Project description:Conjunctival examination for trachomatous inflammation-follicular (TF) guides public health decisions for trachoma. Smartphone cameras may allow remote conjunctival grading, but previous studies have found low sensitivity. A random sample of 412 children aged 1-9 years received an in-person conjunctival examination and then had conjunctival photographs taken with 1) a single-lens reflex (SLR) camera and 2) a smartphone coupled to a 3D-printed magnifying attachment. Three masked graders assessed the conjunctival photographs for TF. Latent class analysis was used to determine the sensitivity and specificity of each grading method for TF. Single-lens reflex photo-grading was 95.0% sensitive and 93.6% specific, and smartphone photo-grading was 84.1% sensitive and 97.6% specific. The sensitivity of the smartphone-CellScope device was considerably higher than that of a previous study using the native smartphone camera, without attachment. Magnification of smartphone images with a simple attachment improved the grading sensitivity while maintaining high specificity in a region with hyperendemic trachoma.
Project description:Although pre- and postoperative three-dimensional (3D) photography are well-established in breast reconstruction, intraoperative 3D photography is not. We demonstrate the process of intraoperative acquisition and visualization of 3D photographs for breast reconstruction and present clinicians' opinions about intraoperative visualization tools.MethodsMastectomy specimens were scanned with a handheld 3D scanner during breast surgery. The 3D photographs were processed to compute morphological measurements of the specimen. Three visualization modalities (screen-based viewing, augmented reality viewing, and 3D printed models) were created to show different representations of the 3D photographs to plastic surgeons. We interviewed seven surgeons about the usefulness of the visualization methods.ResultsThe average time for intraoperative acquisition of 3D photographs of the mastectomy specimen was 4 minutes, 8 seconds ± 44 seconds. The average time for image processing to compute morphological measurements of the specimen was 54.26 ± 40.39 seconds. All of the interviewed surgeons would be more inclined to use intraoperative visualization if it displayed information that they are currently missing (eg, the target shape of the reconstructed breast mound). Additionally, the surgeons preferred high-fidelity visualization tools (such as 3D printing) that are easy-to-use and have minimal disruption to their current workflow.ConclusionsThis study demonstrates that 3D photographs can be collected intraoperatively within acceptable time limits, and quantitative measurements can be computed timely to be utilized within the same procedure. We also report surgeons' comments on usability of visualization methods and of measurements of the mastectomy specimen, which can be used to guide future surgical practice.
Project description:The objective of this study was to develop a low-cost method for rice growth information obtained quickly using digital images taken with smartphone. A new canopy parameter, namely, the canopy volume parameter (CVP), was proposed and developed for rice using the leaf area index (LAI) and plant height (PH). Among these parameters, the CVP was selected as an optimal parameter to characterize rice yields during the growth period. Rice canopy images were acquired with a smartphone. Image feature parameters were extracted, including the canopy cover (CC) and numerous vegetation indices (VIs), before and after image segmentation. A rice CVP prediction model in which the CC and VIs served as independent variables was established using a random forest (RF) regression algorithm. The results revealed the following. The CVP was better than the LAI and PH for predicting the final yield. And a CVP prediction model constructed according to a local modelling method for distinguishing different types of rice varieties was the most accurate (coefficient of determination (R2) = 0.92; root mean square error (RMSE) = 0.44). These findings indicate that digital images can be used to track the growth of crops over time and provide technical support for estimating rice yields.
Project description:Hemispherical photography (HP), implemented with cameras equipped with "fisheye" lenses, is a widely used method for describing forest canopies and light regimes. A promising technological advance is the availability of low-cost fisheye lenses for smartphone cameras. However, smartphone camera sensors cannot record a full hemisphere. We investigate whether smartphone HP is a cheaper and faster but still adequate operational alternative to traditional cameras for describing forest canopies and light regimes. We collected hemispherical pictures with both smartphone and traditional cameras in 223 forest sample points, across different overstory species and canopy densities. The smartphone image acquisition followed a faster and simpler protocol than that for the traditional camera. We automatically thresholded all images. We processed the traditional camera images for Canopy Openness (CO) and Site Factor estimation. For smartphone images, we took two pictures with different orientations per point and used two processing protocols: (i) we estimated and averaged total canopy gap from the two single pictures, and (ii) merging the two pictures together, we formed images closer to full hemispheres and estimated from them CO and Site Factors. We compared the same parameters obtained from different cameras and estimated generalized linear mixed models (GLMMs) between them. Total canopy gap estimated from the first processing protocol for smartphone pictures was on average significantly higher than CO estimated from traditional camera images, although with a consistent bias. Canopy Openness and Site Factors estimated from merged smartphone pictures of the second processing protocol were on average significantly higher than those from traditional cameras images, although with relatively little absolute differences and scatter. Smartphone HP is an acceptable alternative to HP using traditional cameras, providing similar results with a faster and cheaper methodology. Smartphone outputs can be directly used as they are for ecological studies, or converted with specific models for a better comparison to traditional cameras.
