Investigation of factors that influence the relationship between mental rotation ability and anatomy learning.

BACKGROUND: Mental rotation is a cognitive process that involves the rotation of a mental representation of an object. This ability is important for medical students in studying anatomy as this subject requires the understanding of positional relations between organs. OBJECTIVES: To find the effect of video learning of anatomy, training, gender, and type of practical exam on mental rotation ability. Also, to find correlation between mental rotation and anatomy scores. METHODS: Two groups were recruited: group A studied practical anatomy online using videos due to the COVID-19 pandemic lockdown; group B studied anatomy labs on-campus on plastic models. Both groups underwent a mental rotation test. Group A took labs on-campus during their second year and this was considered a training course for their mental rotation ability. Both groups, then, took a second mental rotation test. Group A was finally given a practical anatomy exam using plastic models. RESULTS: Males scored higher than females, though not significantly. The intervention course produced no significant change in mental rotation score of group A. Mental rotation score was correlated more with the theoretical anatomy exams than the MCQ-based practical exam, for both groups. For group A, mental rotation was better correlated with the model-based than the MCQ-based practical exam, especially the post-training score. CONCLUSION: For students to take full advantage of their mental rotation ability, not only their practical anatomy sessions but their practical anatomy exams should be on anatomical specimens and not just videos or images.

Optical Detection of Lithium Therapeutic Levels in Porcine Interstitial Fluid Collected Using a Hollow Microneedle.

Bipolar disorder (BD), a recurrent chronic disorder characterized by mood fluctuating between episodes of mood elevation and depression, is a leading cause of disability worldwide. Lithium is the most widely used medication for management of BD. However, despite its effectiveness in preventing and reducing mood swings and suicidality, it is a potentially hazardous drug. Lithium has a very narrow therapeutic range (0.4-1.2 mmol/L) with the upper limit being uncomfortably close to toxic levels, hence lithium levels should be monitored regularly. The current techniques of monitoring lithium levels require frequent blood tests and elaborate laboratory methods that cannot be translated into point of care devices for personal monitoring. Dermal interstitial fluid (ISF), an underutilized information-rich biofluid, can be accessed using non-invasive techniques and the lithium concentration in ISF has been found to be proportional to concentration in serum. In the current study a microneedle-based sampling method to extract ISF from porcine skin, as it is similar in anatomy to human skin, was employed. Optical determination of lithium therapeutic concentrations in porcine ISF using a colorimetric method based on the reaction between chromogenic agent Quinizarin and Li+ ion was then performed. The resulting spectra show spectral variations which are related to lithium concentrations in spiked samples of porcine ISF, hence suggesting the feasibility of utilizing ISF for real-time and minimally-invasive lithium drug monitoring.

Monte Carlo Characterization of Short-Wave Infrared Optical Wavelengths for Biosensing Applications.

Short-wave infrared (SWIR) spectroscopy has shown great promise in probing the composition of biological tissues. Currently there exists an enormous drive amongst researchers to design and develop SWIR-based optical sensors that can predict the concentration of various biomarkers non-invasively. However, there is limited knowledge regarding the interaction of SWIR light with vascular tissue, especially in terms of parameters like the optimal source-detector separation, light penetration depth, optical pathlength, etc., all of which are essential components in designing optical sensors. With the aim to determine these parameters, Monte Carlo simulations were carried out to examine the interaction of SWIR light with vascular skin. SWIR photons were found to penetrated only 1.3 mm into the hypodermal fat layer. The highest optical pathlength and penetration depths were seen at 1mm source-detector separation, and the lowest being 0.7mm. Although the optical pathlength varied significantly with increasing source-detector separation at SWIR wavelengths, penetration depth remained constant. This may explain why collecting optical spectra from depth of tissue at SWIR wavelengths is more challenging than collecting optical spectra from near-infrared wavelengths, where both the optical pathlength and penetration depth change rapidly with source-detector separation.

