Single Observer Research Articles

The utility of a direct ophthalmoscope in estimating the magnitude of refractive error using a modification of the Brückner test

ABSTRACT Objective To evaluate the utility of a direct ophthalmoscope in detecting the type and magnitude of refractive error using a modified Brückner test. Methods In a prospective observational study, participants between the ages of 10 to 40 years underwent direct ophthalmoscopy by a single observer, using a modified interpretation of the Brückner test. The results were compared with the adjusted spherical equivalents obtained from retinoscopy (RSE), and subjective correction (SSE). The inter-test agreement, sensitivity, specificity, and predictive values were calculated. Results A total of 598 eyes were evaluated. In the eyes with a normal glow, the modified Brückner technique had a substantial degree of agreement when compared with techniques of retinoscopy, subjective refractive assessment in predicting the type of refractive error (κ > 0.75). In comparison with the SSE, the test was around 90% sensitive in detecting the presence of hyperopia and myopia of more than 2 diopters, if the upper or lower crescents respectively, were large enough to cross the midline of the pupil. Conclusion A direct ophthalmoscope is useful in diagnosing the presence and magnitude of spherical refractive errors. Clinical trial registration Clinical Trials Registry – India (CTRI) No.: CTRI/2018/09/015711; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=24928&EncHid=&userName=refractive%20errors

Standardized capillary refill time and relation to clinical parameters in hospitalized dogs.

To assess the relationship between various physical and clinicopathologic parameters and the capillary refill time (CRT) using a standard method; to evaluate the influence of emergency room (ER) versus ICU hospital location on CRT; and to identify latent subgroups among the CRT distribution. Prospective, observational study. University teaching hospital. Client-owned dogs in the ER (n=40) and ICU (n=71). The CRT was defined as the duration required for the oral mucosa of the upper lip to return to its original color after blanching for 4 seconds. The CRT was recorded in seconds to the 10ths place by a single observer using an automated recording device. Median CRT for all dogs was 1.1 seconds (ER, 1.2 s; ICU, 1.1 s; P=1.000). The CRT was significantly associated with rectal temperature (P=0.004), systolic blood pressure (P=0.028), body weight (P=0.031), mucous membrane color (P=0.007), skin turgor (P=0.039), and acute patient physiologic and laboratory evaluation mentation score (P=0.019) for all dogs. The CRT was related to a greater number of variables in the ER than in the ICU patient population. In general, the total population of dogs had CRTs belonging to 1 of 2 groups: either≤1.2 or≥1.7 seconds. A statistically significant association was found between body weight CRT≥1.3 seconds (P=0.02). A CRT following blanching for 4 seconds may provide insight into the hydration status and hemodynamic stability of canine patients. Further research into its clinical application is warranted.

Traveling Volunteers: A Multi-Vendor, Multi-Center Study on Reproducibility and Comparability of 4D Flow Derived Aortic Hemodynamics in Cardiovascular Magnetic Resonance.

