Digital Imaging System for the Detection of Diabetic Retinopathy

COVID-19 since its appearance caused serious problems to the health sector due to the increase in infected and deceased people by directly affecting their respiratory system, making it a primordial disease that led all countries to fight this virus, generating that other diseases go to the background such as diabetes mellitus, which is a disease caused by the neglect of people's lifestyles, that has been increasing over time and that has no cure but can be prevented by controlling your blood glucose level, this disease causes diabetic retinopathy in people that with the advance of it can cause loss of sight. In addition, to detect its stage the ophthalmologist relies on his experience, occupying a lot of time and being prone to make mistakes about the patient. In view of this problem, in this article a digital image processing system was performed for the detection of diabetic retinopathy and classified according to the characteristics obtained from the features by analyzing the fundus of the eye automatically and determining the stage in which the patient is. Through the development of this system, it was determined that it works in the best way, visualizing an efficiency of 95.78% in the detection of exudates, and an efficiency of 97.14% in the detection of hemorrhages and blood vessels, resulting in a reliable and safe system to detect diabetic retinopathy early in diabetic patients. © 2023 IEEE.

Chest X-ray Imaging System for Early Detection of Tuberculosis

Today it is observed that few people respect the biosecurity measures announced by the WHO, which aimed to reduce the amount of COVID-19 infection among people, even knowing that this virus has not disappeared from our environment, being an unprecedented infection in the world. It should be noted that before this pandemic, tuberculosis affected millions of people, having a great role because it is highly contagious and directly affects the lungs, although it has a cure, if it is not treated in time it can be fatal for the person, although there are many methods of detection of tuberculosis, one that is most often used is the diagnosis by chest x-ray, although it has low specificity, when the image processing technique is applied, tuberculosis would be accurately detected. In view of this problem, in this article a chest X-ray image processing system was conducted for the early detection of tuberculosis, helping doctors to detect tuberculosis accurately and quickly by having a second opinion by the system in the analysis of the chest x-ray, prevents fatal infections in patients. Through the development of the tuberculosis early detection system, it was possible to observe the correct functioning of the system with an efficiency of 97.84% in the detection of tuberculosis, detailing the characteristics presented by normal or abnormal images so that the doctor detects tuberculosis in the patient early. © 2023 IEEE.

Computed Tomography Simulator (Ctlab)

University of Oulu and Oulu University of Applied Sciences have established a unique medical imaging teaching and testing laboratory in collaboration with Oulu University Hospital in a European Regional Development Fund -project. Virtually implemented medical imaging devices (CT, MRI, radiography) are unique features of the lab. Many of the virtual tools have been developed by the universities themselves. One of the virtual tools implemented during the project is the CTlab simulator, which can be widely used in computed tomography training for all professionals who use radiation in their work. The CTlab provides fast, comprehensive, and efficient solutions for numerical CT simulations with low hardware requirements. The simulator has been developed to introduce the basic operations and workflow behind the CT imaging modality and to illustrate how the polychromatic x-ray spectrum, various imaging parameters, scan geometry and CT reconstruction algorithm affect the quality of the detected images. Key user groups for the simulator include medical physics, engineering, and radiographer students. CTlab has been created with MATLAB's app designer feature. It offers its user the opportunity to select the virtual imaging target, to adjust CT imaging parameters (image volume, scan angles, detector element size and detector width, noise, algorithm/geometry specific parameters), to select specific scan geometry, to observe projection data from selected imaging target with polychromatic x-ray spectrum, and to select the specific algorithm for image reconstruction (FBP, least squares, Tikhonov regularization). The CTlab has so far been used at a postgraduate course on computed tomography technology with encouraging feedback from the students. At the course, teaching of CT modality were performed by using the simulator, giving students unlimited opportunity to practice the use of virtual imaging device and participate demonstrations remotely during the Covid-19 pandemic. Using CTlab in teaching enhances and deepens the learning experience in the physics behind computed tomography. CTlab can be used remotely (https://www.oulu.fi/fi/projektit/laaketieteellisen-kuvantamisen-opetus-ja-testilaboratorio-0), which makes teaching and training of CT scanner usage successful regardless of time and place. The simulator enables more illustrative and in-depth teaching and offers cost-effectiveness, versatility, and flexibility in education. CTlab can also be used to support teaching in special situations, such as during the Covid-19 pandemic when simulator is utilized remotely to perform teaching-related demonstrations flexibly and safely.Copyright © 2023 Southern Society for Clinical Investigation.