Optical Determination of Lithium Levels in Artificial Interstitial Fluid for Treatment Management of Bipolar Disorder.

Bipolar Disorder (BD), characterized by mood fluctuating between episodes of mood elevation and depression, is a leading cause of disability worldwide. Lithium continues to be prescribed as a first-line mood stabilizer for the management of BD. However, lithium has a very narrow therapeutic index and it is crucial to carefully monitor lithium plasma levels as concentrations greater than 1.2 mmol/L are potentially toxic and can be fatal. The current techniques of lithium monitoring are cumbersome and require frequent blood tests with the consequent discomfort which results in patients evading treatment. Dermal interstitial fluid (ISF), an underutilized information-rich biofluid, can be a proxy for direct blood sampling and allow lithium drug monitoring as its lithium concentration is proportional to the concentrations in blood. Therefore, in this study we seek to investigate the measurement of lithium therapeutic concentrations in artificial ISF. Our study employs a colorimetric method, based on the reaction between chromogenic agent Quinizarin and Li+ ion which can be detected using optical spectroscopy in the visible region (400-800 nm), to determine lithium levels in artificial ISF. The resulting spectra of our experiments show spectral variations which are related to lithium concentrations in spiked samples of artificial ISF, with a correlation coefficient (R) of 0.9. Future work will focus on investigating the feasibility of utilizing ISF for real-time and minimally-invasive lithium drug monitoring.

In-vivo quantification of lactate using Near Infrared reflectance spectroscopy.

Elevated lactate levels in blood (hyperlactatemia) are indications of hypoperfusion or sepsis in critical care conditions. Quantification and monitoring of this important marker is performed using intermittent blood sampling, which fails to provide a complete scenario to aid clinicians in diagnosis. The feasibility of Near Infrared (NIR) Spectroscopy as an alternative to state-of-the-art techniques in critical care environments for non-invasive and continuous monitoring of lactate has previously been established. Nevertheless, the challenge lies in translating this research from bench to bedside monitoring. For this reason, a pilot investigation was carried out with a portable NIR spectrometer, where spectra in the range of 900-1300 nm were collected from 8 healthy human volunteers undertaking a high intensity incremental exercise protocol for lactate monitoring. This paper reports on the measurement set-up, spectra acquisition and analysis of diffuse NIR reflectance spectra of varying concentrations of lactate. The results obtained by 2D correlation analysis and linear regression are promising and show that the wavelengths 923 nm, 1047 nm, 1142 nm, 1233 nm, 1280 nm and 1330 nm are significant for lactate concentration determination in the NIR region. This provides the necessary confidence for using NIR sensor technology for lactate detection in critical care.

Wearable, Environmental, and Smartphone-Based Passive Sensing for Mental Health Monitoring.

Collecting and analyzing data from sensors embedded in the context of daily life has been widely employed for the monitoring of mental health. Variations in parameters such as movement, sleep duration, heart rate, electrocardiogram, skin temperature, etc., are often associated with psychiatric disorders. Namely, accelerometer data, microphone, and call logs can be utilized to identify voice features and social activities indicative of depressive symptoms, and physiological factors such as heart rate and skin conductance can be used to detect stress and anxiety disorders. Therefore, a wide range of devices comprising a variety of sensors have been developed to capture these physiological and behavioral data and translate them into phenotypes and states related to mental health. Such systems aim to identify behaviors that are the consequence of an underlying physiological alteration, and hence, the raw sensor data are captured and converted into features that are used to define behavioral markers, often through machine learning. However, due to the complexity of passive data, these relationships are not simple and need to be well-established. Furthermore, parameters such as intrapersonal and interpersonal differences need to be considered when interpreting the data. Altogether, combining practical mobile and wearable systems with the right data analysis algorithms can provide a useful tool for the monitoring and management of mental disorders. The current review aims to comprehensively present and critically discuss all available smartphone-based, wearable, and environmental sensors for detecting such parameters in relation to the treatment and/or management of the most common mental health conditions.

