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1.
Medicine (Baltimore) ; 100(22): e26207, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087892

RESUMO

ABSTRACT: Terry nails and Lindsay nails are similar forms of proximal apparent leukonychia (PAL). A change in nail bed vascularity is thought to be responsible for PAL. The study was aimed at investigating the frequency of PAL in patients attending a liver disease clinic, the factors associated with its presence, its value for detecting cirrhosis, its prognostic value for mortality, and associated capillaroscopic findings.A total of 521 patients were included (age range, 18-94 years; 69% men). Systematic nail photographs were evaluated by 2 independent investigators. Disease-related data were obtained from the medical records. Mortality was evaluated after 7 years of follow-up. Nailfold capillaroscopy was performed on a subset of 80 patients.PAL was present in 228 patients (43.8%; Terry nails in 205, Lindsay nails in 20, and both in 3). The kappa-coefficient of interobserver agreement was 0.82. The presence of PAL was associated with cirrhosis and, accordingly, with portal hypertension and hepatocellular dysfunction. The positive likelihood ratio of PAL for the diagnosis of cirrhosis was 1.6 (95% CI 1.3-1.92). PAL was independently associated with chronic alcohol abuse and was not a significant predictor of mortality. Venous loop dilatation and prominence of the venous plexus were observed on capillaroscopy in patients with cirrhosis but were not significantly associated with PAL.In summary, PAL is a common finding in patients from a liver clinic; it is associated with liver cirrhosis and with alcohol abuse. PAL is not associated with specific capillaroscopic findings. We propose the generic term proximal apparent leukonychia instead of classic eponymous titles to avoid confusion in the literature.


Assuntos
Hipopigmentação/diagnóstico , Cirrose Hepática/diagnóstico , Hepatopatias/patologia , Angioscopia Microscópica/métodos , Doenças da Unha/congênito , Adulto , Idoso , Alcoolismo/complicações , Capilares/patologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Hipopigmentação/etiologia , Cirrose Hepática/mortalidade , Hepatopatias/complicações , Masculino , Angioscopia Microscópica/estatística & dados numéricos , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico , Doenças da Unha/etiologia , Unhas/irrigação sanguínea , Unhas Malformadas/diagnóstico , Unhas Malformadas/patologia , Fotografação/métodos , Prognóstico
2.
Biomed Res Int ; 2021: 5556057, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969117

RESUMO

In this study, we propose a technique for diagnosing both type 1 and type 2 diabetes in a quick, noninvasive way by using equipment that is easy to transport. Diabetes mellitus is a chronic disease that affects public health globally. Although diabetes mellitus can be accurately diagnosed using conventional methods, these methods require the collection of data in a clinical setting and are unlikely to be feasible in areas with few medical resources. This technique combines an analysis of fundus photography of the physical and physiological features of the patient, namely, the tongue and the pulse, which are used in Traditional Chinese Medicine. A random forest algorithm was used to analyze the data, and the accuracy, precision, recall, and F1 scores for the correct classification of diabetes were 0.85, 0.89, 0.67, and 0.76, respectively. The proposed technique for diabetes diagnosis offers a new approach to the diagnosis of diabetes, in that it may be convenient in regions that lack medical resources, where the early detection of diabetes is difficult to achieve.


Assuntos
Inteligência Artificial , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Fundo de Olho , Medicina Tradicional Chinesa , Fotografação , Algoritmos , Humanos , Imageamento Tridimensional , Pulso Arterial
3.
Biomed Res Int ; 2021: 6674400, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969123

RESUMO

The objective of this paper was to evaluate the existence of golden percentage in natural maxillary anterior teeth with the aid of 3D digital dental models and 2D photographs. And to propose regional values of golden percentage for restoration of maxillary anterior teeth. For this purpose, one hundred and ninety dentate subjects with sound maxillary anterior teeth were selected. Standardized frontal images were captured with DSLR, and the apparent width of maxillary anterior teeth was measured utilizing a software on a personal laptop computer. Once the dimensions were recorded, the calculations were made according to the golden percentage theory (GPT). The data were analyzed by independent and paired T-test. The level of significance was set at p < 0.05. The golden percentage values were not found in this study. The values obtained were 16%, 15%, 20%, 20%, 15%, and 16% moving from the right canine to the left canine teeth. There was no significant gender difference in the golden percentage values. Thus, golden percentage should not be used solely for the correction of anterior teeth or for determining dental attractiveness. Emphasis should be given to a range of dental proportion on regional basis.


