Reference Cards Research Articles

Physician Perspectives on Acupuncture Use in the Pediatric Emergency Department.

Acupuncture is a nonpharmalogical treatment modality that is used to treat pain. Prior research demonstrates that pediatric patients tolerate acupuncture well and patients may experience significant pain relief. The objectives of this study were to (1) explore the experiences of pediatric emergency department (ED) physicians as they used 2 acupuncture procedures, Battlefield Acupuncture and Four Gates procedures, and (2) describe factors impacting the feasibility of acupuncture implementation in the pediatric ED setting. This qualitative study used individual semistructured interviews with pediatric emergency medicine physicians who had completed basic acupuncture training recruited using purposive sampling. Interviews were individually coded and analyzed using thematic analysis. Eight pediatric ED physicians participated in interviews. We identified multiple factors that promoted acupuncture use, multilevel barriers that impacted ED acupuncture implementation, offered multilevel solutions to overcome barriers to ED acupuncture implementation, and overall recommended continued use of ED acupuncture. Participants noted that education for patients, families, ED staff, and the general community may facilitate acupuncture implementation. To promote standardized and equitable access to acupuncture, participants recommended that all ED physicians in the division should be credentialed to provide acupuncture. In addition, participants recognized the benefits of an ED-specific electronic medical record documentation template and acupuncture toolbox including centralized acupuncture supplies, patient and family educational materials, and reference cards for physicians. Participants overall had positive experiences with ED acupuncture. Although multilevel barriers to use of acupuncture were noted, these may be mitigated by several strategies suggested by participants. Future research is needed to further explore the potential impact of these strategies, as well as examine clinical outcomes of acupuncture implementation in the pediatric ED setting.

Normalizing the Optical Signal Enables Robust Assays with Lateral Flow Biosensors.

Lateral flow assays (LFAs) are widely adopted for fast, on-site molecular diagnostics. Obtaining high-precision assay results, however, remains challenging and often requires a dedicated optical setup to control the imaging environment. Here, we describe quick light normalization exam (qLiNE) that transforms ubiquitous smartphones into a robust LFA reader. qLiNE used a reference card, printed with geometric patterns and color standards, for real-time optical calibration: a photo of an LFA test strip was taken along with the card, and the image was processed using a smartphone app to correct shape distortion, illumination brightness, and color imbalances. This approach yielded consistent optical signal, enabling quantitative molecular analyses under different illumination conditions. We adapted qLiNE to detect cortisol, a known stress hormone, in saliva samples at point-of-use settings. The assay was fast (15 min) and sensitive (detection limit, 0.16 ng/mL). The serial qLiNE assay detected diurnal cycles of cortisol levels as well as stress-induced cortisol increase.

New Approach to Generate Ratiometric Signals on Immunochromatographic Strips for Small Molecules.

The self-calibration capability of ratiometric signals has been widely considered to enhance the accuracy, sensitivity, and anti-interference ability of immunoassays. Exploring a new approach to generate ratiometric signals can provide more options for various requirements. Herein, we integrated the negative-readout competitive and positive-readout noncompetitive immunoassays into a single assay by employing different color tracers, labeled peptidomimetic and anti-immunocomplex peptides, to create a new unconstrained ratiometric signal approach. Using an immunochromatographic strip (ICS) and a fungicide benzothiostrobin as the analytical platform and analyte, respectively, we showed that this approach can be extensively applied to fluorescence and colorimetry readouts, which have also been proven for strong anti-interference ability to an external light environment. Moreover, the enormous intuitional color changes of ratiometric fluorescent and colorimetric ICSs (RFICS and RCICS) enabled the formation of the color reference cards (like the pH paper) for visual judgment. After adaptation with a portable smartphone, the quantitative detection limits for RFICS and RCICS were 0.17 and 0.44 ng mL-1, respectively. In addition, the ICSs showed good accuracy for the detection of benzothiostrobin in spiked samples.