An empirical investigation of deviations from the Beer-Lambert law in optical estimation of lactate.

The linear relationship between optical absorbance and the concentration of analytes-as postulated by the Beer-Lambert law-is one of the fundamental assumptions that much of the optical spectroscopy literature is explicitly or implicitly based upon. The common use of linear regression models such as principal component regression and partial least squares exemplifies how the linearity assumption is upheld in practical applications. However, the literature also establishes that deviations from the Beer-Lambert law can be expected when (a) the light source is far from monochromatic, (b) the concentrations of analytes are very high and (c) the medium is highly scattering. The lack of a quantitative understanding of when such nonlinearities can become predominant, along with the mainstream use of nonlinear machine learning models in different fields, have given rise to the use of methods such as random forests, support vector regression, and neural networks in spectroscopic applications. This raises the question that, given the small number of samples and the high number of variables in many spectroscopic datasets, are nonlinear effects significant enough to justify the additional model complexity? In the present study, we empirically investigate this question in relation to lactate, an important biomarker. Particularly, to analyze the effects of scattering matrices, three datasets were generated by varying the concentration of lactate in phosphate buffer solution, human serum, and sheep blood. Additionally, the fourth dataset pertained to invivo, transcutaneous spectra obtained from healthy volunteers in an exercise study. Linear and nonlinear models were fitted to each dataset and measures of model performance were compared to attest the assumption of linearity. To isolate the effects of high concentrations, the phosphate buffer solution dataset was augmented with six samples with very high concentrations of lactate between (100-600 mmol/L). Subsequently, three partly overlapping datasets were extracted with lactate concentrations varying between 0-11, 0-20 and 0-600 mmol/L. Similarly, the performance of linear and nonlinear models were compared in each dataset. This analysis did not provide any evidence of substantial nonlinearities due high concentrations. However, the results suggest that nonlinearities may be present in scattering media, justifying the use of complex, nonlinear models.

The efficacy of support vector machines in modelling deviations from the Beer-Lambert law for optical measurement of lactate.

Lactate is an important biomarker with a significant diagnostic and prognostic ability in relation to life-threatening conditions and diseases such as sepsis, diabetes, cancer, pulmonary and kidney diseases, to name a few. The gold standard method for the measurement of lactate relies on blood sampling, which due to its invasive nature, limits the ability of clinicians in frequent monitoring of patients' lactate levels. Evidence suggests that the optical measurement of lactate holds promise as an alternative to blood sampling. However, achieving this aim requires better understanding of the optical behavior of lactate. The present study investigates the potential deviations of absorbance from the Beer-Lambert law in high concentrations of lactate. To this end, a number of nonlinear models namely support vector machines with quadratic, cubic and quartic kernels and radial basis function kernel are compared with the linear principal component regression and linear support vector machine. Interestingly, it is shown that even in extremely high concentrations of lactate (600 mmol/L) in a phosphate buffer solution, the linear models surpass the performance of the other models.

Measurement of dermal water content using a multi-wavelength optical sensor.

Skin hydration is crucial for overall skin health. Maintaining skin hydration levels preserves skin integrity and prevents tissue damage which can lead to several debilitating conditions. Moreover, continuous monitoring of skin hydration can contribute to the diagnosis or management of serious diseases. For instance, sugar imbalance in diabetes mellitus and kidney disease can lead to the loss of bodily fluids and cause dry skin. Therefore, continuous, accurate and non-intrusive monitoring of skin hydration would present a remarkable opportunity for maintaining overall health and wellbeing. There are various techniques to assess skin hydration. Electrical based Corneometers are currently the gold standard in clinical and non-clinical practice. However, these techniques have a number of limitations. In particular, they are costly, sizeable, intrusive, and operator dependent. Recent research has demonstrated that near infrared spectroscopy could be used as a non-intrusive alternative for the measurement of skin water content. The present paper reports the development and in-vitro validation of a noninvasive, portable, skin hydration sensor. The results indicate that the developed sensor can deliver reliable measurements of skin water content.