Assuntos
Modelos Dentários , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Fotografação , Dente/diagnóstico por imagem , Feminino , Humanos , Masculino , Adulto Jovem
4.
Dermatol Online J ; 27(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33999574

RESUMO

BACKGROUND: The SARS-CoV-2/COVID-19 pandemic dramatically impacted the delivery of healthcare, including dermatological services. In the initial stages of the pandemic, reduced patient flow produced a dramatic drop in the volume of skin cancer screening. Consistent with COVID-19 precautions, our practice conducted visual skin examinations (VSE) utilizing semi-automated total body photography (TBP). METHODS: A cross-sectional study of patient characteristics and self-reported melanoma risk factors associated with TBP usage was conducted on all patients from May to November 2020 in a single practitioner private dermatology setting. The process and histopathology-confirmed outcomes were compared to those in the same 6-month period in 2019. RESULTS: For the May-November 2020 timeframe, those who opted for the home TBP (35%) compared to clinic TBP were younger, had higher self-reported skin cancer risk, and were more likely to have had previous TBP sessions. Overall, the number of TBP sessions increased, while dermoscopy usage and biopsy number decreased. There was no change in the number and distribution of skin cancer diagnoses compared to the same period in 2019. The Melanoma-In-Situ:Invasive Melanoma (MIS:INV) ratio was above the U.S. ratio reported for 2020 of 0.95:1 (95,710 MIS:100,350 INV). CONCLUSION: Semi-automated TBP was successfully implemented during the pandemic without affecting skin cancer detection.


Assuntos
COVID-19 , Detecção Precoce de Câncer/métodos , Melanoma/patologia , Fotografação/métodos , Neoplasias Cutâneas/patologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Chirurgia (Bucur) ; 116(2 Suppl): 35-44, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33963693

RESUMO

Medical visual documentation is an especially important source of information for medicine. Medical photography has become the main method of medical visual documentation. In breast surgery, as in all other medical branches, medical photography has a major role in education and patient follow-up. The published literature was reviewed for medical photography techniques. In co-operation with the University fine arts faculty photography unit, standards for clinical, intra-operative and specimen photography in breast surgery were analyzed and identified. As a result, we have made recommendations for obtaining high quality and academically more effective medical photographs in breast surgery.


Assuntos
Neoplasias da Mama , Fotografação , Neoplasias da Mama/cirurgia , Documentação , Humanos , Resultado do Tratamento
6.
J Stroke Cerebrovasc Dis ; 30(7): 105828, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34010777

RESUMO

Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke which affects the retina. Intravenous thrombolysis is emerging as a compelling therapeutic approach. However, it is not known which patients may benefit from this therapy because there are no imaging modalities that adequately distinguish viable retina from irreversibly infarcted retina. The inner retina receives arterial supply from the central retinal artery and there is robust collateralization between this circulation and the outer retinal circulation, provided by the posterior ciliary circulation. Fundus photography can show canonical changes associated with CRAO including a cherry-red spot, arteriolar boxcarring and retinal pallor. Fluorescein angiography provides 2-dimensional imaging of the retinal circulation and can distinguish a complete from a partial CRAO as well as central versus peripheral retinal non-perfusion. Transorbital ultrasonography may assay flow through the central retinal artery and is useful in the exclusion of other orbital pathology that can mimic CRAO. Optical coherence tomography provides structural information on the different layers of the retina and exploratory work has described its utility in determining the time since onset of ischemia. Two experimental techniques are discussed. 1) Retinal functional imaging permits generation of capillary perfusion maps and can assay retinal oxygenation and blood flow velocity. 2) Photoacoustic imaging combines the principles of optical excitation and ultrasonic detection and - in animal studies - has been used to determine the retinal oxygen metabolic rate. Future techniques to determine retinal viability in clinical practice will require rapid, easily used, and reproducible methods that can be deployed in the emergency setting.