Assessment of three different dermoscopy imaging systems during a fast-track skin cancer clinic

Dermoscopy is a noninvasive diagnostic investigation based on magnification, illumination and obliteration of light scatter on the skin surface allowing better visualization of structures beneath the stratum corneum. We aimed to assess image quality of lesions evaluated at a skin cancer clinic using three different handheld dermatoscopes;the Heine Delta 20T (contact) with an iPad;the MoleScope II (noncontact) with a Samsung 7 smartphone;and the Dino-Lite Edge with direct download to a MacBook laptop (noncontact). The Heine Delta 20T and iPad is the current standard used. The MoleScope is a mobile smartphone-attachable dermatoscope. The Dino-Lite is a handheld digital microscope that connects directly to the computer via a USB port. The cost of the Heine Delta 20T is roughly 1100, the MoleScope II 260 and the Dino-Lite 600. Twenty-three lesions were imaged with each device;15 were pigmented. A total of 69 images were downloaded and transferred to Microsoft PowerPoint for review in random order. The images were scored by four consultant dermatologists, one general practitioner with a special interest and one associate specialist, blinded to the diagnoses. A score of 1-5 (poor- excellent) was attributed to each category: (i) detail/dermoscopic features;(ii) colour discrimination;(iii) magnification. Each assessor recorded whether - based on the image alone - they could make a diagnosis. The lesions were basal cell carcinoma (n = 6), seborrhoeic keratosis (n = 4), lichenoid keratosis (n = 1), benign naevi (n = 4), dysplastic naevi (n = 2), melanoma (n = 1), blue naevus (n = 1), sebaceous gland hyperplasia (n = 1), ruptured cyst (n = 1), pyogenic granuloma (n = 1) and dermatofibroma (n = 1). The mean score for each device and category was calculated as follows. (i) Heine: detail = 3.2, colour = 3 3, magnification = 3 2 (overall score = 3 2);46 2% felt able to make a diagnosis. (ii) MoleScope: detail = 2 5, colour = 2 7, magnification 2 5 (overall score = 2 6);43 5% felt able to make a diagnosis. (iii) Dino-Lite: detail = 3 2, colour = 3 2, magnification = 3 6 (overall score = 3 3);57 2% felt able to make a diagnosis. Analysis on a PC screen allowed greater magnification than is generally employed in clinic, which may have affected assessors. The Heine is not primarily designed for digital dermoscopy. It requires two operators for image capture, whereas the other systems require only one. The MoleScope remains the most 'mobile', whereas the Dino-Lite is attached to a laptop/PC. Both the MoleScope and Dino-Lite can be used as noncontact dermatoscopes, avoiding contact medium use. Considering the current COVID-19 pandemic, these devices are less time consuming, more convenient and easier to clean. Overall, the Dino-Lite produced the best images. Despite the MoleScope scoring lower, it was comparable for diagnostic ability. It is proposed that the MoleScope and Dino-Lite systems may be optimal for use in teledermatology to facilitate virtual clinics.

Role of Chest Radiography as the Imaging Tool in COVID Pandemic Era

Background: The present radiological COVID literature is mainly confined to the CT findings. Using High Resolution Computed tomography (HRCT) as a regular 1st line investigation put a large burden on radiology department and constitute a huge challenge for the infection control in CT suite. Materials and Methods: A prospective study of 700 consecutive COVID positive cases who underwent Chest Xray (CXR) and HRCT thorax were included in the study. Many of these CXR were repeated and followed up over a duration of time to see the progression of disease. Results: 392/700 (56%) were found to be negative for radiological thoracic involvement. 147/700 (21%) COVID positive patients showed lung consolidations, 115/700 (16.5%) presented with GGO, 40/700 (5.7%) with nodules and 42/700 (6%) with reticular–nodular opacities. 150/700 patients (21.4 %) had mild findings with total RALE severity score of 1-2. More extensive involvement was seen in 104/700 (14.8 %) and 43/700 (6.2%) patients, who had severity scores of 3-4 and 5-6 respectively. 11/700 patients had a severity score of >6 on their baseline CXR. Those with severity score of 5 or more than 5 (54/700, 7.7%) required aggressive treatment with mean duration of stay of 14 days, many of them died also (23/54, 42.5%). Conclusion: In cases of high clinical suspicion for COVID-19, a positive CXR may obviate the need for CT. Additionally, CXR utilization for early disease detection and followup may also play a vital role in areas around the world with limited access to CT and RT-PCR test.

