home screen of the software, and subsequently use the &#8216;open PC link&#8217; button to make a connection with the recorder and select the correct settings.
		<ol>
			<li>Select the cross sectional measurement mode by selecting &#8216;Sports mode ON&#8217;.</li>
			<li>Select the correct temperature measurement scale (Celsius or Fahrenheit). Use the &#8216;Write Config to Recorder&#8217; button to copy the settings to the recorder.</li>
			<li>Add the serial and calibration number of all individual subjects to the external recorder, which enables the option to switch users during the experiment. Push the &#8216;Sensor/Barcode Display&#8217; button in the software and add all the serial and calibration numbers. Push the &#8216;Write Sensors to Recorder&#8217; button to copy the data to the recorder.</li>
			<li>Check the battery of the recorder prior to the measurement, to avoid a discharged battery during the measurement and therefore missing data. Note: Normally, a battery state of 75% is sufficient to measure for &#62;10 hr.</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Once all preparations are completed and the predefined settings are checked, start the experiment. To do so, return to the home screen of the recorder and use the &#8216;F2-Sport&#8217; button to start data acquisition.</li>
	<li>When Player XX appears on the screen, push the &#8216;Read&#8217; button to measure Tgi. Use the &#8216;Read&#8217; button again for an extra measurement of Tgi.</li>
	<li>To switch users, push on the correct number on the recorder and subsequently measure the Tc by pushing the &#8216;Read&#8217; button.</li>
	<li>Stop the data collection by pushing the &#8216;Stop&#8217; button.</li>
	<li>When the measurement is finished, turn off the recorder in the correct way to prevent data loss. To do so, use the &#8216;Enter&#8217; button and &#8216;Exit&#8217; becomes visible on the home screen. Push the &#8216;F1-Exit&#8217; button and the recorder shows &#8216;turn of recorder&#8217;. Subsequently, use the power switch to turn off the recorder.</li>
	<li>Export and store the raw data from the external recorder to a computer (see section 5; data handling).</li>
</ol>
4. Experimental Protocol II: Continuous Mode
Note: The continuous mode enables to continuously measure and save the Tgi of an individual subject on a predefined constant time interval, for example every 20 sec. In the next section, the step sequence used to perform this type of measurement is described.
<ol>
	<li>Adjust the recorder to the right settings for the continuous measurement mode prior to the measurement (see section 3, steps 3.1.1-3.1.3).</li>
	<li>Select the continuous measurement mode by selecting &#8216;Sports mode OFF&#8217;.</li>
	<li>Select a measuring frequency by adjusting the &#8216;Read Interval&#8217; to the right constant time interval (hh:mm:ss), with a minimal sampling interval of 10 sec.</li>
	<li>Select the correct temperature measurement scale (Celsius or Fahrenheit). Use the &#8216;Write Config to Recorder&#8217; button to copy the settings to the recorder.</li>
	<li>Check the battery of the recorder prior to the measurement, to avoid a discharged battery during the measurement and therefore missing data. Note: Normally, a battery state of 75% is sufficient to perform a 24 hr&#160;measurement.</li>
	<li>Once all preparations are completed and the predefined settings are checked, start the experiment. Start data acquisition by pushing the &#8216;Run&#8217; button on the home screen of the recorder.</li>
	<li>Subsequently, attach the recorder in a waist bag close to the abdominal area of the subject (maximal 30-40 cm between the abdominal area and the recorder) to avoid measurement errors. 
	Note: After the start of the experiment, every predefined time interval a measurement of Tc will be taken. With the &#8216;Read&#8217; button extra sampling points can be added.</li>
	<li>Stop the Tc measurement by pushing the &#8216;Stop&#8217; button.</li>
	<li>Use the &#8216;F1-Exit&#8217; button to get the message &#8216;turn off unit&#8217; and then use the power switch to turn off the recorder.</li>
	<li>Export and store the raw data from the external recorder to a computer (see section 5; data extraction).</li>
</ol>
5. Data Extraction
<ol>
	<li>Connect the recorder to the computer to complete data export (section 3, step 3.1.1).</li>
	<li>Open the software and click the &#8216;Download&#8217; button in the home screen of the software.</li>
	<li>Enter a file name and push the &#8216;OK&#8217; button. Note: The data will now be stored as a .cvt file, which can be opened using spreadsheet software.</li>
	<li>Open the data file and visually check the collected data for missing data and outliers. Note: A large decrease or increase of the Tgi (&#8804;1 &#176;C) within a short time interval (&#177;1 min) is very unrealistic and may be caused by a disturbance of the radio signal. As a result, the unrealistic data point can be removed for further analysis.</li>
	<li>Interpolate the missing values by averaging the previous and next valid value. Note: Interpolation of the data is possible with a maximum of three missing values in a row.</li>
</ol>