A computational method for rapid orthographic photography of lake sediment cores

Photographs of sediment cores are an important dataset, often containing visual evidence for environmental change via sediment composition and structure. These photographs may be used to stratigraphically correlate adjacent cores or for automated image analysis, and can facilitate collaboration amongst researchers through sharing and annotation of the image files. Here we describe the use of computational photogrammetry (also known as Structure from Motion–Multi-View Stereo) to generate orthographic imagery of sediment cores. Computational photogrammetry is a rapid and economical technique, typically requiring only a few minutes for each metre of core, using consumer-grade digital camera equipment. The photogrammetric methodology corrects for topographic distortion caused by sediment surfaces that are not perfectly flat, and can also record features of the scene surrounding the core, such as notes, colour reference cards and measurement tapes or rulers. As the photogrammetric process also generates a three-dimensional reconstruction of the sediment core, spatial-based analysis can be used to identify damaged or non-representative sections of the core that are to be avoided during image analysis. Using an intermittently laminated sediment core from Lake Surprise, Australia, we tested 22 scenarios using control points in a variety of configurations, as well as calibrated and uncalibrated cameras, to identify techniques that can reconstruct the core accurately and generate orthophotos. Multiple techniques were able to achieve suitable accuracy. In particular, targets placed on the table alongside the core, combined with a calibrated camera, achieved high accuracy and enabled a simple, rapid, and repeatable method for generating high-quality sediment core images.

Increasing capacity to address the physical health needs of patients in a mental health and addictions hospital.

This paper describes the strategy and outcomes of a quality improvement initiative focused on building the capacity of nurses at a mental health and addictions teaching hospital to provide an improved standard of physical health care. Education was provided via a series of e-learning modules and interactive workshops. To reinforce the education and enhance practice change, improvements were made to electronic documentation templates and organizational standards. Further, the organization provided increased access to physical health equipment, a mobile application to support assessments and a reference card for lanyards. Nurses identified increased confidence in performing physical assessments, and documentation improved with standards and automated forced functionality in the electronic health record. Ultimately, the organization successfully implemented a multifaceted strategy to improve physical healthcare services for people with mental health and substance use concerns. Organizational investment can lead to sustainable changes in nursing confidence and increased physical health assessment completion.

Smartphone–Camera–Based Water Reflectance Measurement and Typical Water Quality Parameter Inversion

Crowdsourced data from smart devices play an increasingly important role in water quality monitoring. However, guaranteeing and evaluating crowdsourced data quality is a key issue. This study aims to extract more accurate water reflectance data from smartphone photographs with variable exposure parameters, and to test the usability of these data in deriving water quality parameters. A set of low–cost reference cards was designed to be placed in the center of the photograph near the water surface, and a calculation model was proposed to convert the photograph digital numbers (DNs) to water reflectance. A nonlinear DN–to–reflectance model was constructed using the inherent reflectance and DN of the reference card in the photograph. Then, the reflectance of the water surface in the same photograph was estimated. During the evaluation of this scheme in seven different waterbodies with 112 sampling sites, small differences were observed between the estimated and measured remote sensing reflectance; the average unbiased relative errors (AUREs) for the red, green, and blue bands were 25.7%, 29.5%, and 35.2%, respectively, while the RMSEs for the three bands were 0.0032, 0.0051, 0.0031, respectively. The derived water reflectance data were used to retrieve the Secchi–disk depth (Zsd) and turbidity, with accuracies of 72.4% and 60.2%, respectively. The results demonstrate that the proposed method based on the smartphone camera can be used to derive the remote sensing reflectance and water quality parameters effectively with acceptable accuracy.

Image Correction and In Situ Spectral Calibration for Low-Cost, Smartphone Hyperspectral Imaging

Developments in the portability of low-cost hyperspectral imaging instruments translate to significant benefits to agricultural industries and environmental monitoring applications. These advances can be further explicated by removing the need for complex post-processing and calibration. We propose a method for substantially increasing the utility of portable hyperspectral imaging. Vertical and horizontal spatial distortions introduced into images by ‘operator shake’ are corrected by an in-scene reference card with two spatial references. In situ light-source-independent spectral calibration is performed. This is achieved by a comparison of the ground-truth spectral reflectance of an in-scene red–green–blue target to the uncalibrated output of the hyperspectral data. Finally, bias introduced into the hyperspectral images due to the non-flat spectral output of the illumination is removed. This allows for low-skilled operation of a truly handheld, low-cost hyperspectral imager for agriculture, environmental monitoring, or other visible hyperspectral imaging applications.

