A Novel Equivalent Time Sampling-Based Method for Pulse Transit Time Estimation with Applications into the Cardiovascular Disease Diagnosis.

The increasing incidence of cardiovascular diseases (CVDs) is reflected in additional costs for healthcare systems all over the world. To date, pulse transit time (PTT) is considered a key index of cardiovascular health status and for diagnosis of CVDs. In this context, the present study focuses on a novel image analysis-based method for PTT estimation through the application of equivalent time sampling. The method, which post-processes color Doppler videos, was tested on two different setups: a Doppler flow phantom set in pulsatile mode and an in-house arterial simulator. In the former, the Doppler shift was due to the echogenic properties of the blood mimicking fluid only, since the phantom vessels are non-compliant. In the latter, the Doppler signal relied on the wall movement of compliant vessels in which a fluid with low echogenic properties was pumped. Therefore, the two setups allowed the measurement of the flow average velocity (FAV) and the pulse wave velocity (PWV), respectively. Data were collected through an ultrasound diagnostic system equipped with a phased array probe. Experimental outcomes confirm that the proposed method can represent an alternative tool for the local measurement of both FAV in non-compliant vessels and PWV in compliant vessels filled with low echogenic fluids.

A Comparative Study on a Novel Quality Assessment Protocol Based on Image Analysis Methods for Color Doppler Ultrasound Diagnostic Systems.

Color Doppler (CD) imaging is widely used in diagnostics since it allows real-time detection and display of blood flow superimposed on the B-mode image. Nevertheless, to date, a shared worldwide standard on Doppler equipment testing is still lacking. In this context, the study herein proposed would give a contribution focusing on the combination of five test parameters to be included in a novel Quality Assessment (QA) protocol for CD systems testing. A first approach involving the use of the Kiviat diagram was investigated, assuming the diagram area, normalized with respect to one of the gold standards, as an index of the overall Doppler system performance. The QA parameters were obtained from the post-processing of CD data through the implementation of custom-written image analysis methods and procedures, here applied to three brand-new high-technology-level ultrasound systems. Experimental data were collected through phased and convex array probes, in two configuration settings, by means of a Doppler flow phantom set at different flow rate regimes. The outcomes confirmed that the Kiviat diagram might be a promising tool applied to quality controls of Doppler equipment, although further investigations should be performed to assess the sensitivity and specificity of the proposed approach.

Image quality evaluation of ultrasound imaging systems: advanced B-modes.

The Quality assurance of ultrasound clinical imaging systems is essential for maintaining their performance to the highest level and for complying with the requirements by various regulatory and accrediting agencies. Although there is no standardization yet, most of the quality assessment procedures available in literature are proposed for B-mode and Doppler imaging. However, ultrasound imaging systems offer a variety of advanced imaging modes, besides B-mode and Doppler, which are primarily aimed at improving image quality. This study presents computer-based methods for evaluating image quality for the advanced imaging modes of ultrasound imaging systems: harmonic imaging, spatial compounding imaging, adaptive speckle reduction, and tissue aberration correction. The functions and parameters proposed for evaluating image quality are: grayscale mapping function, image contrast, contrast-to-noise ratio (CNR), and high-contrast spatial resolution. We present our computer-based methods for evaluating image quality of these modes with a number of probe and scanner combinations, which were employed to image targets in ultrasound phantoms. The functions and parameters here proposed in image quality performance evaluation are: grayscale mapping function, image contrast, CNR, and high-contrast spatial resolution. We show that these quantities could be useful in developing standardized methods for evaluating the advanced ultrasound imaging modes, especially when the advanced mode resulted in subtle visual differences.

On the Dependency of the Electromechanical Response of Rotary MEMS/NEMS on Their Embedded Flexure Hinges' Geometry.