Implementation of four-dimensional flow magnetic resonance (4D Flow MR) in clinical routine requires awareness of confounders. To investigate inter-vendor comparability of 4D Flow MR derived aortic hemodynamic parameters, assess scan-rescan repeatability, and intra- and interobserver reproducibility. Prospective multicenter study. Fifteen healthy volunteers (age 24.5 ± 5.3 years, 8 females). 3 T, vendor-provided and clinically used 4D Flow MR sequences of each site. Forward flow volume, peak velocity, average, and maximum wall shear stress (WSS) were assessed via nine planes (P1-P9) throughout the thoracic aorta by a single observer (AD, 2 years of experience). Inter-vendor comparability as well as scan-rescan, intra- and interobserver reproducibility were examined. Equivalence was tested setting the 95% confidence interval of intraobserver and scan-rescan difference as the limit of clinical acceptable disagreement. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used for scan-rescan reproducibility and intra- and interobserver agreement. A P-value <0.05 was considered statistically significant. ICCs ≥ 0.75 indicated strong correlation (>0.9: excellent, 0.75-0.9: good). Ten volunteers finished the complete study successfully. 4D flow derived hemodynamic parameters between scanners of three different vendors are not equivalent exceeding the equivalence range. P3-P9 differed significantly between all three scanners for forward flow (59.1 ± 13.1 mL vs. 68.1 ± 12.0 mL vs. 55.4 ± 13.1 mL), maximum WSS (1842.0 ± 190.5 mPa vs. 1969.5 ± 398.7 mPa vs. 1500.6 ± 247.2 mPa), average WSS (1400.0 ± 149.3 mPa vs. 1322.6 ± 211.8 mPa vs. 1142.0 ± 198.5 mPa), and peak velocity between scanners I vs. III (114.7 ± 12.6 cm/s vs. 101.3 ± 15.6 cm/s). Overall, the plane location at the sinotubular junction (P1) presented most inter-vendor stability (forward: 78.5 ± 15.1 mL vs. 80.3 ± 15.4 mL vs. 79.5 ± 19.9 mL [P=0.368]; peak: 126.4 ± 16.7 cm/s vs. 119.7 ± 13.6 cm/s vs. 111.2 ± 22.6 cm/s [P=0.097]). Scan-rescan reproducibility and intra- and interobserver variability were good to excellent (ICC ≥ 0.8) with best agreement for forward flow (ICC ≥ 0.98). The clinical protocol used at three different sites led to differences in hemodynamic parameters assessed by 4D flow. 2 TECHNICAL EFFICACY STAGE: 2.

Behavioural Adaptation to Hereditary Macular Dystrophy: A Systematic Review on the Effect of Early Onset Central Field Loss on Peripheral Visual Abilities.

Purpose:Hereditary macular dystrophies (HMD) result in early onset central field loss. Evidence for cortical plasticity has been found in HMD, which may enhance peripheral visual abilities to meet the increased demands and reliance on the peripheral field, as has been found in congenitally deaf adults and habitual action video-game players. This is a qualitative synthesis of the literature on the effect of early onset central field loss on peripheral visual abilities. The knowledge gained may help in developing rehabilitative strategies that enable optimisation of remaining peripheral vision.Methods:A systematic search performed on the Web of Science and PubMED databases yielded 728 records published between 1809 to 2020, of which seven case-control studies were eligible for qualitative synthesis.Results:The search highlighted an overall paucity of literature, which lacked validity due to small heterogeneous samples and deficiencies in reporting of methods and population characteristics. A range of peripheral visual abilities at different eccentricities were studied. Superior performance of HMD observers in the peripheral field or similarities between the preferred retinal loci (PRL) and normal fovea were observed in four of seven studies. Findings were often based on studies including a single observer. Further larger rigorous studies are required in this area.Conclusions:Spontaneous perceptual learning through reliance on and repeated use of the peripheral field and PRL may result in some specific superior peripheral visual abilities. However, worse performance in some tasks could reflect unexpected rod disease, lack of intensive training, or persistent limitations due to the need for cones for specific tasks. Perceptual learning through training regimes could enable patients to optimise use of the PRL and remaining peripheral vision. However, further studies are needed to design optimal training regimes.

Comparison of Mean Axial Length Measured by Acoustic Biometry versus Optical Biometry

Purpose: To compare the mean axial length measured by acoustic biometry with optical biometry.&#x0D; Design: Descriptive observational study.&#x0D; Place and Duration of Study: Department of Ophthalmology Liaquat National Hospital and Medical College, Karachi from November 2018 to April 2019.&#x0D; Methods: were 246 patients with visually significant cataract who were recruited in this study by consecutive sampling. Axial lengths were measured by non-contact optical method using Carl Zeiss IOL master. After instillation of local anesthetic, axial lengths were re-measured by contact method with A-Scan probe. All readings were taken by a single observer to avoid data collection bias. Mean and standard deviation was computed for quantitative variable i.e. age, axial length by Applanation ultra sound and axial length by optical biometry. Frequency and percentage was calculated for qualitative variables i.e. gender. Differences of axial length between the Applanation and optical biometry were compared by using pair T-test. Effect modifiers like age and gender were addressed through stratification, post stratification independent test for two groups and ANOVA for more than two groups was applied.&#x0D; Results: The average age of the patients was 58.09 ± 7.27 years. Mean axial length by optical biometry was 23.744 ± 0.74mm as compared to 22.29 ± 0.76 mm by acoustic method and this difference was statistically significant (P = 0.0005).&#x0D; Conclusion: Results of axial length with Optical and acoustic biometry are significantly different with p value less than 0.05. However, optical biometers fail in cases of dense media opacities where acoustic biometry in needed.&#x0D; Key Words: Cataract, Axial length, Applanation ultrasound, Optical Biometry.

