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BACKGROUND: Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression. RESULTS: Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 ± 12.89 years, in current depressive episode of at least moderate severity (mean Montgomery Asberg Depression Rating Scale (MADRS) score 24.59 ± 2.64). tDCS was provided in bilateral frontal montage, F3 anode, F4 cathode, 2 mA, for 30 min, in a 6-week trial, for total 21 sessions, a follow up visit was conducted 5 months from baseline. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A research team member was present by video conference at each session. 93.2% participants (n = 41) completed the 6-week treatment and 72.7% of participants (n = 32) completed the 5 month follow up. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 ± 5.37) which was maintained at the 5 month follow up (mean MADRS 10.86 ± 6.90), rate of clinical response was 77.3% (MADRS improvement of 50% or greater from baseline), and rate of clinical remission was 47.7% (MADRS rating of 9 or less). Acceptability was endorsed as "very acceptable" or "quite acceptable" by all participants. No participants developed mania or hypomania. CONCLUSIONS: In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression. Due to the open-label design, efficacy findings are preliminary. TRIAL REGISTRATION: ClinicalTrials.gov number NCT05436613 registered on 23 June 2022 https//www. CLINICALTRIALS: gov/study/NCT05436613.
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Regular commutes to work can cause chronic stress, which in turn can cause a physical and emotional reaction. The recognition of mental stress in its earliest stages is very necessary for effective clinical treatment. This study investigated the impact of commuting on human health based on qualitative and quantitative measures. The quantitative measures included electroencephalography (EEG) and blood pressure (BP), as well as weather temperature, while qualitative measures were established from the PANAS questionnaire, and included age, height, medication, alcohol status, weight, and smoking status. This study recruited 45 (n) healthy adults, including 18 female and 27 male participants. The modes of commute were bus (n = 8), driving (n = 6), cycling (n = 7), train (n = 9), tube (n = 13), and both bus and train (n = 2). The participants wore non-invasive wearable biosensor technology to measure EEG and blood pressure during their morning commute for 5 days in a row. A correlation analysis was applied to find the significant features associated with stress, as measured by a reduction in positive ratings in the PANAS. This study created a prediction model using random forest, support vector machine, naive Bayes, and K-nearest neighbor. The research results show that blood pressure and EEG beta waves were significantly increased, and the positive PANAS rating decreased from 34.73 to 28.60. The experiments revealed that measured systolic blood pressure was higher post commute than before the commute. For EEG waves, the model shows that the EEG beta low power exceeded alpha low power after the commute. Having a fusion of several modified decision trees within the random forest helped increase the performance of the developed model remarkably. Significant promising results were achieved using random forest with an accuracy of 91%, while K-nearest neighbor, support vector machine, and naive Bayes performed with an accuracy of 80%, 80%, and 73%, respectively.
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Eletroencefalografia , Dispositivos Eletrônicos Vestíveis , Adulto , Humanos , Teorema de Bayes , Eletroencefalografia/métodos , Inquéritos e Questionários , Meios de Transporte , Máquina de Vetores de SuporteRESUMO
OBJECTIVES: Harmonisation is the process whereby standardised uptake values from different scanners can be made comparable. This PET/CT pilot study aimed to evaluate the effectiveness of harmonisation of a modern scanner with image reconstruction incorporating resolution recovery (RR) with another vendor older scanner operated in two-dimensional (2D) mode, and for both against a European standard (EARL). The vendor-proprietary software EQâ¢PET was used, which achieves harmonisation with a Gaussian smoothing. A substudy investigated effect of RR on harmonisation. METHODS: Phantom studies on each scanner were performed to optimise the smoothing parameters required to achieve successful harmonisation. 80 patients were retrospectively selected; half were imaged on each scanner. As proof of principle, a cohort of 10 patients was selected from the modern scanner subjects to study the effects of RR on harmonisation. RESULTS: Before harmonisation, the modern scanner without RR adhered to EARL specification. Using the phantom data, filters were derived for optimal harmonisation between scanners and with and without RR as applicable, to the EARL standard. The 80-patient cohort did not reveal any statistically significant differences. In the 10-patient cohort SUVmax for RR > no RR irrespective of harmonisation but differences lacked statistical significance (one-way ANOVA F(3.36) = 0.37, p = 0.78). Bland-Altman analysis showed that harmonisation reduced the SUVmax ratio between RR and no RR to 1.07 (95% CI 0.96-1.18) with no outliers. CONCLUSIONS: EQâ¢PET successfully enabled harmonisation between modern and older scanners and against the EARL standard. Harmonisation reduces SUVmax and dependence on the use of RR in the modern scanner. ADVANCES IN KNOWLEDGE: EQâ¢PET is feasible to harmonise different PET/CT scanners and reduces the effect of RR on SUVmax.