Decision Method of Optimal Needle Insertion Angle for Dorsal Hand Intravenous Robot.

In the context of COVID-19, the research on various aspects of the venipuncture robot field has become increasingly hot, but there has been little research on robotic needle insertion angles, primarily performed at a rough angle. This will increase the rate of puncture failure. Furthermore, there is sometimes significant pain due to the patients' differences. This paper investigates the optimal needle entry angle decision for a dorsal hand intravenous injection robot. The dorsal plane of the hand was obtained by a linear structured light scan, which was used as a basis for calculating the needle entry angle. Simulation experiments were also designed to determine the optimal needle entry angle. Firstly, the linear structured optical system was calibrated and optimized, and the error function was constructed and solved iteratively by the optimization method to eliminate measurement error. Besides, the dorsal hand was scanned to obtain the spatial point clouds of the needle entry area, and the least squares method was used to fit it to obtain the dorsal hand plane. Then, the needle entry angle was calculated based on the needle entry area plane. Finally, the changes in the penetration force under different needle entry angles were analyzed to determine the optimal needle insertion angle. According to the experimental results, the average error of the optimized structured light plane position was about 0.1 mm, which meets the needs of the project, and a large angle should be properly selected for needle insertion during the intravenous injection.

A uniform approach to cerebral venous sinus thrombosis management

Background: Cerebral venous sinus thrombosis (CVST) is an important cause of stroke with a generally favourable prognosis if diagnosed and treated early. Despite advances over recent years, the management remains variable. The current trend for initial treatment is a dose-adjusted intravenous heparin infusion or low-molecular-weight-heparin (LMWH) such as enoxaparin. Once the patient has stabilized, they are transitioned to longterm anticoagulation such as warfarin therapy or direct oral anticoagulants (DOAC) for 3-6 months, depending on risk factors. The use of a heparin infusion brings many known difficulties and complexities impacting on patient care and length of stay within hospital. Current literature suggests that enoxaparin may be superior to heparin in the treatment of CVST. Aim(s): To conduct an internal audit of patients diagnosed with CVST over a twelve-month period at the Princess Alexandra Hospital. This audit will provide foundation to develop an evidence-based hospital protocol for CVST management. Method(s): A search through the hospital imaging system identified all relevant patients. Information was collected on the initial treatment, specifically comparing the use of heparin to enoxaparin and the duration. Consideration of risk factors, aetiology and complications were summarized. During the recent era of COVID-19, we also collected data on COVID-related CVST and COVID vaccine-related CVST. Finally, we recorded the maintenance anticoagulation treatment that was commenced. Result(s): The purpose of this audit is to critically reflect on current hospital practice with a view to improve patient outcomes, safety, satisfaction, and cost-effective care. We hypothesise that in select cases, it will be a safe and preferable alternative to use enoxaparin as initial therapy over a heparin infusion. Furthermore, with appropriate patient selection, DOACs may be an appropriate maintenance therapy. Conclusion(s): The evidence for medical management of CVST is continuously evolving. This evidence must be carefully evaluated before being widely adopted at a local level.

CLOSE-TO-EFFORTLESS BREATHING PARADIGM MAPS GLOBAL AND REGIONAL LUNG FUNCTION USING ELECTRICAL IMPEDANCE TOMOGRAPHY CROSS SECTIONALLY AND LONGITUDINALLY