Artificial intelligence-assisted interpretation of Ki-67 expression and repeatability in breast cancer

BackgroundKi-67 standard reference card (SRC) and artificial intelligence (AI) software were used to evaluate breast cancer Ki-67LI. We established training and validation sets and studied the repeatability inter-observers.MethodsA total of 300 invasive breast cancer specimens were randomly divided into training and validation sets, with each set including 150 cases. Breast cancer Ki-67 standard reference card ranging from 5 to 90% were created. The training set was interpreted by nine pathologists of different ages through microscopic visual assessment (VA), SRC, microscopic manual counting (MC), and AI. The validation set was interpreted by three randomly selected pathologists using SRC and AI. The intra-group correlation coefficient (ICC) were used for consistency analysis.ResultsIn the homogeneous and heterogeneous groups of validation sets, the consistency among the pathologists that used SRC and AI was very good, with an ICC of>0.905. In the validation set, using SRC and AI, three pathologists obtained results that were very consistent with the gold standard, having an ICC above 0.95, and the inter-observer agreement was also very good, with an ICC of>0.9.ConclusionsAI has satisfactory inter-observer repeatability, and the true value was closer to the gold standard, which is the preferred method for Ki-67LI reproducibility; While AI software has not been popularized, SRC may be interpreted as breast cancer Ki-67LI’s standard candidate method.

Point-of-care semi-quantitative test for adherence to tenofovir alafenamide or tenofovir disoproxil fumarate.

Objective measurement of antiretrovirals may aid clinical interventions for improving adherence to HIV prevention or treatment regimens. A point-of-care urine test could provide real-time information about recent adherence to regimens containing tenofovir disoproxil fumarate or tenofovir alafenamide. We developed a lateral flow immunoassay (LFA) and ELISA for urinary tenofovir. The intensity of the LFA test line was quantified using an optical reader and visually scored 0-5 by two independent people, using a reference card. The sensitivity and specificity of both the ELISA and LFA were determined for two different tenofovir concentration cut-offs for tenofovir disoproxil fumarate and tenofovir alafenamide adherence-1500 and 150 ng/mL, respectively. To validate the assays, we measured 586 urine samples from 28 individuals collected as part of a study of tenofovir pharmacokinetics in adults, which were also measured by MS for reference. Both the LFA signal and ELISA signal were each strongly correlated with drug concentrations (0.91 and 0.92, respectively). The LFA signal and ELISA were highly sensitive and specific at both thresholds (LFA sensitivity/specificity: tenofovir disoproxil fumarate, 89%/96%; and tenofovir alafenamide, 90%/96%) (ELISA sensitivity/specificity: tenofovir disoproxil fumarate, 94%/94%; and tenofovir alafenamide, 92%/84%). Visual scoring of the LFA was also highly sensitive and specific at both the tenofovir disoproxil fumarate threshold and the tenofovir alafenamide threshold (sensitivity/specificity: tenofovir disoproxil fumarate, 91%/94%; and tenofovir alafenamide, 87%/90%). Our rapid semi-quantitative test can measure tenofovir concentrations relevant to both tenofovir alafenamide and tenofovir disoproxil fumarate adherence, which may support adherence-promoting interventions across a range of HIV care settings.

Smartphone-Based Colorimetric Analysis of Urine Test Strips for At-Home Prenatal Care.

Objective: Clinical urine tests are a key component of prenatal care. As of now, urine test strips are evaluated through a time consuming, often error-prone and operator-dependent visual color comparison of test strips and reference cards by medical staff. Methods and procedures: This work presents an automated pipeline for urinalysis with urine test strips using smartphone camera images in home environments, combining several image processing and color combination techniques. Our approach is applicable to off-the-shelf test strips in home conditions with no additional hardware required. For development and evaluation of our pipeline we collected image data from two sources: i) A user study (26 participants, 150 images) and ii) a lab study (135 images). Results: We trained a region-based convolutional neural network that is able to detect the urine test strip location and orientation in images with a wide variety of light conditions, backgrounds and perspectives with an accuracy of 85.5%. The reference card can be robustly detected through a feature matching approach in 98.6% of the images. Color comparison by Hue channel (0.81 F1-Score), Matching factor (0.80 F1-Score) and Euclidean distance (0.70 F1-Score) were evaluated to determine the urinalysis results. Conclusion: We show that an automated smartphone-based colorimetric analysis of urine test strips in a home environment is feasible. It facilitates examinations and provides the possibility to shift care into an at-home environment. Clinical impact: The findings demonstrate that routine urine examinations can be transferred into the home environment using a smartphone. Simultaneously, human error is avoided, accuracy is increased and medical staff is relieved.

