Evaluation of real-time video from the digital indirect ophthalmoscope for telemedicine consultations in retinopathy of prematurity

2020 ◽  
pp. 1357633X2095824
Author(s):  
Tiffany Ho ◽  
Thomas C Lee ◽  
Ja-Yoon Choe ◽  
Sudha Nallasamy
Keyword(s):  
Real Time ◽  
Sensitivity And Specificity ◽  
Retinopathy Of Prematurity ◽  
Clinical Findings ◽  
Postmenstrual Age ◽  
Video Feed ◽  
Store And Forward ◽  
Indirect Ophthalmoscope

Introduction This study aimed to evaluate the validity of using real-time video indirect ophthalmoscopy for telemedicine consultations for paediatric retinal findings, using retinopathy of prematurity (ROP) as a model disease. Methods An ophthalmologist simultaneously performed and recorded routine ROP screenings on enrolled premature infants (aged ≤30 weeks and weighing <1500 g) using the Keeler digital indirect ophthalmoscope. Examinations were graded as no ROP, mild, type 1 or type 2. Masked to clinical findings, another ophthalmologist reviewed and graded streamed video feed transmitted at 4096 kbps. We compared the sensitivity and specificity of diagnosing ROP via streamed and stored-and-forwarded video clips to the gold-standard in-person examination. Results A total of 150 examinations of individual eyes from 34 babies were included. The median postmenstrual age (PMA) at delivery was 24 weeks (range 23–34 weeks), the median birth weight was 630 g (range 455–1530 g) and the median PMA at examination was 37 weeks (range 31–54 weeks). Of those infants with any ROP, the sensitivity and specificity of streamed examinations were 100% and 70.6%, respectively. For type 2 or worse ROP, the sensitivity and specificity were 92.5% and 86.1%, respectively. For type 1 ROP, the sensitivity and specificity were 100% and 99.3%, respectively. Sensitivities (unless already 100%) and specificities were slightly higher for store-and-forward evaluations. Discussion Streamed video feed from the digital indirect ophthalmoscope can be utilised to diagnose clinically significant ROP accurately, though store-and-forward video review yielded slightly better results.

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

2020 ◽  
pp. bjophthalmol-2020-316401
Author(s):  
Qian Yang ◽  
Xiaohong Zhou ◽  
Yingqin Ni ◽  
Haidong Shan ◽  
Wenjing Shi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Predictive Performance ◽  
Screening Guideline ◽  
Postmenstrual Age ◽  
The Mean ◽  
Type 1 Rop ◽  
Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

scholarly journals Modified approach to the characterization of adrenal nodules using a standard abdominal magnetic resonance imaging protocol

2017 ◽  
Vol 50 (1) ◽  
pp. 19-25 ◽  
Author(s):  
António P. Matos ◽  
Richard C. Semelka ◽  
Vasco Herédia ◽  
Mamdoh AlObaidiy ◽  
Filipe Veloso Gomes ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Imaging Protocol ◽  
Intensity Index ◽  
Abdominal Magnetic Resonance Imaging ◽  
Phase Type ◽  
The Mean ◽  
Magnetic Resonance Imaging Protocol ◽  
Type 3

Abstract Objective: To describe a modified approach to the evaluation of adrenal nodules using a standard abdominal magnetic resonance imaging protocol. Materials and Methods: Our sample comprised 149 subjects (collectively presenting with 132 adenomas and 40 nonadenomas). The adrenal signal intensity index was calculated. Lesions were grouped by pattern of enhancement (PE), according to the phase during which the wash-in peaked: arterial phase (type 1 PE); portal venous phase (type 2 PE); and interstitial phase (type 3 PE). The relative and absolute wash-out values were calculated. To test for mean differences between adenomas and nonadenomas, Student's t-tests were used. Receiver operating characteristic curve analysis was also performed. Results: The mean adrenal signal intensity index was significantly higher for the adenomas than for the nonadenomas (p < 0.0001). Chemical shift imaging showed a sensitivity and specificity of 94.4% and 100%, respectively, for differentiating adenomas from nonadenomas. Of the adenomas, 47.6%, 48.5%, and 3.9%, respectively, exhibited type 1, 2, and 3 PEs. For the mean wash-in proportions, significant differences were found among the enhancement patterns. The wash-out calculations revealed a trend toward better lesion differentiation for lesions exhibiting a type 1 PE, showing a sensitivity and specificity of 71.4% and 80.0%, respectively, when the absolute values were referenced, as well as for lesions exhibiting a type 2 PE, showing a sensitivity and specificity of 68.0% and 100%, respectively, when the relative values were referenced. The calculated probability of a lipid-poor lesion that exhibited a type 3 PE being a nonadenoma was > 99%. Conclusion: Subgrouping dynamic enhancement patterns yields high diagnostic accuracy in differentiating adenomas from nonadenomas.