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No conflicts of interest declared.

The ingestible telemetric temperature pill has the ability to provide a continuous, valid and non-invasive measurement of the Tgi. Furthermore, an advantage of the temperature pill is the fact that once ingested, the subjects are unaware of the presence of the pill in the body or that the measurements are performed. Therefore, this method is easily applicable under resting conditions as well as during exercise, a minimal burden for study participants, and can therefore be used in field and laboratory settings. Another ad...

The oxidation of substrates during muscle contractions, necessary to perform exercise and physical activity, importantly impacts our thermoregulatory system as only 20% is used for muscle power1, whilst the majority of the energy is released as heat (80%)2,3. As a consequence, the elevated metabolic heat production during physical activity and exercise typically exceeds the heat dissipation capacity4,5, resulting in an increase in core body temperature (Tc). Accordingly, Tc rises above the hypothalamic set point, which is defined as hyperthermia6, and may even result in an attenuated exercise performance5,7,8 and/or the development of heat-related disorders4,6. For this reason it is important to accurately measure Tc during prolonged exercise and in particular in strenuous ambient conditions.
Literature describes that an ideal method to measure Tc should: 1) be easy applicable, 2) not be biased by environmental conditions, 3) have a high temporal resolution to rapidly monitor changes in Tc, and 4) have the capacity to detect small changes (&#916;0.1&#176;C) in core body temperature9,10. An overview of the different methods to measure the Tc was given by the International Organization of Standardization (ISO 9886)11. It was stated that the esophageal temperature at the level of the left atrium provides the closest agreement with central blood temperature, while this measure is able to rapidly detect (minor) changes in temperature12. Although esophageal temperature measurements are generally accepted as the gold standard to record Tc, its invasive nature limits the practical use of this method. Alternative measures to monitor Tc rely on temperature recordings of external tympanic membrane, mouth, or rectum12. These measurement sites are not optimal to measure the Tc, given their invasive character, methodological difficulties and/or the potential bias by environmental conditions9,12-14 (Table 1). This highlights the need to explore alternative strategies to monitor (changes in) Tc.
Previous studies have described the use of an ingestible telemetric temperature pill as an easily applicable, reliable and valid method to measure the Tgi, which is a representative estimation of Tc9,15. Another, important, advantage of the temperature pill is the suitability in field-based situations, which is of great importance since exercise-induced elevations in Tc are generally higher in field than in laboratory settings16. Currently, the temperature pill is able to measure the Tgi every 10 sec&#160;with an accuracy of &#177;0.1&#176;C, which makes this technique very suitable to measure the Tgi during an exercise event or an important match. Furthermore, in a study by Stevens et al.17 it is demonstrated that the telemetric temperature pill may also be used to monitor intragastric temperature. The ingestible temperature pill is first described in 196118, and further developed at the Johns Hopkins University (Baltimore, USA) in collaboration with the Applied Physics Laboratory of the NASA. The result is a 20 x 10 mm capsule with a telemetry system, micro battery and a quartz crystal temperature sensor. The crystal sensor vibrates at a frequency relative to the temperature of the surrounding substance. This temperature radio signal is transmitted through the body, which can be measured by an external recorder (Figure 1). Each temperature pill has a unique serial and calibration number, which can be used by the recorder to convert the radio signal and measure the corresponding Tgi.