Reliability of Modified Hertels Exophthalmometer as an Intraoperative Tool for Assessment of Relative Globe Position in Orbital/Zygomatic Fracture.

Introduction:Axial globe position assessment is commonly carried out with Hertels Exophthalmometer. Hertels requires an intact lateral orbital rim for its placement, which is often fractured in zygomatic fractures. Hence, to overcome this problem, we have modified the instrument for its application in zygomatic/orbital fractures. Reliability of this Modified Hertels Exopthalmometer has been already validated in normal healthy patients. Therefore, the aim of this study is to assess the efficacy of the Modified Hertels Exophthalmometer in pateints with zygomatic/orbital fracture.Materials and Methods:This is a prospective study carried out between April 2015 and October 2017, including 20 patients with a mean age of 34 years. Enophthalmos was measured using Modified Hertels in patients with unilateral orbital/zygomatic fracture indicated for surgical intervention by a single observer. The data was collected and statistically analyzed. Paired sample t-test was done to compare the preoperative exophthalmometer reading with readings at different time points.Results:A statistically significant difference was noted (P = 0.031) among the variables of Modified Hertels. We believe this instrument to be of practical use in the assessment of enophthalmos/exophthalmos in patients with lateral orbital trauma, surgery or disease and also precludes the use of rim-based exophthalmometry and other modifications of same.

A Microcomputed Tomographic Evaluation of Root Canal Morphology of Maxillary Second Premolars in a Pakistani Cohort

This study aimed to investigate variations in the root canal morphology of maxillary second premolar (MSP) teeth using microcomputed tomography (micro-CT). Sixty (N = 60) human extracted MSPs were collected and prepared for micro-CT scanning. The duration for scanning a single sample ranged between 30 and 40 min and a three-dimensional (3-D) image was obtained for all the MSPs. The images were evaluated by a single observer who recorded the canal morphology type, number of roots, canal orifices, apical foramina(s), apical delta(s), and accessory canals. The root canal configuration was categorized in agreement with Vertucci’s classification, and any configuration not in agreement with Vertucci’s classification was reported as an “additional canal configuration”. Descriptive statistics (such as mean percentages) were calculated using SPSS software. The most common types agreeing with Vertucci’s classification (in order of highest to lowest incidence) were types I, III, V, VII, II, and VI. The teeth also exhibited four additional configurations that were different from Vertucci’s classification: types 2-3, 1-2-3, 2-1-2-1, and 1-2-1-3. A single root was found in 96.7% and the majority of the samples demonstrated two canals (73.3%). Further, 80% of the teeth showed one canal orifice. The number of apical foramina’s in the teeth was variable, with 56.7% having solitary apical foramen. The accessory canal was found in 33.3%, and apical delta was found in only 20% of the samples. Variable morphology of the MSPs was detected in our study. The canal configuration most prevalent was type 1; however, the results also revealed some additional canal types.

Changes in deltoid muscle tension after reverse shoulder arthroplasty as quantified by shear wave elastography: relationship with radiographic parameters and functional outcomes