This paper investigates how the electromechanical response of MEMS/NEMS devices changes when the geometrical characteristics of their embedded flexural hinges are modified. The research is dedicated particularly to MEMS/NEMS devices which are actuated by means of rotary comb-drives. The electromechanical behavior of a chosen rotary device is assessed by studying the rotation of the end effector, the motion of the comb-drive mobile fingers, the actuator's maximum operating voltage, and the stress sustained by the flexure when the flexure's shape, length, and width change. The results are compared with the behavior of a standard revolute joint. Outcomes demonstrate that a linear flexible beam cannot perfectly replace the revolute joint as it induces a translation that strongly facilitates the pull-in phenomenon and significantly increases the risk of ruptures of the comb-drives. On the other hand, results show how curved beams provide a motion that better resembles the revolute motion, preserving the structural integrity of the device and avoiding the pull-in phenomenon. Finally, results also show that the end effector motion approaches most precisely the revolute motion when a fine tuning of the beam's length and width is performed.

Zoonotic parasites of bobcats around human landscapes.

We analyzed Lynx rufus fecal parasites from California and Colorado, hypothesizing that bobcats shed zoonotic parasites around human landscapes. Giardia duodenalis, Cryptosporidium, Ancylostoma, Uncinaria, and Toxocara cati were shed. Toxoplasma gondii serology demonstrated exposure. Giardia and Cryptosporidium shedding increased near large human populations. Genotyped Giardia may indicate indirect transmission with humans.

Non-Invasive Methods for PWV Measurement in Blood Vessel Stiffness Assessment.

In recent years, statistical studies highlighted an increasing incidence of cardiovascular diseases (CVD) which reflected on additional costs on the healthcare systems worldwide. Pulse wave velocity (PWV) measurement is commonly considered a CVD predictor factor as well as a marker of Arterial Stiffness (AS) since it is closely related to the mechanical characteristics of the arterial wall. An increase in PWV is due to a more rigid arterial system. Because of the prevalence of the elastic component, in young people the PWV is lower than in the elderly. Nowadays, invasive and non-invasive methods for PWV assessment are employed: there is an increasing attention in the development of non-invasive devices which mostly perform a regional PWV measurement (over a long arterial portion) rather than local (over a short arterial portion). The accepted gold-standard for non-invasive AS measurement is the carotid-femoral PWV used to evaluate the arterial damage, the corresponding cardiovascular risk and to adapt the proper therapy. This review article considers the main commercially available devices underlining their operating principles in terms of sensors, execution mode, pulse waveforms acquired, site of measurement, distance and time estimation methods, as well as their main limitations in clinical practice.

Experimental infection of cats with Cryptosporidium felis.

OBJECTIVES: The aims of this study were to experimentally inoculate cats with Cryptosporidium felis oocysts and compare fecal detection by fluorescent antibody assay (FA) and quantitative PCR (qPCR), and document clinical signs associated with infection. METHODS: Cryptosporidium felis oocysts were concentrated from the feces of a naturally infected cat and orally inoculated into six cats that tested negative for C felis by an FA and fecal flotation (FF). Cats were observed daily for the presence of clinical signs consistent with infection. Fecal samples from all cats on days 0 and 9, and one sample per cat (days 18-21), were evaluated by all assays. On day 31, two cats negative for C felis by FF and FA were administered methylprednisolone acetate and all assays were repeated on days 34, 36 and 38. Samples from all cats were tested by FF and FA on days 41, 43, 45 and 48. RESULTS: A total of 41 samples were tested, 25 of which were compared by FA and qPCR. Cryptosporidium felis was detected in 2/25 (8%) and in 19/25 (76%) samples by FA and by qPCR, respectively; the other 16 samples were tested by FF and FA. None of the cats was positive for C felis by FF or FA in samples collected on days 0, 9 or 18-21. One, five and six samples tested positive by qPCR on days 0, 9 and 18-21, respectively. The cats administered methylprednisolone acetate tested positive for C felis by FA on day 36 and by qPCR on days 31, 34, 36 and 38. None of the cats showed clinical signs of disease. CONCLUSIONS AND RELEVANCE: Clinical signs were not recognized in any of the cats for the duration of the study. FA was insensitive compared with qPCR for detecting cats with subclinical C felis infection.

Evaluation for associations amongst Giardia duodenalis assemblages and diarrhea in dogs.