SESSION TITLE: Late Breaking Investigations From Pulmonary and Critical Care SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Although spirometry is the standard lung functional test, it requires the patient to perform a series of maneuvers correctly, which is difficult for elderly, children, and patients with severe lung impairments. Furthermore, spirometry lacks regional assessment for detecting and monitoring subtle changes in lung diseases, e.g., chronic obstructive pulmonary disease (COPD) and potentially COVID-19. We aim to establish a home-based imaging system, portable electrical impedance tomography (EIT), that can detect lung function deterioration and monitor its recovery through a close-to-effortless breathing paradigm. METHODS: We developed a palm-sized EIT system and a novel guided breathing paradigm that consists of a periodic inhalation and exhalation at 12 breaths per minute. We validated them on healthy subjects (n=23) performing different breathing efforts (deep vs shallow), then on patients with ILD (n=2), COPD (n=8), asthma (n=4) and bronchiectasis (n=4) against healthy (n=8) cross-sectionally, and last monitored a COVID-19 discharged subject with two age- and gender-matched healthy controls longitudinally. We further applied machine learning to distinguish between healthy and patients, and calculated its sensitivity and specificity. RESULTS: We detected higher amplitude during deep breathing compared to shallow (p < 0.001) in healthy subjects, with right lung having more activated voxels and higher total amplitude than the left lung (p < 0.001), likely due to the position of the heart. Cross-sectionally, we observed lower amplitude in patients compared to healthy (p < 0.01), while coefficient of variation (CV) of the amplitude in the lungs is higher in patients (p < 0.05). Note that CV is a parameter reflecting inhomogeneity which is indicative of lung function deterioration. Longitudinally, the COVID-19 discharged subject had higher CV in the left lung (p < 0.001) which decreased across time (p < 0.01), suggesting a functional deterioration at the beginning followed by a recovery. Regional analysis further pin-pointed the potential deterioration and recovery was in the anterior left lung. Separately, despite the small sample size, the sensitivity and specificity for detecting patients using a machine learning classifier were 76% and 62%, respectively, and will likely increase with a larger sample. CONCLUSIONS: Home-based portable EIT with close-to-effortless guided breathing paradigm can map global and regional lung function deterioration and recovery cross-sectionally and longitudinally. More importantly, it can potentially be deployed as a screening tool for various lung diseases through the application of machine learning. CLINICAL IMPLICATIONS: Portable EIT with guided breathing paradigm enables lung function diagnostic screening and treatment monitoring at home, advancing telemedicine and lowering hospital burden. DISCLOSURES: no disclosure on file for Peng Cao;Owner/Founder relationship with Gense Technologies Ltd Please note: Since 2017 Added 06/06/2022 by Russell Chan, value=Ownership interest No relevant relationships by Wang Chun Kwok No relevant relationships by Wei-Ning Lee No relevant relationships by Terence Tam Employee relationship with Gense Technologies Please note: Setpember 2021 - Now Added 06/07/2022 by Adrien Touboul, value=Salary contractor relationship with Gense Technologies Ltd Please note: since Apr 2021 Added 06/06/2022 by Eddie Wong, value=Consulting fee Employee relationship with Gense Technologies Please note: since 2020 Added 06/06/2022 by Fedi Zouari, value=Royalty

Community Based Eye Screenings Using Retinal and OCT-B Combination Imaging in Glaucoma During COVID-19

Purpose : Retinal imaging is the gold standard in tele-ophthalmology. Limitations in twodimensional imaging can lead to poor triage or unnecessary clinical referrals, especially during COVID-19. Combined retinal imaging with Optical Coherence Tomography-B scan (OCT-B) in detecting vision threatening diseases (VTDs) such as glaucoma in communitybased screenings adds a third dimension to subject data. Methods : A non-mydriatic Topcon 3D Maestro1 imaging system was deployed in this pilot study to screen 120 subjects (43.3% male, mean age 55.1) in community-based screenings. Measurements of vertical cup-to-disc ratio (VCDR), nerve fiber layer (NFL) thickness and macular and ganglion cell layer (GCL) thickness were collected along with color retinal images by the Maestro1. Visual acuity and intraocular pressures (IOP) were obtained as part of the screening protocol. Four types of OCTs were acquired: 78.33% 3D Wide, 13.33% 3D Macula, 5.83% 3D Disc, and 2.51% 5-Line Cross. An on-site certified reader (CR) interpreted results and provided consultation follow-up to a remote ophthalmic subspecialist. Results : Of 222 eyes, OCT-B confirmed follow-up in 86.94%. 88.3% of subjects had referable eye pathology: 23.33% to general or specialty eye clinic and 65% to telemedicine. CR glaucoma referral based on OCT-B scan, VCDR and NFL defects was compared to OCT-B referral based on VCDR ≥0.65. Cohen's kappa was 0.546 with 30% disagreement. Compared to CR, OCT-B generated VCDR had a 91.1% specificity and 42.3% sensitivity in detecting glaucoma. VCDR, IOP, NFL, and GCL measurements were significantly correlated with CR glaucoma referral (p<0.05). Only VCDR, NFL, and GCL were significantly correlated with Maestro 1 glaucoma referral (p<0.05). Conclusions : OCT-B images provide valuable added diagnostic information about referrals in glaucoma. Its ability to capture greater depth of information about the eye, such as NFL and GCL measurements, compared to traditional two-dimensional retinal photography, warrants consideration for OCT-B as a replacement for non-mydriatic retinal photography as the gold standard in ophthalmic diagnostics. Further studies can investigate the utility trend analysis of OCT-B in predicting VTD's progression over time.