Go and separate: a strategic intervention material (SIM) in improving the academic performance of grade 6 science pupils

This study dealt on how I improved the academic performance of my learners on the topic of separating mixtures at Rizal Central Elementary School, Kapatagan, Digos City for the school year 2020-2021. Guide cards, activity cards, assessment cards, enrichment cards and reference cards comprised the Strategic Intervention Material (SIM) entitled “Go and Separate” which was used as a form of remediation. The material covers one of the least-learned competencies in Science VI, Quarter I which is “enumerate techniques in separating mixtures such as decantation, evaporation, filtering, sieving, distillation, and using magnet” and for this study, decantation and evaporation were focused. The data collection was performed using pretest, posttest, and perception survey questionnaire. It was analyzed quantitatively and qualitatively. It was concluded that based on the outcomes of the study, the use of Strategic Intervention Material (SIM) has contributed meaningfully to the academic performance of the learners. It was also perceived that the participants exhibited enthusiasm and enjoyed the use of Strategic Intervention Material (SIM) through their positive responses based on their answers on perception survey questionnaire.

Reference map of localization of contact points and contact areas of posterior teeth

The aim of the study: to find correlations in age-related characteristics of the localization and shape of the contact points in permanent posterior teeth and to develop a reference card for dentists, reflecting the age-related characteristics of the localization, shape and size of the contact areas of the posterior teeth in adults.Materials and research methods. The linear dimensions, area, shape, vertical and horizontal position in the interdental space of 1224 contact points of the posterior teeth in 236 patients aged 20 to 59 years was assessed based on a comprehensive analysis of intraoral radiographs performed using the bitewing technique, the results of the study of contact points using floss, displaying contact points on dental impressions made using a special technique.Research results. It was found that the interdental spaces of the posterior teeth in adult patients are characterized by the following features: the contact areas of the teeth are displaced in the vestibular direction, the buccal and lingual (palatal) interdental embrasures are asymmetric; dynamics of the depth of occlusal interdental embrasures, linear dimensions and area of contact areas is expressed as average digital values for different age groups: 20-40 years: contact areas – 1×2 mm, S = 2 mm2, depth of occlusal interdental embrasure - 1.5 mm ; over 40 years old: contact pads – 1.5×3 mm, S = 4.5 mm2, the depth of the occlusal interdental embrasure – 1.0 mm.Conclusion. On the basis of the data obtained, a «Reference map of the localization of contact points and contact areas of posterior teeth in adult patients» was proposed, which allows a dentist to obtain data on the features of the topography of the contact areas of the posterior teeth, taking into account the patient’s age during planning and performing interproximal caries treatment.

The Effect of Standardized Perioperative Patient Education on Opioid Use After Minor Soft Tissue Procedures Distal to the Wrist

Several studies have explored opioid consumption and opioid prescriber education for upper extremity procedures; however, less literature has focused on patient-centered interventions and their impact on opioid consumption after surgery. The purpose of this study was to create a standardized perioperative patient education program regarding postoperative pain management after hand surgery and to determine if it could reduce opioid use after hand surgery. Patients scheduled to undergo elective outpatient hand surgery comprising minor soft tissue procedures at and distal to the wrist were randomized to receive pain management education or standard care. Before the surgery, all patients viewed a webinar with instructions for participation, whereas the education group received an additional 10 minutes of education on postoperative pain management and a pain management reference card for review after the surgery. All patients completed a postoperative daily log documenting the number of opioids consumed, other pain management modalities used, and pain scores. The primary outcome of the number of opioid pills consumed by the patients was compared between the groups. We constructed a linear regression model to determine the risk factors for postoperative opioid use after surgery. One hundred seventy-four patients completed the study (n= 90 education group; n= 84 standard care group). Patients in the education group took significantly fewer opioid pills (median= 0, range 0-13) than those in the standard care group (median= 0.5, range 0-40). A linear regression model showed that average week-1 pain (B= 0.93; 95% confidence interval, 0.56-1.3) and the number of pills prescribed (B= 0.12; 95% confidence interval, 0.017-0.22) were predictive of greater opioid use. Perioperative patient education significantly reduced postoperative opioid use following a minor soft tissue hand surgery, with greater than 70% of the patients taking no opioids. Prognostic II.