Assuntos
Angiofluoresceinografia , Imagem de Perfusão , Fotografação , Oclusão da Artéria Retiniana/diagnóstico por imagem , Artéria Retiniana/diagnóstico por imagem , Tomografia de Coerência Óptica , Ultrassonografia , Animais , Velocidade do Fluxo Sanguíneo , Tomada de Decisão Clínica , Circulação Colateral , Humanos , Técnicas Fotoacústicas , Valor Preditivo dos Testes , Prognóstico , Fluxo Sanguíneo Regional , Artéria Retiniana/fisiopatologia , Oclusão da Artéria Retiniana/fisiopatologia , Oclusão da Artéria Retiniana/terapia
7.
Clin Dermatol ; 39(1): 45-51, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33972051

RESUMO

Dermatology is a clinical and visual discipline, which makes it the quintessential medical specialty for spot diagnosis and telemedicine. The COVID-19 pandemic has led to an unprecedented worldwide renaissance of teledermatology (TD). It has helped deliver high-quality medical care, while protecting the medical personnel and vulnerable patients from potential infection. Examining a patient from a distance through digital photography has many drawbacks, including lack of physical touch, difficulties in performing full body examinations, and several legal and ethical issues. We summarize have summarized the more common pitfalls and highlight the key aspects of direct patient-to-physician TD. Basic practical advice includes the use of TD for obtaining patient history, examining patient-captured photographs for inflammatory skin disease, and skin cancer screening.


Assuntos
COVID-19/prevenção & controle , Dermatite/diagnóstico por imagem , Dermatologia/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Telemedicina/métodos , COVID-19/epidemiologia , Dermatologia/ética , Dermatologia/legislação & jurisprudência , Detecção Precoce de Câncer/métodos , Humanos , Anamnese , Visita a Consultório Médico , Fotografação/normas , Telemedicina/ética , Telemedicina/legislação & jurisprudência
8.
Indian J Ophthalmol ; 69(5): 1271-1274, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33913875

RESUMO

Purpose: The aim of this work was to study and document retinal changes in coronavirus disease-2019 (COVID-19) positive patients with nonsevere disease using a nonmydriatic handheld fundus camera. Methods: A cross-sectional observational study was conducted on patients affected by COVID-19 who were admitted at our center. Our study included patients with no, mild, and moderate symptoms (nonsevere cases). Intensive care unit (ICU)-admitted patients were excluded considering the difficulty in procuring the fundus image by the handheld camera due to patients positioning. Patients with systemic conditions (diabetes, hypertension, and severe anemia) known to cause retinopathy were also excluded. Bedside anterior segment examination, fundus examination using indirect ophthalmoscopy and fundus imaging of each patient using a nonmydriatic handheld fundus camera was done by a trained ophthalmologist posted for COVID duty. Results: In a cohort of 138 patients, 94 (68.1%) were men and 44 (31.9%) were women. A total of 276 eyes were evaluated. The mean age of the patients was 38.51 ± 14.4 years. Anterior segment evaluation showed no abnormality in any of the eyes. On fundus screening using nonmydriatic handheld camera, a single streak of superficial retinal hemorrhage was noted at the posterior pole of the fundus in the left eye of one patient (0.72%), which was away from fovea. Laboratory tests revealed low hemoglobin (between 10 and 10.9 g/dL falling under mild Anemia) in 12 patients, elevated total leucocyte count in 6 patients, raised LDH in majority of patients (323 ± 101 Units/L) and elevated CRP (14.6 ± 30.99 mg/L). Rest of the lab parameters were within the normal range. Conclusion: In our study, COVID patients with mild-to-moderate symptoms did not show any inflammatory/infective or vaso-occlusive lesions in the retina attributable to COVID-19 infection, except one patient who had a single streak hemorrhage in the macula away from fovea, probably incidental.