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There is an evolution in the demands of modern ophthalmology from descriptive findings to assessment of cellular-level changes by using in vivo confocal microscopy. Confocal microscopy, by producing greyscale images, enables a microstructural insight into the in vivo cornea in both health and disease, including epithelial changes, stromal degenerative or dystrophic diseases, endothelial pathologies and corneal deposits and infections. Ophthalmologists use acquired confocal corneal images to identify health and disease states and then to diagnose which type of disease is affecting the cornea. This paper presents the main features of the healthy confocal corneal layers and reviews the most common corneal diseases. It identifies the visual signatures of each disease in the affected layer and extracts the main features of this disease in terms of intensity, certain regular shapes with both their size and diffusion, and some specific region of interest. These features will lead towards the development of a complete automatic corneal diagnostic system that predicts abnormalities in the confocal corneal data sets.
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Córnea/anatomia & histologia , Córnea/patologia , Doenças da Córnea/diagnóstico , Microscopia Confocal , Voluntários Saudáveis , HumanosRESUMO
A confocal microscope provides a sequence of images, at incremental depths, of the various corneal layers and structures. From these, medical practioners can extract clinical information on the state of health of the patient's cornea. In this work we are addressing problems associated with capturing and processing these images including blurring, non-uniform illumination and noise, as well as the displacement of images laterally and in the anterior-posterior direction caused by subject movement. The latter may cause some of the captured images to be out of sequence in terms of depth. In this paper we introduce automated algorithms for classification, reordering, registration and segmentation to solve these problems. The successful implementation of these algorithms could open the door for another interesting development, which is the 3D modelling of these sequences.
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Córnea/anatomia & histologia , Imageamento Tridimensional/estatística & dados numéricos , Modelos Anatômicos , Algoritmos , Simulação por Computador , Humanos , Microscopia Confocal/instrumentação , Microscopia Confocal/estatística & dados numéricos , Redes Neurais de ComputaçãoRESUMO
Tumour detection, classification, and quantification in positron emission tomography (PET) imaging at early stage of disease are important issues for clinical diagnosis, assessment of response to treatment, and radiotherapy planning. Many techniques have been proposed for segmenting medical imaging data; however, some of the approaches have poor performance, large inaccuracy, and require substantial computation time for analysing large medical volumes. Artificial intelligence (AI) approaches can provide improved accuracy and save decent amount of time. Artificial neural networks (ANNs), as one of the best AI techniques, have the capability to classify and quantify precisely lesions and model the clinical evaluation for a specific problem. This paper presents a novel application of ANNs in the wavelet domain for PET volume segmentation. ANN performance evaluation using different training algorithms in both spatial and wavelet domains with a different number of neurons in the hidden layer is also presented. The best number of neurons in the hidden layer is determined according to the experimental results, which is also stated Levenberg-Marquardt backpropagation training algorithm as the best training approach for the proposed application. The proposed intelligent system results are compared with those obtained using conventional techniques including thresholding and clustering based approaches. Experimental and Monte Carlo simulated PET phantom data sets and clinical PET volumes of nonsmall cell lung cancer patients were utilised to validate the proposed algorithm which has demonstrated promising results.