Near Infrared and Aquaphotomic analysis of water absorption in lactate containing media.

Increased concentrations of lactate levels in blood are often seen in patients with life-threatening cellular hypoperfusion or infections. State-of-the-art techniques used in clinical practice for measuring serum lactate concentrations rely on intermittent blood sampling and do not permit continuous monitoring of this all important parameter in critical care environments.In recent years, Near Infrared (NIR) Spectroscopy has been established as a possible alternative to existing methods that can mitigate these constraints and be used for non-invasive continuous monitoring of lactate. Nevertheless, the dominant absorption of -OH overtone bands of water in the NIR presents a challenge and complicates the accurate detection of other absorbers such as lactate. For this reason, comprehensive analysis of the -OH overtone bands with systematic lactate concentration changes is essential. This paper reports on the analysis of NIR spectra of two aqueous systems of varying concentrations of lactate in saline and whole blood using the principles of Aquaphotomics.The results show distinctive conformational and structural differences in lactate-water binding, which arise due to the molecular interactions of bonds present in respective solvents.

Comparison of a Genetic Algorithm Variable Selection and Interval Partial Least Squares for quantitative analysis of lactate in PBS.

Blood lactate is an important biomarker that has been linked to morbidity and mortality of critically ill patients, acute ischemic stroke, septic shock, lung injuries, insulin resistance in diabetic patients, and cancer. Currently, the clinical measurement of blood lactate is done by collecting intermittent blood samples. Therefore, noninvasive, optical measurement of this significant biomarker would lead to a big leap in healthcare. This study, presents a quantitative analysis of the optical properties of lactate. The benefits of wavelength selection for the development of accurate, robust, and interpretable predictive models have been highlighted in the literature. Additionally, there is an obvious, time- and cost-saving benefit to focusing on narrower segments of the electromagnetic spectrum in practical applications. To this end, a dataset consisting of 47 spectra of Na-lactate and Phosphate Buffer Solution (PBS) was produced using a Fourier transform infrared spectrometer, and subsequently, a comparative study of the application of a genetic algorithm-based wavelength selection and two interval selection methods was carried out. The high accuracy of predictions using the developed models underlines the potential for optical measurement of lactate. Moreover, an interesting finding is the emergence of local features in the proposed genetic algorithm, while, unlike the investigated interval selection methods, no explicit constraints on the locality of features was imposed. Finally, the proposed genetic algorithm suggests the formation of α-hydroxy-esters methyl lactate in the solutions while the other investigated methods fail to indicate this.

Near Infrared Spectrometric Investigations on the behaviour of Lactate.

In patients with life-threatening illnesses, the metabolic production and disposal of lactate are impaired, which leads to a build-up of blood lactate. In critical care units, the changes in lactate levels are measured through intermittent, invasive, blood sampling and in vitro assay. Continuous monitoring is lacking, yet such monitoring could allow early assessment of severity and prognosis to guide therapy. Currently, there is no routine means to measure lactate levels continuously, particularly non-invasively. The motivation of this study was to understand the interaction of lactate with light in the Near Infra Red (NIR) region of the electromagnetic spectrum. This was to create an opportunity to explore the possibility of a non-invasive sensing technology to monitor lactate continuously.In vitro studies were performed using solution samples with varying concentration levels of sodium lactate in isotonic Phosphate Buffer Solution (PBS) at constant pH (7.4). These samples were prepared using stoichiometric solution compositions and spectra for each sample were taken using a state-of-the-art spectrometer in the NIR region. The spectra were then analysed qualitatively by 2D correlation analysis, which identified the regions of interest. Further analysis of these regions using linear regression at four randomly selected wavelengths showed bathochromic shifts, which, moreover, showed systematic variation correlating with lactate concentration.

