Detection of Myofascial Trigger Points With Ultrasound Imaging and Machine Learning

Myofascial Pain Syndrome (MPS) is a common chronic muscle pain disorder that affects a large portion of the global population, seen in 85-93% of patients in specialty pain clinics [10]. MPS is characterized by hard, palpable nodules caused by a stiffened taut band of muscle fibers. These nodules are referred to as Myofascial Trigger Points (MTrPs) and can be classified by two states: active MTrPs (A-MTrPs) and latent MtrPs (L-MTrPs). Treatment for MPS involves massage therapy, acupuncture, and injections or painkillers. Given the subjectivity of patient pain quantification, MPS can often lead to mistreatment or drug misuse. A deterministic way to quantify the pain is needed for better diagnosis and treatment. Various medical imaging technologies have been used to try to find quantifiable and measurable biomarkers of MTrPs. Ultrasound imaging, with it’s accessibility and variety of modalities, has shown significant findings in identifying MTrPs. Elastography ultrasound, which is used for measuring stiffness in soft tissues, has shown that MTrPs tend to be stiffer than normal muscle tissue. Doppler ultrasound has shown that bloodflow velocities differ significantly in areas surrounding MTrPs. MTrPs have been identified in standard B-mode grayscale ultrasound, but have varying conclusions with some studies identifying them as dark hypoechoic blobs and other studies showing them as bright hyperechoic blobs. Despite these discoveries, there is a high variance among results with no correlations to severity or pain. As a step towards quantifying the pain associated with MTrPs, this work aims to introduce a machine learning approach using image processing with texture recognition to detect MTrPs in Bmode ultrasound. A texture recognition algorithm called Gray Level Co-Occurrence Matrix (GLCM) is used to extract texture features from the B-mode ultrasound image. Feature maps are generated to emphasize these texture features in an image format in anticipation that a deep convolutional neural network will be able to correlate the features with the presence of a MTrP. The GLCM feature maps are compared to the elastography ultrasound to determine any correlations with muscle stiffness and then evaluated in the presence of MTrPs. The feature map generation is accelerated with a GPU-based implementation for the goal of real-time processing and inference of the machine learning model. Finally, two deep learning models are implemented to detect MTrPs comparing the effect of using GLCM feature maps of B-mode ultrasound to emphasize texture features for machine learning model inputs

Pronounced structural and functional damage in early adult pediatric-onset multiple sclerosis with no or minimal clinical disability

Pediatric-onset multiple sclerosis (POMS) may represent a model of vulnerability to damage occurring during a period of active maturation of the human brain. Whereas adaptive mechanisms seem to take place in the POMS brain in the short-medium term, natural history studies have shown that these patients reach irreversible disability, despite slower progression, at a significantly younger age than adult-onset MS (AOMS) patients. We tested for the first time whether significant brain alterations already occurred in POMS patients in their early adulthood and with no or minimal disability (n = 15) in comparison with age- and disability-matched AOMS patients (n = 14) and to normal controls (NC, n = 20). We used a multimodal MRI approach by modeling, using FSL, voxelwise measures of microstructural integrity of white matter tracts and gray matter volumes with those of intra- and internetwork functional connectivity (FC) (analysis of variance, p â\u89¤ 0.01, corrected for multiple comparisons across space). POMS patients showed, when compared with both NC and AOMS patients, altered measures of diffusion tensor imaging (reduced fractional anisotropy and/or increased diffusivities) and higher probability of lesion occurrence in a clinically eloquent region for physical disability such as the posterior corona radiata. In addition, POMS patients showed, compared with the other two groups, reduced long-range FC, assessed from resting functional MRI, between default mode network and secondary visual network, whose interaction subserves important cognitive functions such as spatial attention and visual learning. Overall, this pattern of structural damage and brain connectivity disruption in early adult POMS patients with no or minimal clinical disability might explain their unfavorable clinical outcome in the long term

Roadmap on multimode photonics

Multimode devices and components have attracted considerable attention in the last years, and different research topics and themes have emerged very recently. The multimodality can be seen as an additional degree of freedom in designing devices, thus allowing for the development of more complex and sophisticated components. The propagation of different modes can be used to increase the fiber optic capacity, but also to introduce novel intermodal interactions, as well as allowing for complex manipulation of optical modes for a variety of applications. In this roadmap we would like to give to the readers a comprehensive overview of the most recent developments in the field, presenting contributions coming from different research topics, including optical fiber technologies, integrated optics, basic physics and telecommunications

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction

There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report.This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Before opening up for comments on the webpages of ICS and IUGA, five experts from physiotherapy, neurology, urology, urogynecology, and nursing were invited to comment on the paper.A Terminology Report on the conservative management of female pelvic floor dysfunction, encompassing over 200 separate definitions, has been developed. It is clinically based, with the most common symptoms, signs, assessments, diagnoses, and treatments defined. Clarity and ease of use have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Ongoing review is not only anticipated, but will be required to keep the document updated and as widely acceptable as possible.A consensus-based terminology report for the conservative management of female pelvic floor dysfunction has been produced, aimed at being a significant aid to clinical practice and a stimulus for research