Project description:PurposeThe aim of this study was to carry out blue light photography of fluorescein-stained corneas using a novel smartphone attachment.MethodsA smartphone attachment known as the cobalt blue light unit (C-BLU) was developed. It can filter out all wavelengths of light except the blue light emerging from the flashlight of a smartphone. A pilot study was carried out wherein the images captured with the C-BLU system were compared with slit-lamp photographs of the same patients. This setup was then used to photo document fluorescein-stained corneas in various clinical settings assembled at point-of-care.ResultsMany pathologies of the fluorescein-stained cornea were captured using the C-BLU filter. It was used effectively in various settings (remote eye camps, intensive care units (ICU), pediatric group, corneal trauma triaging, etc.). C-BLU was assembled and used by optometrists and ophthalmology residents. The images captured were used for documenting, assisting in the treatment, and also for telecommunication of the patients' findings.ConclusionC-BLU is a low-cost pocket-size filter which is easy to use with a modern smartphone without any technical expertise needed to obtain a clear image of fluorescein-stained pathological corneas.
Project description:PurposeTo assess the subjective quality of anterior segment photos taken from a smartphone camera adapted to the slit lamp compared to a commercial inbuilt slit-lamp camera.MethodsNon-inferiority study. Five paired images of the anterior segment of normal eyes were taken using an iPhone 11 (Apple, Inc., Calif., USA) camera attached to a universal slit-lamp adaptor and a commercial inbuilt slit-lamp camera (Haag-Streit Diagnostics, Bern, Switzerland). Images were collated into a survey in which ophthalmology students, residents, registrars, and consultants participated to select the image taken from the inbuilt slit-lamp camera. If the image quality was subjectively indistinguishable, we expected a 50:50 split for each photograph that was presented. We selected a 10% non-inferiority margin, with the hypothesis that no less than 40% of images believed to be from the conventional camera were in fact from the smartphone camera.ResultsThere were 27 respondents in the survey: ophthalmology consultants (n = 7), registrars (n = 10), residents (n = 7), intern (n = 1) and students (n = 2). The mean correct identification across the respondents was 11.3 out of 25 (45.2%) images. Overall, the smartphone camera was non-inferior to the inbuilt slit-lamp camera (p < 0.001). The non-inferiority of the smartphone camera was significant for consultants (47.4%, p < 0.01), registrars (47.6%, p < 0.001) and residents (37.7%, p < 0.0001).ConclusionsAnterior segment images obtained with a smartphone camera were non-inferior to the commercial inbuilt slit-lamp camera. Smartphone cameras may be a non-inferior tool for communication of anterior segment images having implications for the ease of access to quality telehealth consultations.
Project description:PurposeAn important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus.MethodsSeveral modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced image stitching, and video-recording capabilities. Retinal photographs were obtained in children undergoing routine dilated eye examination. Experienced masked retina-specialist graders determined photograph quality and made diagnoses based on the images, which were compared to the treating clinician's diagnosis.ResultsDilated fundus photographs were acquired in 43 patients with a mean age of 6.7 years. The diagnoses included retinoblastoma, Coats' disease, commotio retinae, and optic nerve hypoplasia, among others. Mean time to acquire five standard photographs totaling 90-degree field of vision was 2.3 ± 1.1 minutes. Patients rated their experience of image acquisition favorably, with a Likert score of 4.6 ± 0.8 out of 5. There was 96% agreement between image-based diagnosis and the treating clinician's diagnosis.ConclusionsWe report a handheld smartphone-based device with modifications tailored for wide-field fundus photography in pediatric patients that can rapidly acquire fundus photos while being well-tolerated.Translational relevanceAdvances in handheld smartphone-based fundus photography devices decrease the technical barrier for image acquisition in children and may potentially increase access to ophthalmic care in communities with limited resources.