A small magnetic strip is attached to the outside of the temperature pill, which deactivates the battery. When this magnetic strip is removed, the pill is activated immediately and starts measuring Tc (Figure 2). Casa and colleagues,19 used six different techniques (gastrointestinal, rectal, aural, temporal, axial and forehead) to measure Tc, with the rectal temperature set as the reference value. They demonstrated that the gastrointestinal measurement of Tc with the temperature pill is the only technique that shows good agreement with the reference Tc. Others investigated the relation between Tgi and rectal temperature and have shown a small but significant bias ranging from 0.07&#176;C to 0.20&#176;C 9,15,20,21. Although the direction and magnitude of the bias differed between studies, the Bland and Altman 95% limits of agreement were &#177;0.4&#176;C, which is acceptable9,22. Additionally, in a review by Byrne et al.9 the Tgi is compared with the rectal and esophageal temperature (gold standard) as a measure for the Tc. They demonstrate that the Tgi measured with the temperature pill is a valid measure for Tc based on the good agreement between intestinal and esophageal temperature. Furthermore, the 95% Bland and Altman limits of agreement were limited to &#177;0.4&#176;C 22, while no significant bias was found between the two measurements9,20,21. These results suggest that the Tgi is a valid measure for Tc.
Another important aspect of a good Tc/Tgi measurement technique is a high temporal resolution to rapidly monitor changes in Tc. Previous studies have demonstrated that the Tgi measured with the temperature pill responds more slowly on changes in Tc compared to the esophageal measurement15,20,23, which can be explained due to the low heat capacity of the esophagus and the proximity to the heart10. In the esophageal temperature measurement, the thermistor is placed at the level of the left atrium10. At this level, the pulmonary artery and the esophagus are in contact and isothermal24, which stimulates a fast response time on changes in temperature of the esophageal measurement. In contrast, the intestines and rectum are less perfused compared to the esophagus, resulting in a delay in measuring temperature changes at these anatomical locations. However, the ingestible telemetric temperature pill has an accuracy of &#177;0.1&#176;C and is able to measure Tgi every 10 sec. A previous study reported that core body temperature can rise at a maximum of 1&#176;C every 5 min if no heat is removed during exercise25. Therefore, the temporal resolution of the temperature pill is suitable to measure changes in Tgi during exercise. Based on these findings, it can be concluded that the temperature pill is a reliable and valid technique to measure Tgi. Despite the use of the telemetric temperature pill in a large number of studies, a clear description about how to use the temperature pill is missing.
Therefore, the purpose of this study is to provide a detailed description of the measurement protocol using an ingestible telemetric temperature pill. Secondly, the application of the telemetric temperature pill in two different study protocols are described, in which a cross-sectional design (measurement every 5 km with a different recorder) and a protocol that continuously records Tgi in individuals are used.

<table><tbody><tr><td>CorTemp data recorder</td><td>CorTemp system, HQ Inc., Florida, USA</td><td>Not applicable</td><td>http://www.hqinc.net/cortemp-data-recorder/</td></tr><tr><td>Cortemp ingestible telemetric temperature pill</td><td>CorTemp system, HQ Inc., Florida, USA</td><td>HT150002</td><td>http://www.hqinc.net/cortemp-sensor-2/</td></tr><tr><td>CorTrack II software (Data processing for a PC only)</td><td>CorTemp system, HQ Inc., Florida, USA</td><td>Not applicable</td><td>http://www.hqinc.net/cortrack-ii-data-graphing-software/</td></tr></tbody></table>

using an ingestible telemetric temperature pill to assess gastrointestinal temperature during exercise