Acromesomelic and Acromelic Dysplasias/Dysostoses

2018 ◽  
pp. 443-496
Author(s):  
Jürgen W. Spranger ◽  
Paula W. Brill ◽  
Christine Hall ◽  
Gen Nishimura ◽  
Andrea Superti-Furga ◽  
...  
Keyword(s):  
Clinical Findings ◽  
Differential Diagnoses ◽  
Radiographic Features ◽  
Albright Hereditary Osteodystrophy ◽  
Grebe Dysplasia ◽  
Myhre Syndrome ◽  
Acromicric Dysplasia

This chapter discusses acromesomelic and acromelic dysplasias/dysostoses and related disorders and includes discussion on acromesomelic dysplasias (Maroteaux type), Grebe dysplasia, brachydactyly A1, brachydactyly B, brachydactyly C, brachydactyly D, brachydactyly E, brachydactyly (Christian type), tricho-rhino-phalangeal dysplasia (type 1), tricho-rhino-phalangeal dysplasia (type 2), acrocapitofemoral dysplasia, Albright hereditary osteodystrophy, acrodysostosis, geleophysic dysplasia, acromicric dysplasia, Myhre syndrome, and SOFT syndrome. Each discussion includes major radiographic features, major clinical findings, genetics, major differential diagnoses, and a bibliography.

scholarly journals Resistance to Acetaminophen Interference in a Novel Continuous Glucose Monitoring System

2018 ◽  
Vol 12 (2) ◽  
pp. 393-396 ◽  
Author(s):  
Peter Calhoun ◽  
Terri Kang Johnson ◽  
Jonathan Hughes ◽  
David Price ◽  
Andrew K. Balo
Keyword(s):  
Type 2 Diabetes ◽  
Real Time ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Interference Effect ◽  
Glucose Monitoring ◽  
Post Dose ◽  
The Difference

Acetaminophen (APAP) can cause erroneously high readings in real-time continuous glucose monitoring (rtCGM) systems. APAP-associated bias in an investigational rtCGM system (G6) was evaluated by taking the difference in glucose measurements between rtCGM and YSI from 1 hour before to 6 hours after a 1-g oral APAP dose in 66 subjects with type 1 or type 2 diabetes. The interference effect was defined as the average post-dose (30-90 minutes) bias minus the average baseline bias for each subject. The clinically meaningful interference effect was defined as 10 mg/dL. The G6 system’s overall mean (±SD) interference effect was 3.1 ± 4.8 mg/dL (one-sided upper 95% CI = 4.1 mg/dL), significantly lower than 10 mg/dL. The G6 system’s resistance to APAP interference should provide reassurance to those using the drug.

scholarly journals Method for Near-Real Time Estimation of Tsunami Sources Using Ocean Bottom Pressure Sensor Network (S-Net)

Geosciences ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 310 ◽  
Author(s):  
Mayu Inoue ◽  
Yuichiro Tanioka ◽  
Yusuke Yamanaka
Keyword(s):  
Real Time ◽  
Time Window ◽  
Tsunami Source ◽  
Ocean Bottom ◽  
Bottom Pressure ◽  
Source Estimation ◽  
Observation Network ◽  
Tsunami Source Estimation

A dense cabled observation network, called the seafloor observation network for earthquakes and tsunami along the Japan Trench (S-net), was installed in Japan. This study aimed to develop a near-real time tsunami source estimation technique using the ocean bottom pressure data observed at those sensors in S-net. Synthetic pressure waveforms at those sensors were computed for 64 earthquake tsunami scenarios with magnitude ranging between M8.0 and M8.8. The pressure waveforms within a time window of 500 s after an earthquake were classified into three types. Type 1 has the following pressure waveform characteristic: the pressure decreases and remains low; sensors exhibiting waveforms associated with Type 1 are located inside a co-seismic uplift area. The pressure waveform characteristic of Type 2 is that one up-pulse of a wave is within the time window; sensors exhibiting waveforms associated with Type 2 are located at the edge of the co-seismic uplift area. The other pressure waveforms are classified as Type 3. Subsequently, we developed a method to estimate the uplift area using those three classifications of pressure waveforms at sensors in S-net and a method to estimate earthquake magnitude from the estimated uplift area using a regression line. We systematically applied those methods for two cases of previous large earthquakes: the 1952 Tokachi-oki earthquake (Mw8.2) and the 1968 Tokachi-oki earthquake (Mw8.1). The locations of the large computed uplift areas of the earthquakes were well defined by the estimated ones. The estimated magnitudes of the 1952 and 1968 Tokachi-oki earthquakes from the estimated uplift area were 8.2 and 7.9, respectively; they are almost consistent with the moment magnitudes derived from the source models. Those results indicate that the tsunami source estimation method developed in this study can be used for near-real time tsunami forecasts.