Project description:PurposeThe current grading systems used for bleb morphology assessment in patients post-trabeculectomy are based on standardized slit-lamp photographs and anterior segment imaging devices. The lack of availability of these expensive and non-portable devices in resource-deficient settings is a significant deterrent in their widespread utilization for proper post-operative management. The rapidly evolving utilization of smartphone photography has significantly benefited diagnostics of posterior segment disorders and is now being increasingly utilized for monitoring anterior segment pathologies as well as post-surgical course. In this study, we study a novel use of smartphones for bleb photography for assessing the morphological characteristics as vascularity and microcysts.MethodsIn this pilot, observational study, we compared the trabeculectomy bleb images of five subjects, obtained by iPhone X (dual lens) and iPhone 6S (single lens). We captured two image sets with both smartphones first with a focussed torchlight and then with a built-in flash video light.ResultsThe images resulting from the newer iPhone X were substantially superior than those from iPhone 6S. For the 12-megapixel dual-camera set-up on the iPhone X, the 1 × lens resulted in better images than the 2 × lens with contrast and overall clarity of the area of interest. While the macro-lens attachment had promising results at 1 × zoom, there is no added advantage of the macro-lens attachment as it resulted in considerable loss of image quality at twice the zoom. Using a 20 D lens helped attain higher magnification and better framing as it reduced the focussing distance needed to get sharp images. The images obtained from both smartphones were of higher quality when illuminated from an external source when compared to the native iPhone flash due to even exposure and fewer autofocus artefacts.ConclusionAnalyses of all image sets showed that the current generation in-built camera app on IOS and newer iPhone camera optics resulted in high-quality images of the ocular surface with high magnification without any loss in clarity.
Project description:BackgroundThe purpose of the present study was to identify smartphone use patterns associated with problematic smartphone use (PSU) among preschool children. Little is known about PSU patterns in younger children, although the age for first smartphone use is decreasing.MethodsWe applied a cross-sectional study design to analyze data obtained from a nationwide survey on smartphone overdependence conducted in 2017 by the South Korean Ministry of Science and ICT and the National Information Society Agency. Data from 1,378 preschool children were analyzed using binomial logistic regression analysis. This study was conducted in compliance with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).ResultsSeventeen percent of the sample met the criteria for PSU. The odds of PSU significantly increased with frequent smartphone use and in children who used a smartphone for more than two hours per day. Using smartphones to watch TV shows or videos for entertainment or fun significantly increased the odds of PSU, whereas using smartphones for education, games, and social networking did not.ConclusionsThe findings indicate that one of five preschool children using smartphones could experience PSU. Compared to other age groups, PSU in young children may be more associated with their caregivers. To prevent PSU in preschool children, caregivers need information about the total screen time recommended for children, smartphone use patterns associated with PSU, suggestions for other activities as possible alternatives to smartphone use, and strategies to strengthen children's self-regulation with regards to smartphone use.
Project description:Spinal cord stimulation (SCS) is an effective and validated treatment to address chronic refractory neuropathic pain in persistent spinal pain syndrome-type 2 (PSPS-T2) patients. Surgical SCS lead placement is traditionally performed under general anesthesia due to its invasiveness. In parallel, recent works have suggested that awake anesthesia (AA), consisting of target controlled intra-venous anesthesia (TCIVA), could be an interesting tool to optimize lead anatomical placement using patient intra-operative feedback. We hypothesized that combining AA with minimal invasive surgery (MIS) could improve SCS outcomes. The goal of this study was to evaluate SCS lead performance (defined by the area of pain adequately covered by paraesthesia generated via SCS), using an intraoperative objective quantitative mapping tool, and secondarily, to assess pain relief, functional improvement and change in quality of life with a composite score. We analyzed data from a prospective multicenter study (ESTIMET) to compare the outcomes of 115 patients implanted with MIS under AA (MISAA group) or general anesthesia (MISGA group), or by laminectomy under general anesthesia (LGA group). All in all, awake surgery appears to show significantly better performance than general anesthesia in terms of patient pain coverage (65% vs. 34-62%), pain surface (50-76% vs. 50-61%) and pain intensity (65% vs. 35-40%), as well as improved secondary outcomes (quality of life, functional disability and depression). One step further, our results suggest that MISAA combined with intra-operative hypnosis could potentialize patient intraoperative cooperation and could be proposed as a personalized package offered to PSPS-T2 patients eligible for SCS implantation in highly dedicated neuromodulation centers.