Exercise results in an increase in core body temperature (Tc), which may reduce exercise performance and eventually can lead to the development of heat-related disorders. Therefore, accurate measurement of Tc during exercise is of great importance, especially in athletes who have to perform in challenging ambient conditions. In the current literature a number of methods have been described to measure the Tc (esophageal, external tympanic membrane, mouth or rectum). However, these methods are suboptimal to measure Tc during exercise since they are invasive, have a slow response or are influenced by environmental conditions. Studies described the use of an ingestible telemetric temperature pill as a reliable and valid method to assess gastrointestinal temperature (Tgi), which is a representative measurement of Tc. Therefore, the goal of this study was to provide a detailed description of the measurement of Tgi using an ingestible telemetric temperature pill. This study addresses important methodological factors that must be taken into account for an accurate measurement. It is recommended to read the instructions carefully in order to ensure that the ingestible telemetric temperature pill is a reliable method to assess Tgi at rest and during exercise.

Representative results from our previous work demonstrating the methods are presented in the next section, in which an example of a cross sectional (Figure 3A) and a continuous measurement (Figure 3B) are given.
Cross sectional measurement of Tgi
An example of data from a cross sectional measurement is shown in Figure 3A. After obtaining baseline Tgi, subjects walked 30 km at a self-selected pace. During exercise th...

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Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise

This study describes an accurate, reliable and non-invasive technique to continuously measure gastrointestinal temperature during exercise. The ingestible telemetric temperature pill is suitable to measure gastrointestinal temperature in laboratory settings as well as in field based settings.

Exercise results in an increase in core body temperature (Tc), which may reduce exercise performance and eventually can lead to the development of ...

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Unit 1

Vital Signs: Temperature

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10.4K Views.  Radboud University Medical Center. This study describes an accurate, reliable and non-invasive technique to continuously measure gastrointestinal temperature during exercise. The ingestible telemetric temperature pill is suitable to measure gastrointestinal temperature in laboratory settings as well as in field based settings. 

Video: Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise

Measuring Skeletal Muscle Thermogenesis in Mice and Rats

Skeletal muscle thermogenesis provides a potential avenue for better understanding metabolic homeostasis and the mechanisms underlying energy expenditure. Surprisingly little evidence is available to link the neural, myocellular, and molecular mechanisms of thermogenesis directly to measurable changes in muscle temperature. This paper describes a method in which temperature transponders are utilized to retrieve direct measurements of mouse and rat skeletal muscle temperature.
Remote transponders are surgically implanted within the muscle of mice and rats, and the animals are given time to recover. Mice and rats must then be repeatedly habituated to the testing environment and procedure. Changes in muscle temperature are measured in response to pharmacological or contextual stimuli in the home cage. Muscle temperature can also be measured during prescribed physical activity (i.e., treadmill walking at a constant speed) to factor out changes in activity as contributors to the changes in muscle temperature induced by these stimuli.
This method has been successfully used to elucidate mechanisms underlying muscle thermogenic control at the level of the brain, sympathetic nervous system, and skeletal muscle. Provided are demonstrations of this success using predator odor (PO; ferret odor) as a contextual stimulus and injections of oxytocin (Oxt) as a pharmacological stimulus, where predator odor induces muscle thermogenesis, and Oxt suppresses muscle temperature. Thus, these datasets display the efficacy of this method in detecting rapid changes in muscle temperature.

Mice and rats are surgically implanted with remote temperature transponders and then habituated to the testing environment and procedure. Changes in muscle temperature are measured in response to pharmacological or contextual stimuli in the home cage or during prescribed physical activity (i.e., treadmill walking at a constant speed).

Skeletal muscle thermogenesis provides a potential avenue for better understanding metabolic homeostasis and the mechanisms underlying energy expenditure. ...