Colorimetric determinations of lithium levels in drop-volumes of human plasma for monitoring patients with bipolar mood disorder.

Lithium preparations are considered the most reliable form of mood stabilizing medication for patients with Bipolar disorder. Nevertheless, lithium is a toxic element and its therapeutic range is extremely narrow, with levels of 0.61.0 mEq considered normal, whereas levels above 1.5 mEq are toxic. Thus unfortunately, many patients reach toxic levels that lead to unnecessary complications. It is believed that personal monitoring of blood lithium levels would benefit patients taking lithium medication. Therefore, our aim is to develop a personal lithium blood level analyzer for patients with bipolar mood disorder, and we report here our initial results of a colorimetric-based method used to test drop-volumes of human plasma that had been spiked with lithium. It was possible to validate results with standard flame photometry readings. Applying the Partial Least Squares (PLS) method on preprocessed spectra, therapeutic concentrations of lithium in a single drop can be predicted in a rapid manner, and furthermore, the calibration results were used to select effective wavelengths which were employed as inputs in Multiple Linear Regression (MLR). The simplified algorithms of this would prove useful when developing a personal lithium analyzer. Overall, both calibration methods gave high correlation and small error outputs with a R2= 0.99036 and RMSEC = 0.03778, and R2= 0.994148 and RMSEC= 0.0294404, for PLS and MLR methods, respectively. The results show that the spectrophotometric determination of blood lithium levels can be extended beyond laboratory applications and indicate the capability of this testing principle to be employed in a personal monitoring device. Future work will now focus on the technical development of a miniaturized system for measurement of lithium levels in blood with an acceptable level of accuracy and sensitivity.

Effectiveness of the DreamSkin® garment on relieving symptoms of eczema/dermatitis using electrical and spectroscopic methods: A case study.

Eczema is a common skin inflammatory disorder particularly among children. The treatment of which usually consists of the application of emollients and moisturisers to maintain skin moisture and to reduce the risk of inflammation, infection and exacerbative factors. Recently, DreamSkin® Health Limited has developed a unique polymer treatment for eczema. The polymer has been applied to medical grade silk clothing as a means of delivering the therapeutic benefits to the sufferers' skin. They claim that the polymer reduces the loss of moisture caused by evaporation from damaged skin; acts as a barrier against external irritants and helps to restore the skin's natural temperature management process. The aim of this study was to assess the products effectiveness at providing symptomatic relief for a volunteer with confirmed eczema and atopic dermatitis over a period of 14 days. Both skin capacitance and NIR spectra were collected during the course of the study, using the Corneometer® CM 825 and a spectrophotometer equipped with a customized reflectance probe for measurements in the Near Infrared region. The treated area showed visibly improved skin and overall results from both techniques showed a noticeable increase in skin water content after 14 days, peaking on the 7th day. However, slight differences were observed in the 7 magnitude of increase between the two instruments. Future work will focus on expanding this study to include more cases as well as performing statistical analysis to build upon our previous work in the area of skin hydration determinations using Near Infrared Spectroscopy.

Investigating skin barrier function utilizing reflectance NIR spectroscopy.

Near Infrared Spectroscopy is seen as a potentially valuable technique for skin analysis, and has been employed by many previous studies to measure skin hydration, since it is competent of providing information regarding various functional groups including OH, CH and NH bands. The aim of this study was to investigate the capability of further utilizing this method by attempting to analyze skin barrier function as well as water content, through the evaluation of skin water uptake on two test sites, one untreated, and another treated with a high lipid moisturizer for a period of 7 days. Reflectance NIRS measurements were supported by capacitance readings obtained using the Corneometer® CM 825. Baseline recordings taken on the first day following treatment showed that more differences were observed between the treated and untreated sites in the regions belonging to, or are influenced by CH and NH groups rather than purely on the water bands. On the hand, moisture levels measured after placing a wet patch on the skin remained nearly equal for both sites but second derivative spectra showed that a clear contrast existed between absorbance heights at the water bands of the treated and untreated, suggesting that moisturizer use could have limited water uptake to a more superficial layer of the skin, whereas for the untreated site, the opposite would have been true and water was able to penetrate deeper. Overall, results here suggest that NIR spectroscopy can possibly provide valuable information not only on skin water contents but perhaps on other skin parameters such as barrier function.