Patient Blood Management: An Initiative Aimed at Improving Outcomes While Decreasing Red Cell Transfusions with Specialty Guidelines for Hematology Patients

Background:Red cell transfusion is the only available therapy for patients with life threatening anemia or hemorrhage. However, it is not risk-free. Complications are both common and potentially severe including infection, volume overload, renal and lung injury, multisystem organ failure, and immunomodulation. Some studies suggest that up to 60% of blood transfusions provide little to no benefit and potential for harm. Each unit is associated with increases in wound complications by 4%, length of stay (LOS) by 1.5 days, and mortality by 0.9% in hospital wide populations, and randomized trials support these estimates. Restrictive red cell transfusion has become vital to minimize patient risks, provide only what the patient needs, and ensures safer transfusion. Medical centers nationwide have begun to adopt restrictive, evidence based guidelines and initiating Patient blood Management (PBM) programs. Our PBM program began in July of 2014 with the primary goal of promoting the optimal use of blood components throughout the medical center.Methods:After formalizing our plan and enlisting support from hospital leadership, our medical center contracted with a major consulting and analytics firm specializing in blood management to provide support in establishing a PBM program. Following review and updating our general transfusion guidelines (Table 1) via consultation with specialty practitioners, we began to evaluate all daily transfusion requests for appropriateness utilizing laboratory and clinical data, in concert with educational presentations to our highest use departments. Multimodal education via lectures, transfusion guideline reference cards, newsletters, and just in time instruction and consultation were used to capture different practitioner types and to create a cohesive message. A multidisciplinary Transfusion Safety committee was established to share goals, information and to encourage collaboration.Following utilization review and benchmarking of our highest use departments we collaboratively developed special transfusion guidelines for select patients. One such group, our outpatient Hematology/Oncology patients, was particularly challenging for guideline development. Their disease process limits treatment options, making transfusion essential for some. Outpatient treatment also poses challenges with monitoring and a variety of social and lifestyle issues, such as resources, travel time and quality of life. In the absence of randomized trial evidence, these issues necessitated a more liberal and broad transfusion guideline (Table 2) while still maintaining the objective of minimum dose for desired benefit. Improved communication and follow through with audits and attendance of Transfusion Medicine representatives at hematology service meetings, as well as extensive transfusion safety education with nursing has enhanced the impact of this initiative.Results and Discussion:Our latest data shows that since implementing our PBM program hospital wide blood component expenditures has decreased by 29% with outpatient cancer transfusion expenditures down 14%. Benchmarking data from October 2014-December 2016 improved our ranking from 5th to 50th percentile overall (100 percentile is lowest utilization) with oncology improving from 20th to 56th percentile amongst all hospitals surveyed. Based on National Surgical Quality Improvement Program data this reduction might be expected to mitigate 661 complications, 24,788 patient inpatient days, 149 deaths, and 36,356 nursing hours.Conclusion:Blood transfusion is increasingly recognized as carrying frequent and serious risks, and should be utilized as a lifesaving resort. Adherence to more parsimonious transfusion practice improves patient safety, minimizes risks, optimizes clinical outcomes, and reduces costs, although data on outpatients with hematologic diseases is low quality at present. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Improving Ki67 assessment concordance by the use of an artificial intelligence-empowered microscope: a multi-institutional ring study.

The nuclear proliferation biomarker Ki67 plays potential prognostic and predictive roles in breast cancer treatment. However, the lack of interpathologist consistency in Ki67 assessment limits the clinical use of Ki67. The aim of this article was to report a solution utilising an artificial intelligence (AI)-empowered microscope to improve Ki67 scoring concordance. We developed an AI-empowered microscope in which the conventional microscope was equipped with AI algorithms, and AI results were provided to pathologists in real time through augmented reality. We recruited 30 pathologists with various experience levels from five institutes to assess the Ki67 labelling index on 100 Ki67-stained slides from invasive breast cancer patients. In the first round, pathologists conducted visual assessment on a conventional microscope; in the second round, they were assisted with reference cards; and in the third round, they were assisted with an AI-empowered microscope. Experienced pathologists had better reproducibility and accuracy [intraclass correlation coefficient (ICC)=0.864, mean error=8.25%] than inexperienced pathologists (ICC=0.807, mean error=11.0%) in visual assessment. Moreover, with reference cards, inexperienced pathologists (ICC=0.836, mean error=10.7%) and experienced pathologists (ICC=0.875, mean error=7.56%) improved their reproducibility and accuracy. Finally, both experienced pathologists (ICC=0.937, mean error=4.36%) and inexperienced pathologists (ICC=0.923, mean error=4.71%) improved the reproducibility and accuracy significantly with the AI-empowered microscope. The AI-empowered microscope allows seamless integration of the AI solution into the clinical workflow, and helps pathologists to obtain higher consistency and accuracy for Ki67 assessment.