Improving the Quality of Clinical Coding and Documentation to Record Accurate Outcomes in Non-Operatively Managed Hip Fractures

Background: Our 2019 Clinical Audit for non-operatively managed hip fractures at our Trust was 9.76% against the national standard of 5% at The National Hip Fracture Database (NHFD) annual report 2017. A re-audit was conducted to review reasons for higher incidence as recommended by NICE and improve outcomes. Method: Hip fracture patients admitted between 1st April 2019 and 31st August 2020 to Southport and Ormskirk NHS Trust were reviewed clinico-radiologically. Data was collected from NHFD, EVOLVE patient records, and PACS imaging systems. Following appropriate “Primary Diagnosis” of hip fracture, confirmation of operative or non-operative management was undertaken following a joint assessment by the Orthopaedic staff and the Clinical Coding department evaluating reasons behind the decision. Secondary outcome measures compared 30-day and one-year mortality with the previous cohort. Results: In the re-audit, 512 cases were reviewed, 50 patients excluded following correct Clinical Coding, 440 hips were operated and 22 (4.8%) managed non-operatively. However, 30-day mortality rose from 30.5% during the audit to 54.50% possibly due to the effect of COVID-19. Conclusions: The newly introduced “Neck of Femur Proforma” has remarkably improved the quality and organization of clinical documentation of diagnosis. Appropriate Clinical Coding allows correct information for the NHFD Trust figures.

Characterization of Flexible Amorphous Silicon Thin-Film Transistor-Based Detectors with Positive-Intrinsic-Negative Diode in Radiography.

Low-dose exposure and work convenience are required for mobile X-ray systems during the COVID-19 pandemic. We investigated a novel X-ray detector (FXRD-4343FAW, VIEWORKS, Anyang, Korea) composed of a thin-film transistor based on amorphous silicon with a flexible plastic substrate. This detector is composed of a thallium-doped cesium iodide scintillator with a pixel size of 99 µm, pixel matrix of 4316 × 4316, and weight of 2.95 kg. The proposed detector has the advantages of high-noise characteristics and low weight, which provide patients and workers with an advantage in terms of the dose and work efficiency, respectively. We performed a quantitative evaluation and an experiment to demonstrate its viability. The modulation transfer function, noise power spectrum, and detective quantum efficiency were identified using the proposed and comparative detectors, according to the International Electrotechnical Commission protocol. Additionally, the contrast-to-noise ratio and coefficient of variation were investigated using a human-like phantom. Our results indicate that the proposed detector efficiently increases the image performance in terms of noise characteristics. The detailed performance evaluation demonstrated that the outcomes of the use of the proposed detector confirmed the viability of mobile X-ray devices that require low doses. Consequently, the novel FXRD-4343FAW X-ray detector is expected to improve the image quality and work convenience in extended radiography.