Behavior

Human Brown Adipose Tissue Depots Automatically Segmented by Positron Emission Tomography/Computed Tomography and Registered Magnetic Resonance Images

Reliably differentiating brown adipose tissue (BAT) from other tissues using a non-invasive imaging method is an important step toward studying BAT in humans. Detecting BAT is typically confirmed by the uptake of the injected radioactive tracer 18F-Fluorodeoxyglucose (18F-FDG) into adipose tissue depots, as measured by positron emission tomography/computed tomography (PET-CT) scans after exposing the subject to cold stimulus. Fat-water separated magnetic resonance imaging (MRI) has the ability to distinguish BAT without the use of a radioactive tracer. To date, MRI of BAT in adult humans has not been co-registered with cold-activated PET-CT. Therefore, this protocol uses 18F-FDG PET-CT scans to automatically generate a BAT mask, which is then applied to co-registered MRI scans of the same subject. This approach enables measurement of quantitative MRI properties of BAT without manual segmentation. BAT masks are created from two PET-CT scans: after exposure for 2 hr to either thermoneutral (TN) (24 &#176;C) or cold-activated (CA) (17 &#176;C) conditions. The TN and CA PET-CT scans are registered, and the PET standardized uptake and CT Hounsfield values are used to create a mask containing only BAT. CA and TN MRI scans are also acquired on the same subject and registered to the PET-CT scans in order to establish quantitative MRI properties within the automatically defined BAT mask. An advantage of this approach is that the segmentation is completely automated and is based on widely accepted methods for identification of activated BAT (PET-CT). The quantitative MRI properties of BAT established using this protocol can serve as the basis for an MRI-only BAT examination that avoids the radiation associated with PET-CT.

The method presented here uses 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET-CT) and fat-water separated magnetic resonance imaging (MRI), each scanned following 2 hr exposure to thermoneutral (24 &#176;C) and cold conditions (17 &#176;C) in order to map brown adipose tissue (BAT) in adult human subjects.

Reliably differentiating brown adipose tissue (BAT) from other tissues using a non-invasive imaging method is an important step toward studying BAT in ...

Mouse Body Temperature Measurement Using Infrared Thermometer During Passive Systemic Anaphylaxis and Food Allergy Evaluation

Mouse body temperature measurement is of paramount importance for investigating allergies and anaphylactic symptoms. Rectal probes for temperature readings is common, and they have been proven to be accurate and invaluable in this regard. However, this method of temperature measurement requires the mice to be anesthetized in order to insert the probe without injury to the animal. This limits the ability to observe other phenotypes of the mouse simultaneously. In order to investigate other phenotypes while measuring temperatures, rectal probes are not ideal, and another method is desired. Here, we introduce a noninvasive method of temperature measurement that foregoes the requirement for mouse anesthesia while maintaining equal reliability to rectal probes in measuring body temperature. We use an infrared thermometer that detects body surface temperatures at ranges between 2 and 150 mm. This method of body temperature measurement is successful in reliably replicating temperature change trends during passive system anaphylaxis experiments in mice. We show that body surface temperatures are about 2.0 &#176;C lower than rectal probe measurements, but the degree of temperature drop follows the same trend. Furthermore, we use the same technique to observe mice in a food allergy model to evaluate temperature and activity levels simultaneously.

Here we present a new method to accurately measure body temperature differences in passive systemic anaphylaxis (PSA) and food allergy mouse models using an infrared thermometer. This procedure has been accurately duplicated in previous PSA results.

Mouse body temperature measurement is of paramount importance for investigating allergies and anaphylactic symptoms. Rectal probes for temperature ...