IntroductionImplantation of a reverse shoulder arthroplasty (RSA) impacts deltoid length, shape and tension. Quantification of changes in deltoid muscle tension with implantation of RSA has remained elusive. The purpose of this study was to use shear wave elastography (SWE) to quantify deltoid muscle stiffness preoperatively, intraoperatively and postoperatively in patients undergoing RSA. MethodsTwenty patients scheduled to undergo RSA (ReUnion, Stryker) were prospectively enrolled in this study. A single observer trained in SWE quantified deltoid stiffness preoperatively, intraoperatively, and postoperatively. Clinical evaluation included pain, motion, quickDASH, ASES, Oxford, and subjective shoulder value scores. Preoperative and postoperative radiographs were measured by an independent observer to determine the lateralization and distalization shoulder angles (LSA and DSA). A statistical analysis was then performed to determine whether changes in deltoid muscle stiffness correlated with any of these parameters. ResultsImplantation of a RSA lead to an increase SWE deltoid stiffness value from 22.4 ± 4.2 kPa preoperatively to 29.9 ± 5.23 kPa (P˂ .0001) immediately after surgery, and 26.6 ± 6.6kPa (P= .03) at most recent follow-up. Preoperative SWE deltoid stiffness values did not differ when measured in the office or under anesthesia. Reverse arthroplasty did not significantly change the LSA (P= .051), but did increase the DSA (P< .0001). Greater SWE deltoid stiffness values correlated with better active elevation (P= .0128) better external rotation (P= .0247), and larger DSA (P= .0026). Elevation and external rotation showed a positive correlation with the DSA and a negative correlation with the LSA. ConclusionAfter implantation of one RSA design incorporating glenoid and humeral lateralization, deltoid stiffness as measured with SWE increased significantly. Deltoid stiffness seems to correlate with joint distalization, elevation and external rotation. SWE seems to be reliable to quantify deltoid stiffness after reverse shoulder arthroplasty. Level of EvidenceLevel IV; Diagnostic Study

Magnetic resonance imaging of the normal canine eye using a T1‐weighted volumetric acquisition

MRI is becoming increasingly available within the veterinary profession, and eyes are frequently included as part of a cranial study. The advantages of volumetric imaging are numerous, when compared to traditional two-dimensional imaging, and could be utilised within the veterinary setting. This report describing the normal MRI appearance of the canine eye, aimed to establish a standard reference range on a T1w volumetric acquisition. This study retrospectively assessed 62 eyes from 31 dogs that had undergone MRI at the Small Animal Hospital, Langford Vets, University of Bristol between 2016 and 2018 using a standardised MRI protocol. Dogs were excluded if they had presented with any reported ocular or orbital abnormalities. Measurements were performed from the 3D T1w volumetric sequence by a single observer using a previously published technique. Mean axial globe length was 2.13 cm and equatorial width 2.16 cm. Mean anteroposterior depth of the anterior chamber was 0.40 cm and 0.97 cm for the vitreous chamber. The mean anteroposterior and equatorial distance of the lens was 0.75 cm and 1.15 cm, respectively. Mean optic nerve width was 0.15 cm, and the mean width of the entire optic nerve sheath was 0.43 cm. Statistically significant relationships were noted between age and axial globe length and both lens dimensions. Highly significant relationships were noted between all variables, except lens dimensions and body weight Conclusion: This study provides reference values to assist in the interpretation of ocular structures during MRI on a T1w volumetric acquisition.

The impact of virtual reality training on laparoscopic surgical skills; A prospective blinded controlled trial

Background. Laparoscopic surgery has gained popularity in the last few decades replacing open standard techniques in several procedures. While its use and scope expand, a standardized method of training and assessment in laparoscopic skills is lacking. Aim. To assess the effect of virtual reality (VR) training on laparoscopic surgical skills. Materials and Methods. It is a prospective, controlled study conducted at Sagar Hospital’s skill lab and Shanthi Hospital and Research Centre (SHRC). We included 27 post graduates in general surgery. They were divided into two groups. One group underwent training in VR Simulator for one week, 30 minutes each day. The second group received no training. Their proficiency while mobilizing the Gallbladder from its liver bed was assessed using a validated scale by a single blinded observer. Results. The statistical analysis was done using a non-parametric test (Mann-Whitney U test). Residents who underwent training in VR simulator got better scores in Overall rating and also in individual parameters when compared with the control group (P = &lt;0.05). Conclusions. Laparoscopic surgical skills can be increased by using proficiency-based VR simulator training and it can be transferred to actual operations. VR simulators are a valid tool for laparoscopic surgical skills training.

