Friday 14 August 2020

NORMAL BODY TEMPERATURE- CHANGING THE STANDARD

 COVID-19 is on our minds, incessantly and endlessly playing in our ears on every call, on the news, online-offline and everywhere.

Even though I am not a betting person, I think it is safe to bet we have all given in to the need to check our temperature at some point.

My moment of truth was a few days back when I felt feverish. I reached for the thermometer, and it showed  96.2 F (35.7 C). I thought my eyesight was playing up. So I reached for the digital thermometer and got the reading 96.2 F. Not high not even the normal  “98.6 F or 37 C (range: 97.2-99.5 F / 36.2-37.5C ) as established by the German Physician Carl R A Wunderlich in the 19th century. Then I recalled that this had happened to me before although I never really bothered with it always considering the digital thermometer must not be accurate or the batteries must be weak.  But now I am more sensitive to such things as the temperature records, thanks to COVID-19. 

"Normal body temperature. 

Thermometer showing slightly above 36°C" by "Ivan Radic" 
 is licensed under a Creative Commons Attribution 2.0 Generic License.


I remembered an article titled “Decreasing human body temperature in the United States since the Industrial Revolution” by Myroslava Protisv that had momentarily caught my attention in early January  I had tagged it for a later read. I then forgot about it in the Covid-19 information deluge. 

A quick search and I found the article, which describes the previous values derived from the study of armpit temperature in 25000 patients is no longer appropriate, with the average American temperature now running more than a degree lower.  “The authors who analysed 677,423 human body temperatures from three cohorts spanning 157 years of measurement found a decrease of -0.03 C and -0.32 C in men and women respectively per birth decade.

What does this mean for diagnosing fever? So far nothing, as experts agree that a fever still remains a fever that is a rise in temperature to above 100 F  for adults and,  and high temperatures above 103 F( 39.4 C)  the level for causing concern and a need for visiting the emergency room for adults.

 On the other hand, the article’s findings are very significant to the normal body temperature values followed around the world.  The authors have related the fall to decrease in metabolic rate to different factors, mainly reducing population-level chronic inflammation due to reduction in mild persistent infections and changes in ambient temperatures in recent times.  The resting metabolic rate reflects the body temperature and ambient temperature. The body temperature increases when the ambient temperature falls and decreases when the ambient temperature rises.  So essentially, population-level presence of chronic inflammation and ambient temperatures control the body temperature.

Assuming these explanations are valid, and the authors make a compelling argument. The normal temperatures around the world’s different regions with vastly different climates, as seen in the map and levels of infections, was never the same as those that were found by Carl R A Wunderlich in Germany.

https://www.climate-charts.com/World-Climate-Maps.html#temperature

Although currently, experts agree that the changes to the normal temperature do not affect the level considered as fever, and that may very well be the case in severe fever, one has to wonder, if that is the case in establishing the presence of fever itself.

Multiple questions need to be answered.

What is the normal body temperature range of people from different climatic and hygiene level regions of the world?

Can individuals’ basic( normal) body temperature change within their lifetime by on relocating to a climatically different region?

Intriguing questions that we have the means to answer due to the COVID-19 pandemic.  

The spread of coronavirus disease (COVID -19) across the globe has made the simple thermometer a star gadget, with thermometers becoming the most often purchased gadget during the COVID-19 pandemic.    Temperature screening has taken an entirely new dimension, with more temperatures, checked and recorded per day than ever before.

This combination of availability of the equipment (thermometer), skill and awareness of the importance of recording the body temperature provides us with the exceptional opportunity to establish the new range of normal  body temperature region-wise around the world through extensive collaborative studies.

Please share your comments and thoughts. I would love to hear from you.

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Saturday 1 August 2020

TO SHARE OR NOT TO SHARE ? Creative Commons maybe your answer

You just saw a case that was so unique or so typical that you are dying to share with your colleagues, students or the World Wide Web at large.

Were you just asked to contribute a picture or content for a publication or presentation?

And now you are thorn between the natural academic, and professional desire to share for the greater good, and the practical realities of life that may cause you considerable problems if you do.

The content may not be yours to share. Today's academic and hospital settings ensure that patients are inevitably seen by at the very least two disciplines and often many more. Under those circumstances, ownership of the content to be shared needs to be agreed upon by all. The lack of agreement and clarity is perhaps the greatest cause of information not being shared at all, and remaining unused in departmental archives.

The next complication arises when after sharing the content; you realize that you no longer can use it due to copyright issues, with the person or publication that used the material having the ownership now.

 So, does all this mean we should stop sharing?

Thankfully, no.

There is a way out that is both cost-free and hassle-free.  You or your department/s can share content to be used anywhere while holding the copyright of the material.

Creative Commons (CC) as shared on their website "is a nonprofit organization that helps overcome legal obstacles to the sharing of knowledge and creativity to address the world's pressing challenges". Currently, over 1.6 billion works are registered under the creative commons, including free to access journals across all disciplines. 


https://creativecommons.org/share-your-work/ https://vimeo.com/13590841

Wanna Work Together? from Creative Commons on Vimeo.

With different licenses that allow various levels of freedom of sharing the work, a creative license is an excellent solution for sharing your work or findings without the risk of losing your rights to the content. 

I have been using creative commons licensing for some time now. Last year I received a request for a Carcinoma Cuniculatum picture, rather than worrying about all the possibilities, I licensed the image, and then shared it. 


Oral Carcinoma Cuniculatum
Mandana Donoghue / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)

I hope you will find this information useful; there is also excellent information available on the creative commons platform, and other sites on the nature, details and use of the licensing.

Happy sharing.

   # Creative Commons,