Modified mRNA delivery to the heart using Lipid Nanoparticles

Myocardial infarction is a global health burden for which there is no treatment available that aims to recover the damaged tissue after the ischemic event. Lipid nanoparticles (LNPs) represent a well characterized class of mRNA delivery systems, which were recently approved for clinical usage in their application for mRNA-based covid-19 vaccines. After myocardial infarction, endogenous mechanisms that enable repair of the functional damaged tissue can be triggered by modified mRNA (modRNA) delivery, locally in the infarcted area. As a first step, in order to optimize the LNP formulation for effective myocardial delivery and study cellular tropism of the LNPs in the heart, different LNPs formulations will be evaluated as delivery systems in a murine healthy heart model. Different LNP formulations varying in type and amount of helper lipid were used as delivery systems for modRNA encoding the reporter genes luciferase or eGFP. In vitro, LNPs were evaluated for modRNA delivery in a human endothelial cell line (HMEC-1), induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs) and induced pluripotent stem cell -derived fibroblasts (iPS-FBs). In vivo, modRNA delivery was evaluated in C57BL-6 mice, undergoing open chest heart surgery under general anaesthesia in order to infuse LNPs into the left ventricular wall. For determination of luciferase expression levels, animals were infused with luciferin substrate intraperitoneally 24 hrs after injection. Heart, liver, lungs, spleen and kidneys were extracted for imaging in a bioluminescence imaging system. The organs were then stored in liquid nitrogen for further ex-vivo modRNA delivery analysis. For determining cellular tropism, histology was performed on mice treated with eGFP modRNA. Both bioluminescence imaging and luminescence analysis in tissue lysates showed that mRNA transfection is achieved in the myocardium 24 hours after LNP intramyocardial administration. However, all LNP formulations also resulted in high expression levels in other organs, including liver and spleen. Changes in type or amount of helper lipid in LNPs strongly affected transfection levels. Histology of the treated hearts revealed a distinct transfection pattern. The targeted, interstitial cells were negative for CD31 (marker for endothelial cells and monocytes) and Troponin I3 (marker for cardiomyocytes) (Figure 1). We show that, using an optimized LNP formulation, a significant degree of modRNA local transfection of the heart can be achieved. However, despite the local route of administration (into the left ventricular wall), the highest LNP transfection is shown in remote organs such as liver and spleen. More improvements of the LNP formulations must be done to increase their tropism towards the heart tissue for their optimization as cardiac delivery systems. Determining which cell types are being targeted is also important in order to establish a therapeutic target when applying the LNPs for cardiac therapy. (Figure Presented).

A new approach for reduction of the noise from microscopy images using Fourier decomposition

In this paper, an efficient method based on the Fourier decomposition method (FDM) is presented for noise removal of medical microscopic images. We propose an adaptive thresholding technique based FDM for denoising of heavily degraded images. An accurate image deconvolution is done with variance stabilization transformation and multi-scale Wiener filtering as a pre-processing step. The different series of frequency intrinsic band functions (FIBF's) obtained with FDM which are further separated into noise and signal-significant FIBF's based on cosine similarity index. The FDM adaptive thresholding technique is used to filter-out the unwanted frequency coefficients related to mixed Poisson-Gaussian noise (MPG). The thresholded FIBF's and signal significant FIBF's are combined to obtained reconstructed output. Finally, the optimization is done using mixed noise unbiased risk estimate (MNURE). To evaluate the effectiveness of proposed scheme, we have compared the results of the proposed scheme with six different state-of-the-art techniques. The simulation results verify, the effectiveness of proposed method. The proposed algorithm achieves better performance in terms of four quantitative evaluation measures by reducing the effect of noise.

Development and in vitro Evaluation of Atazanavir Microcrystals for Intranasal Delivery

Background: Nasal route of drug administration has gained popularity nowadays specially for drugs acting on nasopulmonary area. Atazanavir is an antiviral drug which has proved efficacy in different viral infection including COVID-19. Therefore the hypothesis is, if given through intra nasal route this formulation will be able to prevent the viral infection like COVID-19 by directly acting on the virus at its entry point. Objectives: This study aims to prepare a stable mucoadhesive microcrystal formulation of this antiviral drug with good permeation for intra nasal delivery. Materials and Methods: The formulation was prepared by high-speed homogenization process. Prepared microcrystals were estimated for in vitro drug release and permeation, drug excipient interaction study by DSC, FTIR and in vitro mucoadhesiveness study on agar gel plate. A short-term stability study was conducted on all formulations for 6 months. Results: The melting point and absorbance maxima of atazanavir were found as 200.9°C and 248 nm. The DSC and FTIR study results confirmed no drug excipient interaction was there in the formulation. The particle size of the formulations was found as 5-11 µm in range. Drug release was better and faster from the microcrystals as compare to pure powder drug. The flux for microcrystal formulation was found to be 100 whereas flux for the pure drug powder was 24. Formulations had sufficient mucoadhesive strength due to incorporation of HPMC 400 polymer and they were found stable after six months stability study. Conclusion: Lastly, it can be concluded that this formulation would be a promising system for the delivery through intra nasal route as it showed good drug release and permeation during a short time span in in vitro nasal condition with a particle size range suitable for intranasal delivery. However, further in vivo studies are required to confirm the hypothesis.