Assuntos
COVID-19 , Fotografação , Adulto , Estudos Transversais , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Adulto Jovem
9.
Indian J Ophthalmol ; 69(5): 1303-1305, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33913883

RESUMO

We describe a novel method of stereoscopic 3D slit-lamp photography using a portable compact 3D digital camera. Thirteen eyes of 13 patients underwent slit-lamp photography using a Fujifilm 3D compact digital camera. We modified a universal smartphone microscope adapter to attach the camera to the slit-lamp. Photography was attempted on Zeiss and on HAAG-Streit slit-lamps. Success was defined as capturing a stereogram that consists of two simultaneous pictures, one from each slit-lamp ocular. Stereoscopic 3D slit-lamp photos could be captured in all 13 eyes in which they were attempted on Zeiss slit-lamps. Captured 3D media included external, eyelid, conjunctival, corneal, anterior chamber, lens, vitreous, and optic disc pathologies. Stereoscopic 3D photography could not be obtained using this Fujifilm 3D digital camera on Haag-Streit slit-lamps because of alignment incompatibility between the oculars of the slit-lamp and the camera. Digital stereoscopic 3D slit-lamp photography is feasible using a compact 3D digital camera and compatible slit-lamp design. Images obtained using this technique may be helpful in clinical education.


Assuntos
Cristalino , Disco Óptico , Câmara Anterior , Humanos , Fotografação , Microscopia com Lâmpada de Fenda
10.
Nutrients ; 13(4)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33923638

RESUMO

Valid and useful dietary assessment methods for adolescents with type 1 diabetes (T1D) are needed. In this study, we compared an image-based method with a written food diary for dietary intake estimation among adolescents with T1D and evaluated the adolescents' experiences of the methods. Adolescents with T1D aged 13 to 18 years (n = 13) photographed their meals (n = 264) with a mobile phone camera and simultaneously kept a written food diary for four consecutive days. The participants filled out electronic background and feedback questionnaires. The agreement between the methods was evaluated using intraclass correlation coefficients (ICCs) and Bland-Altman plot analyses. The agreement between the methods was moderate to excellent for the energy intake (ICC = 0.91, 95% confidence interval (CI): 0.66 to 0.97, p < 0.001) and good to excellent for total carbohydrate intake (ICC = 0.95, 95% CI: 0.84 to 0.99, p < 0.001). The adolescents considered photographing easier and faster than keeping a food diary. In conclusion, the image-based method appeared comparable to the food diary for dietary intake estimation among adolescents with T1D. The photographing of meals may become a useful dietary assessment tool for adolescents with T1D, but must be further developed and validated.


Assuntos
Diabetes Mellitus Tipo 1 , Registros de Dieta , Inquéritos sobre Dietas/métodos , Dieta/estatística & dados numéricos , Fotografação , Adolescente , Telefone Celular , Carboidratos da Dieta/análise , Ingestão de Energia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários
11.
J Dent Hyg ; 95(2): 36-41, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33875528

RESUMO

Purpose: Prolonged muscle strain and repetitive movements in the dental workforce may lead to work-related musculoskeletal disorders (WMSDs). The purpose of this study was to determine whether feedback involving photography and self-assessments would improve the postures and the accuracy of ergonomic self-assessment among practicing dentists and dental hygienists.Methods: convenience sample of dentists and dental hygienists was used for this randomized control design study (n=50). The Modified-Dental Operator Posture Assessment Instrument (M-DOPAI) was used for ergonomic evaluations of the randomly assigned control and experimental (training) groups over a four-week period. All participants were photographed and completed a M-DOPAI without viewing the photographs or receiving feedback at baseline. Participants in the control group independently completed a M-DOPAI without any additional photographs or feedback during weeks two and three. The experimental group had additional photographs taken and completed a M-DOPAI along with the principal investigator. Mixed-design ANOVAs were used to evaluate improvements in ergonomic scores and the accuracy of ergonomic self-assessments.Results: The training group utilizing photography resulted in improvements in ergonomic scores as compared to the control group. Improvements in the accuracy of ergonomic self-assessments was demonstrated among practicing dental hygienists. All participants strongly agreed that it was important to understand and properly apply ergonomics, and to develop accurate ergonomic self-assessment skills for clinical practice.Conclusions: Improving self-awareness for ergonomics through self-assessment can help reduce the risk of developing WMSDs among practicing dentists and dental hygienists.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Higienistas Dentários , Odontólogos , Ergonomia , Humanos , Doenças Musculoesqueléticas/prevenção & controle , Doenças Profissionais/prevenção & controle , Fotografação , Autoavaliação (Psicologia)
12.
Comput Methods Programs Biomed ; 205: 106093, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33882417