Giardia duodenalis is a species complex comprising at least eight assemblages. Most dogs harbor the host-adapted assemblages C and D and approximately 30 % harbor the zoonotic assemblages. Humans and dogs with giardiosis can exhibit a variety of clinical manifestations ranging from the absence of clinical signs to acute or chronic diarrhea. Human studies report conflicting results concerning associations between clinical signs and assemblage type. The objective of this study was to use results of molecular and phylogenetic analyses to evaluate associations between G. duodenalis assemblages and diarrhea in client-owned dogs from the United States. Fecal samples that were positive for Giardia cysts were classified as normal or diarrheal. Samples were analyzed by PCR assays of the beta-giardin (bg), glutamate dehydrogenase (gdh), and triose phosphate isomerase (tpi) genes. Sequences of the three genes were analyzed by BLAST analysis and phylogenetic analysis was performed by Neighbor-Joining analysis. Two hundred and eighty-eight Giardia-positive fecal samples were evaluated by the three PCRs. One or more genes were amplified from 95 normal samples and 93 diarrheal samples, 27 samples were positive for one or more genes but could not be sequenced due to low quality DNA, and 73 samples tested negative. Ninety seven percent of the samples (182/188) in both the diarrheal and normal groups typed as dog-specific assemblages (D or C) by at least one gene. Phylogenetic analysis of the three genes placed the isolates from assemblages A, B, C and D separated from each other with strong bootstrap support. Diarrhea was not associated with the Giardia assemblage or other parasitic co-infection in this sample set. Other factors, such as the role of gut microbiota in giardiosis should be considered in future studies.

Experimental infection of cats with Cystoisospora felis.

BACKGROUND: Cystoisospora felis is a common parasite of cats and is diagnosed by fecal flotation, but false-negative results can be common. HYPOTHESIS/OBJECTIVES: To experimentally inoculate cats with C. felis oocysts, to compare fecal flotation and polymerase chain reaction (PCR) results, and to describe any clinical signs consistent with infection. ANIMALS: Six cats. METHODS: Cystoisospora felis oocysts were identified morphologically from feces of a naturally infected kitten with diarrhea, sporulated oocysts (5000) were inoculated to 6 cats that were negative for fecal parasites by fecal flotation and by a fluorescent antibody assay (FA) for Giardia spp. and Cryptosporidium spp. Cats were observed daily for the presence of clinical signs consistent with infection. Fecal samples were evaluated by fecal flotation and FA up to 3 times per week post inoculation (PI) to Day 27. Thirty-six samples collected before inoculation and from Days 8, 10, 13, 15, and 20 PI were assayed using an internal transcribed spacer 1 (ITS1) PCR that amplifies DNA of C. felis. RESULTS: All cats were negative for C. felis by both assays before inoculation. All cats shed C. felis oocysts by Day 10 PI, oocysts were not detected by fecal flotation after Day 15 PI. Cystoisospora felis DNA was amplified from 24/36 (66.6%) fecal samples from 6/6 (100%) of the cats. Oocysts were not detected by fecal flotation in 4 of the samples that were positive for C. felis DNA by PCR. Clinical signs were not recognized in any of the study cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Fecal flotation is a convenient assay for detection of C. felis but could occasionally give false-negative results when compared to this ITS1 PCR.

Design, Fabrication, Testing and Simulation of a Rotary Double Comb Drives Actuated Microgripper.

This paper presents the development of a new microgripper actuated by means of rotary-comb drives equipped with two cooperating fingers arrays. The microsystem presents eight CSFH flexures (Conjugate Surface Flexure Hinge) that allow the designer to assign a prescribed motion to the gripping tips. In fact, the adoption of multiple CSFHs gives rise to the possibility of embedding quite a complex mechanical structure and, therefore, increasing the number of design parameters. For the case under study, a double four-bar linkage in a mirroring configuration was adopted. The presented microgripper has been fabricated by using a hard metal mask on a Silicon-on-Insulator (SOI) wafer, subject to DRIE (Deep Reactive Ion Etching) process, with a vapor releasing final stage. Some prototypes have been obtained and then tested in a lab. Finally, the experimental results have been used in order to assess simulation tools that can be used to minimize the amount of expensive equipment in operational environments.

Grasping and Releasing Agarose micro Beads in Water Drops.