COMPARING CARDIAC COMPUTED TOMOGRAPHY AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN POST-OPERATIVE LEAK AFTER LEFT ATRIAL APPENDAGE CLOSURE DEVICE PLACEMENT

Background: Left atrial appendage closure (LAAC) devices are a practical replacement to long term oral anticoagulation in the appropriate patient. Incomplete occlusion and resulting device leak are important clinical endpoints which may prompt anticoagulation continuation. During the coronavirus pandemic, cardiac computed tomography (CCT) was used as an alternative to transesophageal echocardiogram (TEE) for pre-planning and post-operative confirmation. A residual leak of >5mm on TEE has been used as a cutoff for anticoagulation continuation, but CCT is less codified for device leak quantification and its significance. Objective: Compare CCT and TEE in regards to post-operative leak with respect to resulting outcomes after LAAC device implant. Methods: Between March 1st 2020 and October 31st 2021, 151 patients underwent LAAC device implantation at a single center. These patients had a pre-procedural CCT or TEE and a subsequent confirmatory CCT or TEE 45 days after implant. Baseline demographics, imaging, device characteristics, and resulting outcome measures were collected by chart review. Data was then retrospectively analyzed with a non-linear model to assess significance. Results: Of the 151 patients, the median age was 77 with an interquartile range (IQR) of 10 and 40% were female. The median CHADSVASc was 4 and HASBLED score was 4 with an IQR of 2 and 1, respectively. For the 45 day post-procedural imaging confirmation there was a total of 110 patients who underwent TEE, 30 underwent CCT, and 11 dropped out. A total of 34 patients (22%) had a device leak of any size. In CCT group there were 18 patients (60%) with a device leak <5mm and in the TEE group 16 patients (15%) had a device leak with 14 having a primary leak <5mm (P < 0.001). Major adverse events include: 1 death (all-cause), 14 major bleeding events, 1 MACE event (MI). There was zero instances of post-device stroke. None of these outcomes were statistically significant in regards to device leak or imaging modality. Conclusion: Based on this analysis, CCT had a significantly greater rate of detecting post-operative device leak when compared to TEE. There does not appear to be any significant difference in outcomes with regards to CCT and TEE in patients undergoing LAAC device implant. This suggests that CCT may be overly sensitive for subclinical device leak.

Development of a Low Cost and Raspberry-based Thermal Imaging System for Monitoring Human Body Temperature

Since 2020, COVID-19 had caused about millions of deaths and huge economic losses in the world. Taiwan had a successful story of preventing COVID-19 invasion. Unfortunately, COVID-19 broke down the preventing a couple of months ago. In addition, Taiwan doesn't have enough the vaccines to stop the COVID-19 spreading. This event really let Taiwan people to live painfully and inconveniently every day. However, it is really needed a system assist Taiwan people to prevent from the COVID-19 attack. According to this need, we attempt to develop a thermal imaging which is capable of detecting the people with fever. The price of thermal imaging system is usually very high. Most of companies or organizations can't afford it instead of a cheap forehead gun. Although forehead gun can precisely measure human body temperature, its inconvenient usage increases employees' loading. This paper presents the development of the low cost thermal imaging system. The system consists of PureThermal Mini/FLIR Lepton 3.5, Raspberry cam, and Raspberry pi 4. The PureThermal Mini is a thermal module with smart I/O. It has a FLIR Lepton3.5 thermal imager. The thermal imager can provide the system a thermal image with the resolution 160×120. Currently, its price is around 15,000NTD. The resolution of the thermal image is quite low. In order to fit the need of the system, an image resize algorithm is applied to create a large size of thermal image for further application. About Raspberry Cam, it is a regular cam which can be directly installed on Raspberry Pi. Its resolution is up to 2592×1944 and its cost is about 1,500NTD. Its image can supply the system to deal with Artificial Intelligence process, such as human facial recognition. Raspberry Pi 4 is the core controller of system. It contains our developed Python program which is used to handle all of system processes. 3D printing is also applied to build the structure frames of the system. The cost of the developed system is less than 20,000NTD. It is capable of detecting more than two people simultaneously and automatically. With the assistance of the system, companies or organizations can efficiently protect their employees away from the attack of COVID-19. © 2021 IEEE.

Comparison of remote and in-person tutorials of color appearance phenomena

Accurately describing the effect of lighting on color appearance phenomena is critical for color science education. While it is ideal to conduct in-person tutorials to demonstrate the color appearance fundamentals, laboratory tutorials have been limited due to COVID-19. The limitation of in-person gatherings and the increase popularity of remote teaching help evoke alternative methods to demonstrate color appearance phenomena. Here, a remote tutorial method is described, and results are compared to in-person tutorials. While the remote tutorial had weaker result in representing observers’ color experience compared to the in-person lab tutorial, remote demonstrations can be used to demonstrate and discuss the limitations of color imaging, and the difference between the human visual system and digital imaging systems. © 2021 Society for Imaging Science and Technology. All rights reserved.