RESUMO

Background and Objective; Genetic risk factors for childhood cancer may also influence facial morphology. 3D photography can be used in the recognition of differences in face shape among individuals. In previous research, 3D facial photography was used to identify increased facial asymmetry and greater deviation from normal facial morphology in a group of individuals with distinct morphological features who had childhood cancer compared to healthy controls. In this study, we aim to determine whether there is a difference in facial morphology between children with cancer without previously selected morphological features and healthy controls, detected with 3D facial photography. METHODS: Facial 3D photographic images were obtained of children with a newly diagnosed malignancy. The resulting sample comprised 13 different cancer types. Patients were excluded if they had a known genetic cause of the cancer. Patients were compared to healthy controls, matched for sex, age and ethnic background. The degree of asymmetry and overall deviation of an individual's face from an age and sex typical control face were measured. RESULTS: A total of 163 patients of European descent were included. No significant difference in asymmetry between patients and controls could be identified. On average, patients deviated more from an age and sex typical face than the controls. CONCLUSION: This study shows that children with cancer deviate more than controls, possibly suggesting a higher prevalence of genetic anomalies within this group. The results suggest that this is not sufficient to discriminate patients from controls. Further research is necessary to explore the patterns of individual variation among the overall deviation of patients and controls.


Assuntos
Imageamento Tridimensional , Neoplasias , Criança , Face , Assimetria Facial/diagnóstico por imagem , Humanos , Fotografação
13.
Nurs Res ; 70(3): E21-E28, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33891385

RESUMO

BACKGROUND: Despite the increasing number of studies using photo-elicitation for data collection in qualitative research, there is a need to further explore its use among families of children and adolescents living with chronic illness. OBJECTIVE: The aim of this study was to discuss methodological and pragmatic considerations about the use of photo-elicitation interviews (PEIs) for data collection with families of children and adolescents living with chronic illness. METHODS: We discussed methodological aspects of using PEIs as reported in publications. A search of the literature was carried out to identify articles presenting information on methodological aspects of the use of PEIs in qualitative data collection, regardless of age group. In pursuit of complementing the evidence with pragmatic considerations of using PEIs, we illustrate with an example of a recent qualitative study of our own that aimed to understand the narratives about hope of families of children and adolescents living with chronic illness. RESULTS: We synthesized common aspects that need to be considered when using PEIs with different populations: ethical issues, cameras, guidance, and interviews. We also presented our experience of using the PEI technique to collect data from families. Because of our experience, we denominate our method as the "family photo-elicitation interview" (FPEI). Our method goes beyond the PEI technique because it integrates aspects of family nursing theories when conducting interviews with families. FPEIs strengthen family interaction and allow family members to share their perspectives. DISCUSSION: We present a new perspective of PEIs-the FPEI-in the pediatric context. Previous studies have not addressed considerations about using PEIs for families. We hope our results assist novice researchers in planning and implementing FPEIs in qualitative research. We recommend that researchers explore the use of FPEIs in other contexts, such as geriatrics or palliative care.