The micromanipulation of micro objects is nowadays the focus of several investigations, specially in biomedical applications. Therefore, some manipulation tasks are required to be in aqueous environment and become more challenging because they depend upon observation and actuation methods that are compatible with MEMS Technology based micromanipulators. This paper describes how three grasping-releasing based tasks have been successfully applied to agarose micro beads whose average size is about 60 µ m: (i) the extraction of a single micro bead from a water drop; (ii) the insertion of a single micro bead into the drop; (iii) the grasping of a single micro bead inside the drop. The success of the performed tasks rely on the use of a microgripper previously designed, fabricated, and tested.

Breast Ultrasound Technology and Performance Evaluation of Ultrasound Equipment: B-Mode.

Ultrasound (US) has become increasingly important in imaging and image-guided interventional procedures. In order to ensure that the imaging equipment performs to the highest level achievable and thus provides reliable clinical results, a number of quality control (QC) methods have been developed. Such QC is increasingly required by accrediting agencies and professional organizations; however, these requirements typically do not include detailed procedures for how the tests should be performed. In this paper, a detailed overview of QC methods for general and breast US imaging using computer-based objective methods is described. The application of QC is then discussed within the context of a common clinical application (US-guided needle biopsy) as well as for research applications, where QC may not be mandated, and thus is rarely discussed. The implementation of these methods will help in finding early stage equipment faults and in optimizing image quality, which could lead to better detection and classification of suspicious findings in clinical applications, as well as improving the robustness of research studies.

Time-to-Boundary Function to Study the Development of Upright Stance Control in Children.

BACKGROUND: The development of postural control across the primary school time horizon is a complex process, which entails biomechanics modifications, the maturation of cognitive ability and sensorimotor organization, and the emergence of anticipatory behaviour. Postural stability in upright stance has been thus object of a multiplicity of studies to better characterize postural control in this age span, with a variety of methodological approaches. The analysis of the Time-to-Boundary function (TtB), which specifies the spatiotemporal proximity of the Centre of Pressure (CoP) to the stability boundaries in the regulation of posture in upright stance, is among the techniques used to better characterize postural stability in adults, but, as of now, it has not yet been introduced in developmental studies. The aim of this study was thus to apply this technique to evaluate the development of postural control in a sample population of primary school children. METHODS: In this cross-sectional study, upright stance trials under eyes open and eyes closed were administered to 107 healthy children, divided into three age groups (41 for Seven Years' Group, Y7; 38 for Nine Years' Group, Y9; 28 for Eleven Years' Group, Y11). CoP data were recorded to calculate the Time-to-Boundary function (TtB), from which four spatio-temporal parameters were extracted: the mean value and the standard deviation of TtB minima (Mmin, Stdmin), and the mean value and the standard deviation of the temporal distance between two successive minima (Mdist, Stddist). RESULTS: With eyes closed, Mmin and Stdmin significantly decreased and Mdist and Stddist increased for the Y7 group, at Y9 Mmin significantly decreased and Stddist increased, while no effect of vision resulted for Y11. Regarding age groups, Mmin was significantly higher for Y9 than Y7, and Stdmin for Y9 was higher than both Y7 and Y11; Mdist and Stddist resulted higher for Y11 than for Y9. CONCLUSION: From the combined results from the spatio-temporal TtB parameters, it is suggested that, at 9 years, children look more efficient in terms of exploring their limits of stability than at 7, and at 11 the observed TtB behaviour hints at the possibility that, at that age, they have almost completed the maturation of postural control in upright stance, also in terms of integration of the spatio-temporal information.

Efficacy of a combination of febantel, pyrantel, and praziquantel for the treatment of kittens experimentally infected with Giardia species.