Feasibility and clinical usefulness of modelling glioblastoma migration in adjuvant radiotherapy

Glioblastoma (GBM) is one of the most common primary brain tumours in adults, with a dismal prognosis despite aggressive multimodality treatment by a combination of surgery and adjuvant radiochemotherapy. A detailed knowledge of the spreading of glioma cells in the brain might allow for more targeted escalated radiotherapy, aiming to reduce locoregional relapse. Recent years have seen the development of a large variety of mathematical modelling approaches to predict glioma migration.The aim of this study is hence to evaluate the clinical applicability of a detailed micro- and meso-scale mathematical model in radiotherapy. First and foremost, a clinical workflow is established, in which the tumour is automatically segmented as input data and then followed in time mathematically based on the diffusion tensor imaging data. The influence of several free model parameters is individually evaluated, then the full model is retrospectively validated for a collective of 3 GBM patients treated at our institution by varying the most important model parameters to achieve optimum agreement with the tumour development during follow-up. Agreement of the model predictions with the real tumour growth as defined by manual contouring based on the follow-up MRI images is analyzed using the dice coefficient.The tumour evolution over 103-212 days follow-up could be predicted by the model with a dice coefficient better than 60% for all three patients. In all cases, the final tumour volume was overestimated by the model by a factor between 1.05 and 1.47.To evaluate the quality of the agreement between the model predictions and the ground truth, we must keep in mind that our gold standard relies on a single observer's (CB) manually-delineated tumour contours. We therefore decided to add a short validation of the stability and reliability of these contours by an inter-observer analysis including three other experienced radiation oncologists from our department. In total, a dice coefficient between 63% and 89% is achieved between the four different observers. Compared with this value, the model predictions (62-66%) perform reasonably well, given the fact that these tumour volumes were created based on the pre-operative segmentation and DTI.

Statistics of a single sky: constrained random fields and the imprint of Bardeen potentials on galaxy clustering

ABSTRACT We explore the implications of a single observer’s viewpoint on measurements of galaxy clustering statistics. We focus on the Bardeen potentials, which imprint characteristic scale-dependent signatures in the observed galaxy power spectrum. The existence of an observer breaks homogeneity as it singles out particular field values at her/his position, like a spontaneous symmetry breaking. As a result, spatial averaging of the data must be performed while holding the Bardeen potentials fixed at the observer’s position. In practice, this can be implemented with the formalism of constrained random fields. In the traditional Cartesian Fourier decomposition, this constraint imprints a signature in the observed galaxy power spectrum at wavenumbers comparable to the fundamental mode of the survey. This effect, which is well within the cosmic variance, is the same for all observers regardless of their local environment because differences of potential solely are observable. In a spherical Bessel Fourier decomposition, this constraint affects the monopole of the observed galaxy distribution solely, like in CMB data. As a corollary, the scale dependence of the non-Gaussian bias induced by a local primordial non-Gaussianity is not significantly affected by the observer’s viewpoint.

A Closed Loop Feature Detection Platform for Automated Neonate Cardio‐Respiratory Measurements