In vivo optical investigation of short term skin water contact and moisturizer application using NIR spectroscopy.

Nowadays, a number of noninvasive methods and instruments are available to inspect the biophysical properties and effects of various applicants on human skin, providing quantitative measurements and more details regarding the interactions between skin and various products. Such methods include Near Infrared Spectroscopy (NIRS), a technique which over the years, has gained quite a reputation in being able to accurately determine moisture levels and water contents due to its sensitivity to hydrogen bonding. This paper reports preliminary results of an in vivo study carried out on the skin of a small number of human participants, investigating the optical response of human skin after direct short-term contact with water followed by application of a moisturizer, using a highly advanced spectrophotometer in the region of 900-2100 nm, and equipped with a reflectance fibre optic probe. Results obtained here certainly raise some questions regarding the optical characteristics of different skin types and the influence of frequent moisturizer use, as well as the varying response between different water bands in the NIR region. Future work will focus on gaining more knowledge about these, in order to further improve optical skin measurements, and hopefully support the design and development of a portable and/or miniaturized optical device that could provide reliable, accurate and fast skin hydration readings in real time.

Comparing the rates of absorption and weight loss during a desorption test using near infrared spectroscopy.

The importance of determining skin hydration has over the years prompt the development of many instruments and methods, specifically designed to assess this parameter or water contents especially in the stratum corneum, and have greatly matured to suit different anatomical sites and measure multiple attributes. Of those, Near Infrared Spectroscopy (NIRS) has gained wide interest as a precise, safe, fast and noninvasive technique for determining skin hydration due to its high sensitivity to hydrogen bonding and ability to measure the amount of water in skin directly using the intensities of overtone and combination bands of OH and HOH water bonds occurring in the NIR region, that are good indicators of the state of skin hydration. This paper reports near infrared spectrophotometric measurements using a highly sophisticated spectrophotometer in the region of 1000-2500 nm to study the water uptake and dehydration properties of skin in vitro using samples of porcine skin. Initial results of pure liquid water and skin samples have clearly displayed the prominent bands associated with water content, and desorption tests have been able to verify changes in these bands associated with water content, although a clear correlation between the rates of weight loss and absorbance loss at various hydration periods has not yet been established. These preliminary results are expected to further explain the relationship between water and skin, and its role within, in hope to aid the future development of a portable instrument based on near infrared spectroscopy that would be capable of directly measuring skin hydration and/or water content in a fast and noninvasive manner.

In vitro spectrophotometric near infrared measurements of skin absorption and dehydration.

The application of Near Infrared Spectroscopy(NIRS) for measuring skin water content has long been established, and has gained w ide interest as a precise, safe, fast and noninvasive technique for determining skin hydration.This paper reports near infrared spectrophotometric measurements using a highly sophisticated spectrophotometer in the region of 1000-2500 nm to study the water uptake and dehydration properties of skin in vitro using samples of porcine skin. Initial results of pure liquid water and skin samples have clearly displayed the prominent bands associated with water content, and desorption tests have been able to verify changes in these bands associated with water content, although a clear correlation between the rates of weight loss and absorbance loss at various hydration periods has not yet been established. These preliminary results are expected to further explain the relationship between water and skin, and its role within, in hope to aid the future development of a portable instrument based on near infrared spectroscopy that would be capable of directly measuring skin hydration and/or water content in a fast and noninvasive manner.