This study evaluated the effect of two combination products containing febantel, pyrantel, and praziquantel (FPP) for the treatment of Giardia species in experimentally infected kittens. In experiment 1, five kittens were administered the United States (US) formulation of FPP at doses of 37.8 mg/kg, 7.56 mg/kg, and 7.56 mg/kg, respectively, PO, q24h, for 5 days and four kittens remained as controls. In experiment 2, five kittens were administered the European formulation of FPP at the doses of 12.5 mg/kg, 12 mg/kg, and 4.16 mg/kg, respectively, PO, q24h, for 5 days and four kittens remained as controls. In experiment 3, six kittens were administered the US formulation of FPP at 56.5 mg/kg, 11.3 mg/kg, 11.3 mg/kg, respectively, PO, q24h, for 5 days and five kittens remained as controls. Thirteen days after treatment, kittens testing negative for Giardia species cysts were administered 20 mg/kg methylprednisolone acetate, IM, weekly for a maximum of two injections. Feces were analyzed for Giardia species cysts using a direct immunofluorescence test. After experiment 3, four of the six treated kittens, but no control kittens, remained negative for Giardia species after the administration of methylprednisolone acetate.

Evaluation of associations among Coxiella burnetii and reproductive abnormalities in cats.

OBJECTIVES: Coxiella burnetii is an obligate intracellular bacterium that is found worldwide, is associated or suggested to be associated with reproductive abnormalities in a number of species including cats, and is the cause of Q fever in humans. In a previous study, C burnetii DNA was amplified from the uterine tissues of 8.5% of client-owned cats in the USA but reproductive history was unknown and histopathological examination was not performed. In this study, uterine tissues of 26 normal cats and 11 cats with histopathological evidence of uterine disease or other reproductive abnormalities were evaluated for the presence of C burnetii. METHODS: A PCR assay that amplifies the repetitive transposon-like region (Trans 1 and 2) and a PCR assay that amplifies the IS-1111-insertion sequence (IS-1111) were optimised and applied to the DNA extracts. The sensitivity threshold of both PCR assays was 12 pg/µl. Positive samples were evaluated for the presence of the organism using immunohistochemistry performed on paraffin-embedded tissue. RESULTS: Amplicons of the expected size developed in three samples (one from a cat with reproductive abnormalities) in the IS-1111 assay; however, there was not enough DNA for sequence analysis. Immunohistochemical analysis was used to further evaluate these three samples and was negative for C burnetii. While C burnetii could not be confirmed by sequence analysis or immunohistochemistry, the PCR positive prevalence rate (8.1%) was similar to that published previously. CONCLUSIONS AND RELEVANCE: Biosafety precautions should be taken when working with cats that are aborting or parturient. Further research should be performed to evaluate the role that C burnetii may play in reproductive abnormalities in cats.

Prevalence and Diversity of Cryptosporidium and Giardia Identified Among Feral Pigs in Texas.

The population size and geographic range of feral pigs in the United States are rapidly expanding. Nevertheless, the role of this invasive species in the ecology and transmission of zoonotic enteric pathogens is poorly understood. Our objectives were to describe the prevalence and diversity of Cryptosporidium and Giardia shedding among feral pigs throughout Texas and to identify risk factors for infection. Fecal samples were collected from feral pigs in Texas from February 2014 through May 2015. Cryptosporidium oocysts and Giardia cysts were detected using a direct immunofluorescence assay, and genotyping of positive samples was performed. The prevalence of Cryptosporidium shedding was 1.6% (6/370), and C. scrofarum and C. suis were identified. The prevalence of Giardia shedding was 4.3% (16/370), and assemblages A and E were identified. Cryptosporidium shedding was significantly more common among juvenile and subadult pigs than among adult pigs, but age group was not associated with Giardia shedding status. Feral pigs may serve as a source of Cryptosporidium and Giardia transmission to humans and livestock.

A texture analysis approach for objective uniformity evaluation in diagnostic ultrasound imaging: A preliminary study.

Ultrasound image uniformity is an important parameter for quality assurance in diagnostic ultrasounds, but it is usually assessed by a qualitative judgement of technicians so its estimation is rough and subjective. In this work a novel method is developed to give an objective measurement of the Bmode image uniformity over the whole field of view or some of its part: the Texture Distribution Analysis Method (TDAM) is based on a segmentation of the Region of Interest, depending on some texture features calculated from co-occurrence matrices. Results on a set of 10 test images with different non-uniformities (Uniformity Image Test Set or UITS) show a good sensitivity and agreement of TDAM with the mean judgment by 5 human observers (TUV): TDAM and TUV uniformity values are coherent for the whole UITS, nevertheless a high uncertainty in uniformity values has been observed (up to 28 percent). Preliminary results look encouraging and more efforts are worth to refine the method.