Sudden Infant Death Syndrome (SIDS, a leading cause of death for neonate infants 1 month to 1 year old) and some forms of neonate death (ND, the leading cause of death for newborns 28 days old or less) are thought to result, in part, from unseen brain abnormalities affecting cardio-respiratory function, but for which no clear genetic or environmental mechanisms are known. Mouse genetic and exposure models present an opportunity to uncover potential molecular and environmental mechanisms in SIDS and ND. However, measuring cardio-respiratory function to model SIDS and ND in neonate mice is expensive, difficult, and inefficient. Previously, we have developed for in-lab facile production an inexpensive face-mask pneumotachograph system for neonate respiratory measurements. A remaining challenge is the time and effort needed to carryout neonate respiratory measurements. For example, the neonate autoresuscitation assay consisting of repeated anoxic exposures followed by recovery requires the full attention of a single observer for the duration of the assay (2-3hrs) for a single subject, thus limiting the number of pups in a litter that can be assayed. To address these inefficiencies, we sought to develop a closed loop feature detection platform for automated neonate cardio-respiratory measurements that can be deployed in large numbers for high throughput parallel studies by a single person. The platform design consists of three sub-systems. First, we leveraged our previously published pneumotachograph face-mask system for precise respiratory measurements (PMID: 28213294). Second, we developed a micro-controller automated bell-housing gas switching system for near square wave induction of respiratory challenges. Third we developed a micro-computer-based data-acquisition system with real-time feature detection and response outputs for controlling gas exposure times. The gas switching system consists of linear and rotational actuated carousel that holds four bell housings into which distinct gas mixes can flow by solenoid valves. Through the rotational and linear actuation driven by a pair of stepper motors, the required bell housing is rotated into position and moved over the end of the pneumotach and challenge (e.g. anoxic) gas flow is initiated by a solenoid valve, all under the control of the microcontroller. Micro-controller action is directed by serial input from a micro-computer receiving cardio-respiratory waveform data through an analog to digital converter board. On the micro-computer, a python program detects specific wave form features in real time (lag = 100ms), such as an apnea and bradycardia. Upon apnea detection, the micro-controller is directed to switch to a rescue gas by retraction of the bell housing, rotation, and extension of a different bell housing containing the rescue gas mix. The resumption of normal breathing and heart rate can also be detected and incorporated into the criteria for the automated initiation of the next anoxic exposure trial. Data is stored for later offline automated analysis. The described apparatus offers an inexpensive approach for automated high throughput neonate cardio-respiratory assessment for facile screening to yield important clues in developmental pathophysiology.

Correlation between intraocular pressure obtained with water drinking test versus modified diurnal tension curve measurement in pseudoexfoliation glaucoma.

The aim of this paper was to study the correlation and agreement between the intraocular pressure (IOP) peak value and fluctuations detected with the modified diurnal tension curve (mDTC) and the water drinking test (WDT) in pseudoexfoliation glaucoma (XFG) patients. This prospective observational study enrolled 42 eyes of 42 XFG patients. The IOPs were measured at 2-h intervals from 8 am to 4pm with a Goldmann applanation tonometer by a single observer to establish the mDTC. The WDT was then performed between 4 and 5pm on the same day and the IOP was measured 4 times at 15-min intervals after water ingestion. The IOPpeak, IOPmean, IO min, and IOPfluctuation were measured with both the mDTC and WDT. The paired sample t test, Spearman's correlation coefficient and Bland-Altman plots were used for statistical analysis. The mean age of the 42 patients consisting of 24 females and 18 males was 66.9 ± 6.8years, and the mean central corneal thickness was 517.7 ± 29.1µm. The mean values with the mDTC and WDT measurements were 15.05 ± 2.75mmHg and 17.17 ± 3.25mmHg (p ≤ 0.0001, r = 0.884) for IOPmean, 16.76 ± 3.45mmHg and 18.92 ± 3.94mmHg (p ≤ 0.0001, r=0.787) for IOPpeak, and 13.61 ± 2.56mmHg and 15.11 ± 2.84mmHg (p ≤ 0.0001, r=0.824) for IOPmin, respectively, and a positive correlation was present between these values. There was a positive correlation between the peak, minimum, and mean IOP values determined using the mDTC and WDT in treated XFG patients. WDT can be used as an alternative in the assessment of the IOP in these patients as a more practical method.

Fulfilment of technical and hygienic requirements among street food vendors in Slovenia