Clinical photography in skin of colour: tips and best practices.

High quality photos are critical to dermatology: both for clinical care and education. Although best practices for capturing skin photos have been outlined,1 these omit specific challenges of taking photos of dark skin. Bias against accurate capture of dark skin in photographic technology is a longstanding issue2 . Film photography colour balance relied on reference cards portraying white models2 , and digital photography still has issues capturing detailed photos of darker skin.

A comparison of ceramic crown color difference between different shade selection methods: Visual, digital camera, and smartphone

Statement of problemThe light source stability of digital cameras and smartphones is important in shade matching in restorative and prosthetic dentistry to communicate objectively with the dental laboratory. Techniques that standardize the light source of such devices are lacking, and this limitation can lead to color mismatches, difficulties in color communication, and treatment documentation. PurposeThe purpose of this clinical study was to compare the magnitude of color difference (ΔE) among 3 shade selection methods during the fabrication of ceramic crowns: visual shade selection with a shade guide, digital shade selection with a digital camera and cross-polarizing filter, and digital shade selection with a smartphone and a light-correcting device. Material and methodsForty-five patients in need of ceramic crowns were enrolled, and shade selection was evaluated according to different protocols: visual shade selection (A-D shade guide and IPS Natural Die Material Shade Guide, sent to the dental laboratory technician via a laboratory prescription); digital shade selection with a digital camera (D7000; Nikon Corp) with an 85-mm lens and wireless close-up flash, with and without a cross-polarizing filter (Polar eyes); and digital shade selection with a smartphone and a light-correcting device (iPhone XS attached to Smile Lite MDP, with and without its cross-polarizing filter accessory). Information from the smartphone was imported to an app (IPS e.max Shade Navigation App; Ivoclar AG) that converted the reading to a shade and level of translucency for the ceramic restoration. For all photographs, a gray reference card with known color values was positioned by the mandibular teeth and was used for white balancing of the digital photographs with a software program. All photographs were edited and sent to the dental laboratory: white-balanced with the shade guide; white-balanced with the substrate shade guide; black and white; saturated; and cross-polarized. Ceramic crowns were made with the same lithium disilicate material (IPS e.max CAD; Ivoclar AG) and cemented with the same resin cement (RelyX Ultimate Clicker, A3 shade; 3M). The ΔE values between the crown and the adjacent tooth were determined. The data were analyzed by using a 1-way analysis of variance (ANOVA) and Tukey post hoc tests (α=.05). ResultsThe mean ΔE between a cemented ceramic crown and the adjacent tooth in the visual shade selection group was 5.32, significantly different than both digital camera (ΔE=2.75; P=.002) and smartphone (ΔE=2.34; P=.001), which were not different from each other (P=.857). ConclusionsThe digital shade selection with photographs acquired with both a digital camera and a smartphone with a light-correcting device showed a threshold within the acceptable values (ΔE<3.7), whereas the visual shade selection showed an average ΔE above the threshold for acceptable values (ΔE>3.7). The use of a gray reference card helped standardize the white balance from the digital images.