Analysis of risk factors for early clinical recurrence of inflammatory bowel disease after fecal microbiota transplantation

Objective: To explore the risk factors for early clinical recurrence of inflammatory bowel disease (IBD) after fecal microbiota transplantation (FMT). Methods: A retrospective study was conducted on 192 patients with IBD who received FMT treatment in the Colorectal Disease Specialty/Intestinal Microecology Treatment Center of the Tenth People’s Hospital Affiliated to Tongji University from February 2017 to June 2020. Univariate and multivariate logistic regression models were used to analyze the risk factors for early recurrence of inflammation. Feces from all participants were collected to extract the total bacterial genomic DNA. The V6-8 regions of the bacterial 16S rDNA gene were amplified by polymerase chain reaction (PCR), the PCR products were detected by the denaturing gradient gel electrophoresis (DGGE) method, and the intestinal flora was analyzed by DNA fingerprinting. Stool samples from all patients were tested for 9 bacteria, white blood cells (WBC) and platelet (PLT) counts, as well as the erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) level. Results: Of the 192 patients, 15 cases had inflammation recurrence during FMT and within one week after treatment, including 11 cases of ulcerative colitis (UC) and 4 cases of Crohn’s disease (CD), with a total recurrence rate of 7.8%. High Mayo inflammatory activity score, Mayo endoscopic sub-item score (MES) =3 points, CRP>10 mg/L, anemia, albumin <30 g/L, absolute value of peripheral blood lymphocytes (PBL) <500/mm3, and intolerance to enteral full nutrition were independent risk factors for recurrence during and after FMT in UC patients (P<0.05). Albumin <30 g/L and simultaneous use of immunosuppressive agents were associated with disease recurrence during and after FMT in CD patients. WBC, PLT, and CRP were all negatively correlated with Enterococcus (EC), and ESR was positively correlated with Saccharomyces boulardii (SB) (P<0.01). Conclusion: The low recurrence rate of IBD after FMT indicates the safety of FMT, but this procedure should be cautiously used in patients with severe intestinal barrier dysfunction and/or severe intestinal dysfunction.

Delineation of the Arm Blood Vessels Utilizing Hyperspectral Imaging to Assist with Phlebotomy for Exploiting the Cutaneous Tissue Oxygen Concentration.

SIGNIFICANCE: The estimation of tissue oxygenation is vital in the diagnosis and therapeutic evaluation of a huge assortment of diseases. The hyperspectral (HS) imaging system is a rising innovation that can be utilized to build a highly sensitive, non-invasive, and tissue hemoglobin immersion map. OBJECTIVE: As a result of the urgent need to design and implement early detection devices and applications for the COVID-19 pandemic, we propose building a non-invasive custom optical imaging system to assist with phlebotomy and vascular approach to survey the reliability of blood oxygen saturation (SpO2) levels recovered from spectral images. MATERIALS AND METHODS: HS images were gathered from 15 healthy subjects without previous medical history complications and with an average age range of 20 to 38 years, who were undergoing phlebotomy. The forearm was vigorously illuminated utilizing an HS camera with polychromatic source light of spectrum range (400∼980 nm). Spectroscopic reflectance images were caught by a focal plane exhibit for the region of interest (ROI). Then the custom algorithm comprising normalization and moving average filtering for noise removal was applied, followed by K-mean clustering for image segmentation to visualize and highlight the arteries and the veins in the investigated forearm. RESULTS: The investigations show that after normalization of the recorded signal from the HS camera of the participating subjects it was noticed that at wavelength of 460 nm the oxygenated arteries had a stronger signal than the de-oxygenated veins, and at a wavelength of 750 nm the de-oxygenated veins had a stronger signal than the oxygenated arteries. Thus, the ideal wavelength to reveal the oxygenated arteries was 460 nm, and the ideal wavelength to reveal the de-oxygenated veins was 750 nm. CONCLUSIONS: HSI is a prospective technique to assist with phlebotomy and non-contact oxygen saturation approach. Additionally, it may permit future surgical or pharmacological intercessions that titrate or limit ischemic injury continuously.