Immunology and Infection

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time. There are many reported approaches for temperature management, including improvised methods that repurpose standard supplies (e.g., ice, chilled saline, fans, blankets) but more sophisticated technologies designed for temperature management are typically more successful in delivering an optimized protocol. Over the last decade, advanced technologies have developed around two heat transfer methods: surface devices (water blankets, forced-air warmers) or intravascular devices (sterile catheters requiring vascular placement). Recently, a novel device became available that is placed in the esophagus, analogous to a standard orogastric tube, that provides efficient heat transfer through the patient&#39;s core. The device connects to existing heat exchange units to allow automatic patient temperature management via a servo mechanism, using patient temperature from standard temperature sensors (rectal, Foley, or other core temperature sensors) as the input variable. This approach eliminates vascular placement complications (deep venous thrombosis, central line associated bloodstream infection), reduces obstruction to patient access, and causes less shivering when compared to surface approaches. Published data have also shown a high degree of accuracy and maintenance of target temperature using the esophageal approach to temperature management. Therefore, the purpose of this method is to provide a low-risk alternative method for controlling patient temperature in critical care settings.

This study presents a novel method to provide efficient patient temperature control for cooling or warming patients. A single use, triple lumen device is placed into the esophagus, analogous to a standard orogastric tube, and connects to existing heat exchange units to perform automatic patient temperature management.

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often ...

Infrared Thermography for the Detection of Changes in Brown Adipose Tissue Activity

Measuring brown adipose tissue (BAT) activity by positron emission tomography computed tomography (PET-CT) via the accumulation of 18F-fluorodeoxyglucose (FDG) after a meal or in obese or diabetic patients fails as the method of choice. The main reason is that 18F-FDG competes with the postprandial high glucose plasma concentration for the same glucose transporter on the membrane of BAT cells. In addition, BAT uses fatty acids as a source of energy as well, which is not visible with PET-CT and could be changed along with glucose concentration in obese and diabetic patients. Therefore, to estimate the physiological importance of BAT in animals and humans, a new infrared thermography method used in recent publications is applied.
After overnight fasting, BAT activity was measured by infrared thermography before and after a meal in human volunteers and&#160;female wild-type mice. The camera software calculates the object&#39;s temperature using distance from the object, skin emissivity, reflected room temperature, air temperature, and relative humidity. In mice, the shaved area above the BAT was a region of interest for which average and maximal temperatures were measured. The phase of the estrous cycle in female mice was determined after an experiment by vaginal smears stained with cresyl violet (0.1%) stain solution. In healthy volunteers, two skin areas of the neck were selected: the supraclavicular area (above the collarbone, where BAT cells are present) and the interclavicular area (between the collarbones, where there is no BAT tissue detected). BAT activity is determined by the subtraction of those two values. Also, the average and maximal temperatures of skin areas could be determined in animals and human participants.
Changes in BAT activity after a meal measured by infrared thermography, a non-invasive and more sensitive method, were shown to be sex, age, and phase of the estrous cycle dependent in laboratory animals. As part of diet-induced thermogenesis, BAT activation in humans was also proven to be sex, age, and body mass index dependent. Further determining the pathophysiological changes in BAT activity after a meal will be of great importance for participants with high glucose plasma concentrations (obesity and diabetes mellitus type 2), as well as in different laboratory animals (knock-out mice). This method is also a variable tool for determining possible activating drugs that could rejuvenate BAT activity.

Here, we present a protocol for measuring brown adipose tissue activity after a meal in humans and laboratory animals.

Measuring brown adipose tissue (BAT) activity by positron emission tomography computed tomography (PET-CT) via the accumulation of 18F-fluorodeoxyglucose ...

Using a Combination of Indirect Calorimetry, Infrared Thermography, and Blood Glucose Levels to Measure Brown Adipose Tissue Thermogenesis in Humans