PurposeThis cross-sectional study aimed to evaluate the compliance of hygienic and technical standards of street food vendors in Slovenia with the requirements of the general hygienic food principals set in the Codex Alimentarius and Regulation (EC) No. 852/2004 on the hygiene of foodstuffs.Design/methodology/approachFood vendors were observed directly and discretely using a semi-structured observation sheet that allowed fast evaluation. The employee's behaviour was not affected during the observations because they were not aware of being observed. Each observation lasted approximately 30 min. Food vendors were divided into groups according to their location, type of facility, number of employees and type of food sold.FindingsDepending on the type of street vendor, more inconsistencies were found amongst food stands compared to food trucks and kiosks. Most food trucks and kiosks scored very high in both personal and hygienic-technical standards. Some of the major inconsistencies were lack of suitably located washbasins, improper hand-washing technique, improper waste management, working surfaces that were inadequately separated from consumers, and inconsistent maintenance of the cold chain. Food handlers have been confirmed as a critical risk factor.Research limitations/implicationsDespite methodology validation, the data was collected by a single observer, limiting the ability to obtain a more reliable estimate of the observations. The sample was disproportionate according to the type of street food facilities.Practical implicationsThe results provide a basis for (1) national professional guidelines of good hygiene practices for food business operators, which should cover street food vendors more extensively in future updates, and (2) the development of food safety training programmes tailored for street vendors.Originality/valueThe study provides valuable insights into current hygienic-technical conditions of the street food vending sector.

Mobile mecavision: automatic plant monitoring system as a precision agriculture solution in plant factories

Precision agriculture (PA) is an approach in farming systems based on information and technology to enhance agricultural production. PA is applied in plant factories to produce high-quality vegetables in a controlled environment by implementing an automatic crop growth monitoring system. Optimization of the observation process carried out with computer system techniques used in the monitoring process and assessment of the plant condition. Individual observation of cultivated plants requires a monitoring system and numerous equipment. Therefore, a monitoring system equipped with a mobile mechanism is needed to support the monitoring process of crops individually by a single observer. The objective of this study was to design and implement an automatic plant monitoring system based on mobile mechanisms and computer vision using simple equipment in plant factories. The Mobile Mecavision, a monitoring system consists of a mobility system and an image acquisition system controlled by Raspberry Pi. The components are A4988, NEMA 17, and Logitech C270 HD Webcam. The evaluation for system performance carried out using the extreme point shift system and t-test. The aspect of image functionality evaluated using the Structural Similarity Measure test and the result was obtained an image similarity value of 89% to 92% with a 90% level of confidence. The result of the performance test on the mobility aspect obtained that the system shifted numerically but not statistically. The overall performance of the system indicated that the monitoring system could be applied to monitor the crop growth in plant factories.

STRIDE BP REVIEW OF PUBLISHED EVIDENCE ON ACCURATE BLOOD PRESSURE MEASURING DEVICES

Objective: STRIDE BP has systematically reviewed PubMed publications reporting validation data of BP measuring devices using an established protocol. Lists of accurate devices for clinical use are available on the STRIDE BP website (www.stridebp.org) and are circulated to hypertension societies. This report presents the results of the STRIDE BP review. Design and method: The STRIDE BP Advisory Board reviewed 446 validation studies of 287 BP measuring devices reported in 294 PubMed publications up to Nov. 2019. Using an online review system each study is evaluated independently by 2 reviewers experienced in validation studies using a structured checklist which is specific for each protocol and a final internal review is developed. This is reviewed by 2 members of the STRIDE BP Advisory Board and a final decision is taken to approve or reject the study. Results: 220 devices were approved (77%) and 115 (52%) were ‘Preferred’ according to predefined criteria (specific device features depending on its use; recent validation study). The numbers of approved office, home and ambulatory BP monitors for general population, children and pregnancy/preeclampsia are shown in the Table. Of 446 validations 390 (87%) were published as device ‘Pass’ and 56 (13%) ‘Fail’. Of 390 validations published as ‘Pass’, 95 (24%) were rejected in the STRIDE BP review process. The latter studies were rejected because of major protocol violation (single observer 22%, inadequate sample size 13%, BP measurement protocol violation 36%, inappropriate data analysis 31%, validation criteria not reported 32%). Conclusions: Using a standardised review process STRIDE BP provides independent evaluation of the accuracy of BP measuring devices that are available in various countries. The STRIDE BP review process by international experts, which examines validation studies using a structured and detailed process, is more critical than the classic review process of PubMed journals, which often miss important methodological issues in the validation studies. By widely circulating this information, STRIDE BP encourages health care professionals and the public to use only accurate devices for the evaluation of BP.