Novel Specialty Optical Fibers and Applications

Novel Specialty Optical Fibers and Applications focuses on the latest developments in specialty fiber technology and its applications. The aim of this reprint is to provide an overview of specialty optical fibers in terms of their technological developments and applications. Contributions include:1. Specialty fibers composed of special materials for new functionalities and applications in new spectral windows.2. Hollow-core fiber-based applications.3. Functionalized fibers.4. Structurally engineered fibers.5. Specialty fibers for distributed fiber sensors.6. Specialty fibers for communications

The Boston University Photonics Center annual report 2010-2011

This repository item contains an annual report that summarizes activities of the Boston University Photonics Center in the 2010-2011 academic year. The report provides quantitative and descriptive information regarding photonics programs in education, interdisciplinary research, business innovation, and technology development. The Boston University Photonics Center (BUPC) is an interdisciplinary hub for education, research, scholarship, innovation, and technology development associated with practical uses of light.This report summarizes activities of the Boston University Photonics Center (BUPC) during the period July 2010 through June 2011. These activities span the Center’s complementary missions in education, research, technology development, and commercialization. In education, 21BUPC graduate students received Ph.D. diplomas. BUPC faculty taught 20 photonics courses. One graduate student was funded through the Photonics Center Dean’s Fellowship Program. BUPC supported the Research Experiences for Teachers (RET) in Biophotonic Sensors and Systems. In addition to working in the laboratories and heading to Northeastern University for shared seminars, the eight teachers split into two groups to participate in cleanroom activities. The University hosted its annual Science and Engineering Day, where the Photonics Center sponsored the Herbert J. Berman "Future of Light" Prize. Professor Goldberg’s Boston Urban Fellows Project started its sixth year. For more on our education programs, turn to the Education section on page 62. In research, BUPC faculty published journal papers spanning the field of photonics. Eleven patents were awarded to faculty this year for new innovations in the field. A number of awards for outstanding achievement in education and research were presented to BUPC faculty members. These honors include the NSF CAREER Award for Professors Altug, the 2010 R&sD 100 Award for Professor Bifano, and the Dean’s Catalyst Award for Professor Joshi. New external grant funding for the 2010-2010 fiscal year totaled $20.9M. For more information on our research activities, turn to the Research section on page 24. In technology development, this year was the beginning of a transitional period at the Photonics Center as ARL pipeline programs were completed and new research projects were proposed as part of the newly funded National Science Foundation (NSF) Industrial University Cooperative Research Center (I/UCRC) on Biophotonic Sensors and Systems. As researchers finished programs for ARL development, many successfully presented programs at the first annual I/UCRC meeting in April 2011. In the I/UCRC model, industry members of the Center provide the market vision and orient research to solve urgent market needs – in an extension of the successful ARL pipeline model in which the Department of Defense’s urgent needs motivated our research goals. For more information on our technology development pipeline and projects, turn to the Technology Development section on page 49. In commercialization, the business incubator continues to operate at capacity. Its tenants include ten technology companies with a majority having core business interests primarily in photonics and life sciences. It houses several companies founded by current and former BU faculty and students and provides students with an opportunity to assist, observe, and learn from start-up companies. For more information about business incubator activities, turn to the Business Incubation chapter in the Facilities and Equipment section on page 74. In early 2010, the BUPC unveiled a five-year strategic plan as part of the University’s comprehensive review of centers and institutes. The BUPC strategic plan will enhance the Center’s position as an international leader in photonics research. For more information about the strategic plan, turn to the BUPC Strategic Plan section on page 11

Multimode optical fiber specklegram smart bed sensor array

Significance: Monitoring the movement and vital signs of patients in hospitals and other healthcare environments is a significant burden on healthcare staff. Early warning systems using smart bed sensors hold promise to relieve this burden and improve patient outcomes.We propose a scalable and cost-effective optical fiber sensor array that can be embedded into a mattress to detect movement, both sensitively and spatially. Aim: Proof-of-concept demonstration that a multimode optical fiber (MMF) specklegram sensor array can be used to detect and image movement on a bed. Approach: Seven MMFs are attached to the upper surface of a mattress such that they cross in a 3 × 4 array. The specklegram output is monitored using a single laser and single camera and movement on the fibers is monitored by calculating a rolling zero-normalized cross-correlation. A 3 × 4 image is formed by comparing the signal at each crossing point between two fibers. Results: The MMF sensor array can detect and image movement on a bed, including getting on and off the bed, rolling on the bed, and breathing. Conclusions: The sensor array shows a high sensitivity to movement, which can be used for monitoring physiological parameters and patient movement for potential applications in healthcare settings.Stephen C. Warren-Smith, Adam D. Kilpatrick, Kabish Wisal, and Linh V. Nguye

University/Industry Cooperative Teaching Laboratory for Undergraduate Education

Abstract An undergraduate optics laboratory sponsored by the National Science Foundation of the United States was established to foster a link between local industry and academia. A series of innovative experiments was developed utilizing highspeed data acquisition equipment and signal processing software to demonstrate the fundamentals of diffraction, fiber optics, and physical optics principles. The experiments were performed in two complementary settings. The university experiments concentrated on basic optical principles and experimental techniques. A parallel industrial component was provided by local industry. Students were invited to industrial research laboratories to work on real-life optical problems of current interest. The students were able to see the relevance between fundamental optical principles and real industrial problems, use state-of-the-art equipment, and experience working in an industrial laboratory. Feedback was also solicited from industry management regarding improvements to academic training of students for the work force