In mammals, brown adipose tissue (BAT) is activated rapidly in response to cold in order to maintain body temperature. Although BAT has been studied greatly in small animals, it is difficult to measure the activity of BAT in humans. Therefore, little is known about the heat-generating capacity and physiological significance of BAT in humans, including the degree to which components of the diet can activate BAT. This is due to the limitations in the currently most used method to assess the activation of BAT-radiolabeled glucose (fluorodeoxyglucose or 18FDG) measured by positron emission tomography-computerized tomography (PET-CT).
This method is usually performed in fasted subjects, as feeding induces glucose uptake by the muscles, which can mask the glucose uptake into the BAT. This paper describes a detailed protocol for quantifying total-body human energy expenditure and substrate utilization from BAT thermogenesis by combining indirect calorimetry, infrared thermography, and blood glucose monitoring in carbohydrate-loaded adult males. To characterize the physiological significance of BAT, measures of the impact of BAT activity on human health are critical. We demonstrate a protocol to achieve this by combining carbohydrate loading and indirect calorimetry with measurements of supraclavicular changes in temperature. This novel approach will help to understand the physiology and pharmacology of BAT thermogenesis in humans.

Here, we present a protocol to quantify the physiological significance of the impact of brown adipose tissue (BAT) activity on human metabolism. This is achieved by combining carbohydrate loading and indirect calorimetry with measurements of supraclavicular changes in temperature. This novel approach can help develop a pharmacological target for BAT thermogenesis in humans.

In mammals, brown adipose tissue (BAT) is activated rapidly in response to cold in order to maintain body temperature. Although BAT has been studied ...

Surgical Implantation of Temperature Telemetric Monitoring System in Mouse Model: A Surgical Procedure to Implant Temperature Telemetric Device to Measure Mouse Core Body Temperature

Source: King, M. A. et al.&#160; <a href="https://www.jove.com/video/62738" target="_blank">A Preclinical Model of Exertional Heat Stroke in Mice</a>. J. Vis. Exp. (2021)
In this video, we describe a surgical procedure to implant a temperature telemetric device&#160; in a mouse model to continuously measure its core body temperature.

Source: King, M. A. et al.&#160; A Preclinical Model of Exertional Heat Stroke in Mice. J. Vis. Exp. (2021)
In this video, we describe a surgical ...

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Adult

Equipments Used to Measure Body Temperature

Body temperature can be assessed using various devices and measured in Celsius or Fahrenheit.
Glass-bulb Thermometer:
Glass-bulb thermometers are hollow glass tubes with a bulb tip containing liquid such as ethanol or mercury. Historically, glass bulb mercury thermometers were the standard device to measure body temperature. Today, mercury thermometers are prohibited in many countries due to the hazardous effects of mercury and the risk of exposure if the glass bulb breaks. In general, glass-bulb thermometers pose a risk of unintended injury to patients if the glass breaks.&#160;
Electronic and Digital Thermometer:
Electronic and digital thermometers are designed to assess oral, rectal, or axillary body temperature in 1 to 60 seconds. The electronic thermometer comprises a rechargeable battery-powered display unit, a temperature-processing probe covered by a disposable probe cover, and a thin wire cord. Some models have separate, unbreakable, reusable probes with single-use disposable covers for oral and rectal usage. These battery-powered devices display a numerical temperature. In some, the most recent measurements have a 60-second pulse timer that automatically converts temperature readings from Fahrenheit to Celsius.
Tympanic Membrane Thermometer:
Tympanic membrane thermometers are an otoscope-like speculum that uses infrared sensors to measure heat emitted by the tympanic membrane. The probe is encased with a probe cover and securely placed into the ear canal to close the opening. Depending on the product, the reading takes between 1 and 3 seconds.
Disposable single-use Thermometers or Chemical Dot Thermometers:
Disposable single-use or chemical dot thermometers are unbreakable and detect the patient&#39;s temperature in seconds. Since they are only used once, single-use thermometers eliminate the risk of cross-infection. This is ideal for use with patients on isolation precautions.
Chemical dot thermometers are temperature-sensitive patches or tape, which are placed on the stomach or forehead, that change color to reflect the temperature. The Celsius version has 50 dots, each reflecting a 0.1&#176; C temperature increase from 35.5&#176; C to 40.4&#176; C. The Fahrenheit version features 45 dots with 0.2&#176; F variations and a temperature range of 96&#176;F to 104.8&#176; F. These thermometers can be used on children. If the color of the tape or patch indicates abnormal temperature, a more traditional type of thermometer should be used to verify the temperature reading.
Temporal Artery Thermometer:
Temporal artery thermometers use the heat radiated by the skin above the temporal artery to determine body temperature. These devices are battery-powered and have a temperature display.