scholarly journals Two Distinct Types of Sweat Profile in Healthy Subjects While Exercising at Constant Power Output Measured by a Wearable Sweat Sensor

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Dong-Hoon Choi ◽  
Grant Kitchen ◽  
Ji Soo Kim ◽  
Yi Li ◽  
Kain Kim ◽  
...  
Keyword(s):  
Heart Rate ◽  
Real Time ◽  
Healthy Subjects ◽  
Perceived Exertion ◽  
Chloride Concentration ◽  
Rating Of Perceived Exertion ◽  
Real Time Monitoring ◽  
Sweat Chloride

AbstractWearable sweat sensors have enabled real-time monitoring of sweat profiles (sweat concentration versus time) and could enable monitoring of electrolyte loss during exercise or for individuals working in extreme environments. To assess the feasibility of using a wearable sweat chloride sensor for real-time monitoring of individuals during exercise, we recorded and analyzed the sweat profiles of 50 healthy subjects while spinning at 75 Watts for 1 hour. The measured sweat chloride concentrations were in the range from 2.9–34 mM. The sweat profiles showed two distinct sweat responses: Type 1 (single plateau) and Type 2 (multiple plateaus). Subjects with Type 2 profiles had higher sweat chloride concentration and weight loss, higher maximum heart rate, and larger changes in heart rate and rating of perceived exertion during the trial compared to subjects with Type 1 profiles. To assess the influence of level of effort, we recorded sweat profiles for five subjects at 75 W, 100 W, and 125 W. While all five subjects showed Type 1 sweat profiles at 75 W, four of the subjects had Type 2 profiles at 125 W, showing an increase in sweat chloride with exercise intensity. Finally, we show that sweat profiles along with other physiological parameters can be used to predict fluid loss.

scholarly journals Multiplex real-time RT-PCR assay for bovine viral diarrhea virus type 1, type 2 and HoBi-like pestivirus

2016 ◽  
Vol 229 ◽  
pp. 1-7 ◽  
Author(s):  
Viviana Mari ◽  
Michele Losurdo ◽  
Maria Stella Lucente ◽  
Eleonora Lorusso ◽  
Gabriella Elia ◽  
...  
Keyword(s):  
Real Time ◽  
Bovine Viral Diarrhea Virus ◽  
Bovine Viral Diarrhea ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Diarrhea Virus ◽  
Viral Diarrhea ◽  
Viral Diarrhea Virus

scholarly journals Severe Retinopathy of Prematurity Is Not Independently Associated With Worse Neurodevelopmental Outcomes in Preterm Neonates

2021 ◽  
Vol 9 ◽  
Author(s):  
Marie Altendahl ◽  
Myung Shin Sim ◽  
Artemiy Kokhanov ◽  
Bradley Gundlach ◽  
Irena Tsui ◽  
...  
Keyword(s):  
Health Insurance ◽  
Retinopathy Of Prematurity ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Age Cohort ◽  
Male Sex ◽  
The Relationship ◽  
Type 1 Rop

Purpose: To evaluate the relationship between retinopathy of prematurity (ROP) severity and neurodevelopmental outcomes in premature neonates at 0–36 months corrected age.Methods: A retrospective chart review was performed on 228 neonates screened for ROP at the UCLA Mattel Children's Hospital between 2011 and 2018. Demographic information, clinical outcomes, ROP severity (no ROP, type 1 ROP, type 2 ROP), and Bayley-III neurodevelopmental scores were collected. Infants were grouped into corrected age cohorts (0–12, 12–24, and 24–36 months) to assess neurodevelopmental outcomes with increasing age. Within each age cohort, ANOVA and Chi-Square testing were used to detect differences in birth characteristics and neurodevelopmental scores between infants with type 1 ROP, type 2 ROP, or no ROP. Univariable analyses assessed the relationship between ROP severity and neurodevelopmental outcomes within each age cohort. A multivariable analysis was then performed to determine if ROP severity remained significantly associated with worse neurodevelopmental scores after controlling for birth weight (BW), intraventricular hemorrhage grade (IVH), health insurance type, male sex, and age at Bayley testing.Results: Without controlling for factors associated with prematurity, neonates with type 1 ROP had poorer cognition (p = 0.001) and motor (p = 0.006) scores at ages 0–12 months and poorer cognition (p = 0.01), language (p = 0.04) and motor (p = 0.04) scores at ages 12–24 months than infants without ROP, but no significant differences were detected at ages 24–36 months. After adjusting for BW, IVH, insurance type, male sex, and age at Bayley testing, ROP severity was no longer associated with worse neurodevelopmental scores in any domain.Conclusion: This study emphasizes that poorer neurodevelopmental outcomes in preterm neonates are most likely related to lower birthweight, associated co-morbidities of prematurity, and socioeconomic factors such as health insurance, not severity of ROP itself.

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