Effect of ambient lighting conditions on tooth color quantification in cross-polarized dental photography: A clinical study

Statement of problemLimited data are available in the dental literature regarding the effect of ambient lighting on the consistency of color quantification in cross-polarized photography. PurposeThe purpose of this clinical study was to investigate the effects of ambient lighting conditions and postprocessing photograph calibration on color quantification in cross-polarized dental photography. Material and methodsTwelve volunteers with intact maxillary central incisors were recruited. Cross-polarized photographs were captured under light-emitting diode (LED), fluorescent ceiling, and natural lighting. The photographs were repeated after a 1-week interval, yielding a total of 72 photographs. The average Commission Internationale de l’Eclairage L∗a∗b∗ coordinates of the right central incisor were obtained with a software program before and after calibration by using a neutral gray reference card. The color difference (ΔE) values were calculated for each participant between the repeated photographs under the change and no change in illumination both before and after calibration. A 3-way repeated measures ANOVA was used to compare these values (α=.05). ResultsA statistically significant 3-way interaction was found between the illuminant type, change in illumination, and calibration (P<.001); however, all the ΔE values were within a clinically acceptable threshold (ΔE≤3.7). Before calibration, when photographs were captured under no change in illumination, LED lighting was found to have a significantly lower ΔE than fluorescent (P=.008) and natural and fluorescent lightings (P=.011), but when there was a change in illumination, no significant differences (P>.05) were found. After calibration, all the ΔE values were ≤1 and significantly lower than the values before calibration (P<.001). ConclusionsBoth the ambient illuminant type and change in illumination had minimal effects on ΔE. Calibration through the use of a neutral gray reference card was found to result in reduced and imperceptible color change (ΔE≤1) for all illuminant types.

The Human Factor in Automated Image-Based Nutrition Apps: Analysis of Common Mistakes Using the goFOOD Lite App.

BackgroundTechnological advancements have enabled nutrient estimation by smartphone apps such as goFOOD. This is an artificial intelligence–based smartphone system, which uses food images or video captured by the user as input and then translates these into estimates of nutrient content. The quality of the data is highly dependent on the images the user records. This can lead to a major loss of data and impaired quality. Instead of removing these data from the study, in-depth analysis is needed to explore common mistakes and to use them for further improvement of automated apps for nutrition assessment.ObjectiveThe aim of this study is to analyze common mistakes made by participants using the goFOOD Lite app, a version of goFOOD, which was designed for food-logging, but without providing results to the users, to improve both the instructions provided and the automated functionalities of the app.MethodsThe 48 study participants were given face-to-face instructions for goFOOD Lite and were asked to record 2 pictures (1 recording) before and 2 pictures (1 recording) after the daily consumption of each food or beverage, using a reference card as a fiducial marker. All pictures that were discarded for processing due to mistakes were analyzed to record the main mistakes made by users.ResultsOf the 468 recordings of nonpackaged food items captured by the app, 60 (12.8%) had to be discarded due to errors in the capturing procedure. The principal problems were as follows: wrong fiducial marker or improper marker use (19 recordings), plate issues such as a noncompatible or nonvisible plate (8 recordings), a combination of various issues (17 recordings), and other reasons such as obstacles (hand) in front of the camera or matching recording pairs (16 recordings).ConclusionsNo other study has focused on the principal problems in the use of automatic apps for assessing nutritional intake. This study shows that it is important to provide study participants with detailed instructions if high-quality data are to be obtained. Future developments could focus on making it easier to recognize food on various plates from its color or shape and on exploring alternatives to using fiducial markers. It is also essential for future studies to understand the training needed by the participants as well as to enhance the app’s user-friendliness and to develop automatic image checks based on participant feedback.

Measurement of Water Leaving Reflectance Using a Digital Camera Based on Multiple Reflectance Reference Cards.

With the development of citizen science, digital cameras and smartphones are increasingly utilized in water quality monitoring. The smartphone application HydroColor quantitatively retrieves water quality parameters from digital images. HydroColor assumes a linear relationship between the digital pixel number (DN) and incident radiance and applies a grey reference card to derive water leaving reflectance. However, image DNs change with incident light brightness non-linearly, according to a power function. We developed an improved method for observing and calculating water leaving reflectance from digital images based on multiple reflectance reference cards. The method was applied to acquire water, sky, and reflectance reference card images using a Cannon 50D digital camera at 31 sampling stations; the results were validated using synchronously measured water leaving reflectance using a field spectrometer. The R2 for the red, green, and blue color bands were 0.94, 0.95, 0.94, and the mean relative errors were 27.6%, 29.8%, 31.8%, respectively. The validation results confirm that this method can derive accurate water leaving reflectance, especially when compared with the results derived by HydroColor, which systematically overestimates water leaving reflectance. Our results provide a more accurate theoretical foundation for quantitative water quality monitoring using digital and smartphone cameras.