Comparison Of Periodontal Health Of Orthodontic And Non-Orthodontic Patients

Objective: To compare the periodontal health status among orthodontic and non-orthodontic groups aged between 14-30 years of both genders. Study design And Setting: This comparative cross sectional study was conducted at Department of Orthodontics and Periodontics from January 2019-till June 2019 at dental Hospital of Bahria Dental College Karachi. Methodology: Those patients aged 14-30 under orthodontics treatment for about 3 months and were able to give consent were included in the study. Periodontal status among both groups (65 orthodontics and 65 non orthodontic) patients was evaluated with the help of CPITN probe on index teeth. To assess the oral hygiene status; the questionnaire was formulated regarding the use and frequency of toothbrush; use of interdental cleaners such as interdental brush, use of mouthwash, use of tongue cleaners and dental appointments. A single observer from periodontics department was appointed for observation and record data of patients coming to orthodontic department and to carry out a clinical examination. The data was scrutinized using SPSS 23, and using the chi-square test various other comparisons were performed. Results: Statistically significant association was observed in CPITN scores between the orthodontic and non-orthodontic patients (p &lt; 0.05). Patients who underwent orthodontic treatment had increased plaque accumulation and probing depth which resulted in periodontal tissue destruction. Conclusion: It was concluded that the periodontal condition of ortho patients was deteriorating as compare to non ortho patient. There was no noticeable attachment loss found that could lead to mobility of the tooth and its loss

Sequential measurement-device-independent entanglement detection by multiple observers

Violation of a Bell inequality certifies that the underlying state must be entangled in a device-independent way, although there exist some entangled states which do not violate such an inequality. However, for every entangled state, it is possible to find a Hermitian operator called an entanglement witness that can detect entanglement through some local measurements in a device-dependent method, but implementation of wrong measurements may lead to fake detection of entanglement. To avoid such difficulties, measurement-device-independent entanglement witness (MDI-EW) based on a semiquantum nonlocal game was proposed, which is not only robust against wrong measurements but also against a specific kind of lossy detectors. We employ here a measurement-device-independent entanglement witness to detect entanglement in a scenario where half of an entangled pair is possessed by a single observer while the other half is with multiple observers performing unsharp measurements, sequentially, independently, and preserving entanglement as much as possible. Interestingly, we find that the numbers of successful observers who can detect entanglement, measurement-device-independently, both with equal and unequal sharpness parameters of the noisy measurements, are greater than that obtained with standard and Bell-inequality-based entanglement detection methods, reflecting its robustness. The entanglement contents of the sequentially shared states are also analyzed. Unlike other scenarios, our investigations also reveal that in this measurement-device-independent situation, states having entanglement in proximity to maximal remain entangled until there are two sequential observers, even if they measure sharply.

The reproducibility of measuring maximum abdominal aortic aneurysm diameter from ultrasound images

BackgroundAccurate repeat assessment of the diameter of an abdominal aortic aneurysm (AAA) is important. This study investigated the reproducibility of different methods of measuring AAA diameter from ultrasound images.MethodsFifty AAA patients were assessed by ultrasound. Maximum AAA diameter was measured independently by three trained observers on two separate occasions using a standardised protocol. Five diameters were measured from each scan, three in the anterior–posterior (AP) and two in the transverse (TV) plane, including inner-to-inner (ITI), outer-to-outer (OTO) and leading edge-to-leading edge (LETLE). Intra- and inter-observer reproducibility were reported as reproducibility coefficients. Statistical comparison of methods was performed using linear mixed effects models.ResultsIntra-observer reproducibility coefficients (AP LETLE 2.2 mm; AP ITI 2.4 mm; AP OTO 2.6 mm) were smaller than inter-observer reproducibility coefficients (AP LETLE 4.6 mm: AP ITI 4.5; and AP OTO 4.8 mm). There was no statistically significant difference in intra-observer reproducibility of three types of measurements performed in the AP plane. Measurements obtained in the TV plane had statistically significant worse intra-observer reproducibility than those performed in the AP plane.ConclusionsThis study suggests that the comparison of maximum AAA diameter between repeat images is most reproducibly performed by a single trained observer measuring diameters in the AP plane.