Assuntos
Doença Crônica/psicologia , Relações Familiares/psicologia , Entrevistas como Assunto/métodos , Fotografação/métodos , Adolescente , Criança , Humanos , Pediatria/métodos , Pesquisa Qualitativa , Projetos de Pesquisa
14.
J Int Med Res ; 49(3): 300060521997329, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33719659

RESUMO

OBJECTIVE: To compare the ocular counter-roll (OCR) measured using iris images during binocular fixation and head tilt with OCR measured via fundus photography. METHODS: Fifty-three healthy college students participated in this study. The mean OCR was measured by collection of iris images and fundus images under seven head tilt conditions (0 degrees; 10, 20, and 30 degrees right; and 10, 20, and 30 degrees left). Three iris images (crossed pupil center, pupil center, and pupil periphery) were taken using a slit-lamp biomicroscope with an ophthalmic camera and a half-silvered mirror; fundus images were collected via fundus photography. The mean OCR values were compared between images taken with each method. RESULTS: No iris images or head tilt conditions revealed any significant differences in mean OCR comparison with fundus images. The mean difference in OCR was smallest, and the correlation was greatest, between the crossed pupil center and fundus images. CONCLUSION: A half-silvered mirror and iris images can replace fundus photography for the measurement of OCR.


Assuntos
Movimentos Oculares , Iris , Humanos , Iris/diagnóstico por imagem , Fotografação , Pupila , Rotação
15.
Zootaxa ; 4926(3): zootaxa.4926.3.7, 2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33756743

RESUMO

Mallophora Macquart, 1834 is a bee-mimicking genus of Asilidae, which has more than 50 described species in the Neotropical Region. Examination of specimens of this genus from Colombia indicate that there are two undescribed species based on the structure of the hind leg of males. Here we describe Mallophora gauteovan sp. nov. and Mallophora kalos sp. nov. from Tayrona National Park (Magdalena) and Arauca, respectively. For each new species a diagnosis and a description including the structure of the face, thorax, male hind leg, abdomen, and hypandrium are provided. All morphological structures are documented with digital photographs.


Assuntos
Dípteros , Distribuição Animal , Animais , Abelhas , Colômbia , Masculino , Fotografação
16.
Lancet Digit Health ; 3(1): e10-e19, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33735063

RESUMO

BACKGROUND: Diabetic retinopathy screening is instrumental to preventing blindness, but scaling up screening is challenging because of the increasing number of patients with all forms of diabetes. We aimed to create a deep-learning system to predict the risk of patients with diabetes developing diabetic retinopathy within 2 years. METHODS: We created and validated two versions of a deep-learning system to predict the development of diabetic retinopathy in patients with diabetes who had had teleretinal diabetic retinopathy screening in a primary care setting. The input for the two versions was either a set of three-field or one-field colour fundus photographs. Of the 575 431 eyes in the development set 28 899 had known outcomes, with the remaining 546 532 eyes used to augment the training process via multitask learning. Validation was done on one eye (selected at random) per patient from two datasets: an internal validation (from EyePACS, a teleretinal screening service in the USA) set of 3678 eyes with known outcomes and an external validation (from Thailand) set of 2345 eyes with known outcomes. FINDINGS: The three-field deep-learning system had an area under the receiver operating characteristic curve (AUC) of 0·79 (95% CI 0·77-0·81) in the internal validation set. Assessment of the external validation set-which contained only one-field colour fundus photographs-with the one-field deep-learning system gave an AUC of 0·70 (0·67-0·74). In the internal validation set, the AUC of available risk factors was 0·72 (0·68-0·76), which improved to 0·81 (0·77-0·84) after combining the deep-learning system with these risk factors (p<0·0001). In the external validation set, the corresponding AUC improved from 0·62 (0·58-0·66) to 0·71 (0·68-0·75; p<0·0001) following the addition of the deep-learning system to available risk factors. INTERPRETATION: The deep-learning systems predicted diabetic retinopathy development using colour fundus photographs, and the systems were independent of and more informative than available risk factors. Such a risk stratification tool might help to optimise screening intervals to reduce costs while improving vision-related outcomes. FUNDING: Google.