Can a Visual Biofeedback system based on predictive information improve postural performance?

The aim of this study is to assess if predictive information can be used to implement visual biofeedback (VBF) systems to improve postural performance. The Centre of Pressure (CoP) coordinates, extracted directly from a force plate, are used to implement two different realtime VBF, which respectively use current CoP coordinates (VBF(real_time)) and predictive stability information (VBF(predictive)). Predictive coordinates are calculated in agreement with time-to collision theory, using the real-time CoP components. In both VBF, subjects know if they are or are not in the stability area by an emoticon image displayed on the computer monitor. The expression of emoticon was smiling if the CoP coordinates were inside the area of stability, it was sad if the CoP coordinates exceed the stability area. Two groups of eighteen healthy young subjects performed the protocol in two different sequences: noVBF-VBF(real_time) and noVBF-VBF(predictive). Each condition was repeated three times, and its effect was studied by four parameters extracted directly from CoP coordinates (sway path, sway area, mean amplitude and mean frequency). Both VBFs determine a modification of postural parameters compared to the baseline condition (noVBF) with decrease of sway area and mean amplitude and increase of mean frequency. The comparison between the two VBFs shows significant difference for all parameters except for mean frequency. In particular, sway path, sway area and mean amplitude values for the VBF(predictive) decreased more than the same values for the VBF(real_time). The preliminary results may prove useful for the possibility of using this kind of VBF as a tool to improve postural performance.

Effect of oral administration of cyclosporine on Toxoplasma gondii infection status of cats.

OBJECTIVE: To evaluate whether anti-inflammatory doses of cyclosporine activate Toxoplasma gondii in chronically infected cats or potentiate infection in cats exposed for the first time. ANIMALS: 30 T gondii-negative cats. PROCEDURES: Cats were assigned to 1 of 3 groups (10 cats/group). Group 1 (control) cats were administered a placebo for 126 days; group 2 cats were administered a placebo for 84 days, followed by cyclosporine at 7.5 mg/kg/d, PO, for 42 days; and group 3 cats were administered cyclosporine at 7.5 mg/kg/d, PO, for 126 days. Cats were orally inoculated with T gondii on day 42. Results for fecal flotations, PCR assays, and histologic examinations and IgM and IgG titers were analyzed. Cyclosporine concentrations were measured on selected days. RESULTS: All cats were infected by T gondii and developed signs of self-limiting gastrointestinal tract infection. Group 3 had the highest incidence and severity of CNS and pulmonary histopathologic findings typical of toxoplasmosis. One cat in group 3 died of systemic toxoplasmosis; that cat had a cyclosporine concentration of 1,690 ng/mL. Group 2 cats infected with T gondii before cyclosporine administration did not have repeated oocyst shedding. Group 3 cats shed fewer oocysts for a shorter time than did control cats of group 1. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration of cyclosporine in accordance with the protocol for this study did not potentiate the enteroepithelial phase of T gondii infection. Cats with high cyclosporine blood concentrations at the time of primary T gondii infection may be at risk of developing systemic toxoplasmosis.

Metronidazole for the treatment of feline giardiasis.

There are several drugs available for the treatment of giardiasis in cats, including metronidazole. The purpose of this study was to determine whether metronidazole benzoate administered at a dose of 25 mg/kg, orally, twice a day for 7 days lessens or eliminates Giardia cyst shedding in cats with chronic infection. Twenty-six, adult, laboratory-reared cats were used in this study. Sixteen cats had been inoculated orally with cysts of a human Giardia sp. isolate and had completed a Giardia vaccine study in one animal holding room. The other ten cats were infected with the same Giardia sp. presumably by contamination from the adjacent room where the Giardia vaccine study cats were located. From each cat, a fecal sample was collected within 1 week of the start of treatment and then every 2 to 4 days for 15 days after treatment was completed. Fecal samples were analyzed for the presence of Giardia cysts using a commercially available direct immunofluorescence test (IFA). Clinical signs of drug toxicity were not detected during the study.