Body temperature can be assessed using various devices and measured in Celsius or Fahrenheit.
Glass-bulb Thermometer:
Glass-bulb thermometers are hollow ...

KEY TERMS AND CONCEPTS

Assessing Body Temperature - Oral

Here are the steps to accurately measure oral temperature using an electronic thermometer:
Step 1:
Start by practicing proper hand hygiene to prevent the spread of microorganisms.
Step 2:
Take the thermometer out of the charging unit, switch it on, and wait for the ready sign.
Step 3:
Gently slide the probe cover until a click is heard. This simple action prevents cross-contamination and ensures the correct placement of the probe cover.
Step 4:
Instruct the patient to open their mouth and place the thermometer probe beneath their tongue in the posterior sublingual pocket within the side of the lower jaw. Positioning the probe deep within this pocket establishes contact with the blood vessels closest to the surface.
Step 5:
Advise the patient to close their lips around the thermometer. Ensure they don&#39;t bite it to maintain the correct position.
Step 6:
Click the scan button on the equipment and keep the probe in place until an audible sound indicates completion. The patient&#39;s temperature will then appear on the display unit.
Step 7:
Remove the probe from the mouth and dispose of the probe cover by pressing the ejection button on the thermometer probe stem.
Step 8:
Perform hand hygiene once again and document the findings.
Step 9:
Finally, place the thermometer probe back into its charging unit.

Here are the steps to accurately measure oral temperature using an electronic thermometer:
Step 1:
Start by practicing proper hand hygiene to prevent the ...

Assessing Body Temperature - Rectal

Rectal temperature measurement is considered the most precise method for assessing core body temperature and typically registers higher than oral temperature. For adults, the rectal thermometer should be inserted 1 to 1.5 inches into the rectum to obtain the most accurate reading.
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal area.
Step 3: Expose only the anal region, maintaining patient warmth and privacy.
Step 4: If present, clean the anal area of any feces or secretions. Remove soiled gloves, perform hand hygiene, and put on clean gloves.
Step 5: Retrieve the thermometer from its charging unit and attach the rectal thermometer probe stem.
Step 6: Securely fit a disposable plastic probe cover over the thermometer probe stem to prevent infection transmission.
Step 7: Apply a generous amount of water-soluble lubricant to the thermometer, covering the first 1 to 1.5 inches. Lubrication minimizes rectal discomfort.
Step 8: Using the non-dominant hand, gently part the patient&#39;s buttocks to expose the anus. Advise the patient to take slow, deep breaths and relax, which helps ease the insertion of the thermometer by relaxing the anal sphincter.
Step 9: Carefully insert the lubricated thermometer toward the umbilicus up to about 1.5 inches. Ensure the probe is inserted correctly to optimize contact with rectal blood vessels.
Step 10: If resistance is felt, cease insertion to avoid damaging the rectal mucosa.
Step 11: Hold the thermometer steady until the thermometer beeps, signaling that the reading is finished. Record the temperature displayed on the thermometer unit.
Step 12: Press the ejection button to release the probe cover. Safely dispose of the probe cover and clean the thermometer stem with an alcohol swab, particularly around any ridges or connections.
Step 13: Clean the patient&#39;s anal area with soft tissue to remove any lubricant or fecal residue. Discard the tissue and perform any additional perineal hygiene as needed.
Step 14: To conclude the procedure, remove and dispose of gloves in a designated container and perform hand hygiene.
Step 15: Document the temperature and all procedural steps accordingly.