Assuntos
Aprendizado Profundo , Retinopatia Diabética/diagnóstico , Idoso , Área Sob a Curva , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Fotografação , Prognóstico , Curva ROC , Reprodutibilidade dos Testes , Medição de Risco/métodos
17.
Lancet Digit Health ; 3(1): e29-e40, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33735066

RESUMO

BACKGROUND: In current approaches to vision screening in the community, a simple and efficient process is needed to identify individuals who should be referred to tertiary eye care centres for vision loss related to eye diseases. The emergence of deep learning technology offers new opportunities to revolutionise this clinical referral pathway. We aimed to assess the performance of a newly developed deep learning algorithm for detection of disease-related visual impairment. METHODS: In this proof-of-concept study, using retinal fundus images from 15 175 eyes with complete data related to best-corrected visual acuity or pinhole visual acuity from the Singapore Epidemiology of Eye Diseases Study, we first developed a single-modality deep learning algorithm based on retinal photographs alone for detection of any disease-related visual impairment (defined as eyes from patients with major eye diseases and best-corrected visual acuity of <20/40), and moderate or worse disease-related visual impairment (eyes with disease and best-corrected visual acuity of <20/60). After development of the algorithm, we tested it internally, using a new set of 3803 eyes from the Singapore Epidemiology of Eye Diseases Study. We then tested it externally using three population-based studies (the Beijing Eye study [6239 eyes], Central India Eye and Medical study [6526 eyes], and Blue Mountains Eye Study [2002 eyes]), and two clinical studies (the Chinese University of Hong Kong's Sight Threatening Diabetic Retinopathy study [971 eyes] and the Outram Polyclinic Study [1225 eyes]). The algorithm's performance in each dataset was assessed on the basis of the area under the receiver operating characteristic curve (AUC). FINDINGS: In the internal test dataset, the AUC for detection of any disease-related visual impairment was 94·2% (95% CI 93·0-95·3; sensitivity 90·7% [87·0-93·6]; specificity 86·8% [85·6-87·9]). The AUC for moderate or worse disease-related visual impairment was 93·9% (95% CI 92·2-95·6; sensitivity 94·6% [89·6-97·6]; specificity 81·3% [80·0-82·5]). Across the five external test datasets (16 993 eyes), the algorithm achieved AUCs ranging between 86·6% (83·4-89·7; sensitivity 87·5% [80·7-92·5]; specificity 70·0% [66·7-73·1]) and 93·6% (92·4-94·8; sensitivity 87·8% [84·1-90·9]; specificity 87·1% [86·2-88·0]) for any disease-related visual impairment, and the AUCs for moderate or worse disease-related visual impairment ranged between 85·9% (81·8-90·1; sensitivity 84·7% [73·0-92·8]; specificity 74·4% [71·4-77·2]) and 93·5% (91·7-95·3; sensitivity 90·3% [84·2-94·6]; specificity 84·2% [83·2-85·1]). INTERPRETATION: This proof-of-concept study shows the potential of a single-modality, function-focused tool in identifying visual impairment related to major eye diseases, providing more timely and pinpointed referral of patients with disease-related visual impairment from the community to tertiary eye hospitals. FUNDING: National Medical Research Council, Singapore.


Assuntos
Algoritmos , Aprendizado Profundo , Oftalmopatias/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Idoso , Área Sob a Curva , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação/métodos , Estudo de Prova de Conceito , Curva ROC , Sensibilidade e Especificidade , Singapura/epidemiologia
18.
J Safety Res ; 76: 90-100, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653574

RESUMO

INTRODUCTION: Speed cameras have been implemented to improve road safety over recent decades in the UK. Although the safety impacts of the speed camera have been estimated thoroughly, the criteria for selecting camera sites have rarely been studied. This paper evaluates the current speed camera sites selection criteria in the UK based on safety performance. METHOD: A total of 332 speed cameras and 2,513 control sites with road traffic accident data are observed from 2002 to 2010. Propensity score matching method and empirical Bayes method are employed and compared to estimate the safety effects of speed cameras under different scenarios. RESULTS: First, the main characteristics of speed cameras meeting and not meeting the selection criteria are identified. The results indicate that the proximity to school zones and residential neighborhoods, as well as population density, are the main considerations when selecting speed camera sites. Then the official criteria used for selecting camera sites are evaluated, including site length (a stretch of road that has a fixed speed camera or has had one in the past), previous accident history, and risk value (a numerical scale of the risk level). The results suggest that a site length of 500 m should be used to achieve the optimum safety effects of speed cameras. Furthermore, speed cameras are most effective in reducing crashes when the requirement of minimum number of historical killed and seriously injured collisions (KSIs) is met. In terms of the risk value, it is found that the speed cameras can obtain optimal effectiveness with a risk value greater than or equal to 30, rather than the recommended risk value of 22.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Fotografação/estatística & dados numéricos , Segurança/estatística & dados numéricos , Teorema de Bayes , Pontuação de Propensão , Reino Unido
19.
Int J Mol Sci ; 22(4)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33671198

RESUMO

Near-infrared (NIR) fluorescence-guided surgery is an innovative technique for the real-time visualization of resection margins. The aim of this study was to develop a head and neck multicellular tumor spheroid model and to explore the possibilities offered by it for the evaluation of cameras for NIR fluorescence-guided surgery protocols. FaDu spheroids were incubated with indocyanine green (ICG) and then included in a tissue-like phantom. To assess the capability of Fluobeam® NIR camera to detect ICG in tissues, FaDu spheroids exposed to ICG were embedded in 2, 5 or 8 mm of tissue-like phantom. The fluorescence signal was significantly higher between 2, 5 and 8 mm of depth for spheroids treated with more than 5 µg/mL ICG (p < 0.05). The fluorescence intensity positively correlated with the size of spheroids (p < 0.01), while the correlation with depth in the tissue-like phantom was strongly negative (p < 0.001). This multicellular spheroid model embedded in a tissue-like phantom seems to be a simple and reproducible in vitro tumor model, allowing a comparison of NIR cameras. The ideal configuration seems to be 450 µm FaDu spheroids incubated for 24 hours with 0.05 mg/ml of ICG, ensuring the best stability, toxicity, incorporation and signal intensity.


Assuntos
Cabeça/diagnóstico por imagem , Imageamento Tridimensional , Modelos Biológicos , Pescoço/diagnóstico por imagem , Neoplasias/cirurgia , Fotografação/instrumentação , Espectroscopia de Luz Próxima ao Infravermelho , Esferoides Celulares/citologia , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células , Fluorescência , Humanos , Verde de Indocianina/toxicidade , Cinética , Imagens de Fantasmas
20.
Am J Phys Anthropol ; 174(4): 832-838, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33522597

RESUMO

OBJECTIVES: Standard methods of recording occlusal dental wear are problematic in that they either do not allow for individual variation of wear or are not designed to allow for comparisons of wear patterns. In this article, we (a) present a novel method for recording and analyzing molar wear, and (b) evaluate this method in light of existing methods. MATERIALS AND METHODS: Eighty-two lower mandibular first molars from two regions (medieval Denmark, prehistoric Ohio Valley) were used to assess the method for replicability (intra and inter observer error) and accuracy (comparison to established methods of recording wear). Wear scores were recorded using the MolWear Android App (Beta) by both authors, and established methods of Smith and Scott by the first author. Intraobserver and interobserver error and comparison of the three methods were compared using Spearman's correlation coefficients. RESULTS: The MolWear method presented high intraobserver (r = 0.985, p < 0.01) and interobserver (r = 0.978, p < 0.01) repeatability. Compared to other methods, the method was strongly correlated with Smith (r = 0.962, p < 0.01) and Smith (r = 0.891, p < 0.01). DISCUSSION: The new MolWear method provides an improved way of measuring occlusal molar wear. This method bridges the gaps between established methods, performing comparatively while capturing more information about the distribution of wear in addition to the extent of wear. This method should be used for research comparing interpopulation or intrapopulation quantity of dental wear. While designed for a bioarchaeological population, this method could extend to any Y5 molar including nonhuman primates and hominins.


Assuntos
Dente Molar/patologia , Paleodontologia/métodos , Atrito Dentário/patologia , Humanos , Fotografação
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