Bruise chromophore concentrations over time

Presented at the IEEE - SPIE Medical Imaging. 2008. San Diego, California USA.During investigations of potential child and elder abuse, clinicians and forensic practitioners are often asked to offer opinions about the age of a bruise. A commonality between existing methods of bruise aging is analysis of bruise color or estimation of chromophore concentration. Relative chromophore concentration is an underlying factor that determines bruise color. We investigate a method of chromophore concentration estimation that can be employed in a handheld imaging spectrometer with a small number of wavelengths. The method, based on absorbance properties defined by Beer-Lambert's law, allows estimation of differential chromophore concentration between bruised and normal skin. Absorption coefficient data for each chromophore are required to make the estimation. Two different sources of this data are used in the analysis- generated using Independent Component Analysis and taken from published values. Differential concentration values over time, generated using both sources, show correlation to published models of bruise color change over time and total chromophore concentration over time

Automatización de la Datación de Equimosis en el Peritaje Médico Legal Peruano mediante Redes Neuronales Artificiales y Procesamiento de Imágenes

Las equimosis poseen un extraordinario interés médico – legal, ya que proporcionan los más valiosos indicios para la reconstrucción de la violencia en los que se produjeron. Tradicionalmente, los médicos de acuerdo a su experiencia utilizan la evaluación visual para determinar la edad de la equimosis, pero esta técnica ha sido sustancialmente subjetiva y ha demostrado ser inexacta y poco fiable. El propósito de este estudio es desarrollar un sistema inteligente que incorpore el procesamiento de imágenes utilizando la técnica RGB de la metodología de colorimetría con el objetivo de obtener el píxel promedio de la zona indurada de la equimosis y una red Perceptrón Multicapa que tiene como variables de entrada el color promedio de la zona indurada obtenido por el procesamiento de imágenes, el color de piel, edad y sexo del lesionado, la presencia de tejido laxo, tejido óseo y tejido vascular, así como también la temperatura ambiental; las cuales han sido cuidadosamente seleccionadas con la finalidad de obtener una mayor precisión en la datación de equimosis. El procesamiento de imágenes se implementó en el lenguaje de programación Java, el cual tiene por finalidad obtener el promedio de los pixeles RGB más influyentes de la zona indurada de la equimosis. Así mismo, la fase de aprendizaje y validación de la red Perceptrón Multicapa se realizó con la herramienta matemática MATLAB, utilizando el algoritmo backpropagation que brindó una taza de error de 1.26% y 1.37% respectivamente. En consecuencia, el sistema inteligente propuesto en esta tesis genera una mayor precisión en la datación de equimosis en comparación al 80% de inexactitud de los diagnósticos de los médicos legales. Palabras clave: datación de equimosis, procesamiento de imágenes, backpropagation.The ecchymosis has a special medical - legal interest, as these provide the most valuable clues for the reconstruction of violence in which they occurred. Traditionally, doctors according to their experience using visual assessment to determine the age of ecchymosis, but this technique has been substantially subjective and has proven to be inaccurate and unreliable. The purpose of this thesis is to develop an intelligent system that incorporates image processing technique using the RGB colorimetric methodology in order to obtain the average pixel of indurated area of ecchymosis and a multilayer perceptron network whose input variables the average color of the indurated area obtained by images processing, color, age and sex of the injured, the presence of loose tissue, bone tissue and vascular tissue, as well as the ambient temperature, which have been carefully selected in order to obtain a more accurate dating of ecchymosis. The image processing is implemented in the Java programming language, which aims to obtain the average of the RGB pixels most influential of indurated area of ecchymosis. Also, the learning and validation phase of the multilayer perceptron network was performed with the mathematical tool MATLAB, using the backpropagation algorithm which provided an error rate of 1.26% and 1.37%, respectively. In consequence, the intelligent system proposed in this thesis generates a more precise dating ecchymosis compared to 80% of incorrect medical diagnoses. Keywords: Dating of ecchymosis, Image processing, Backpropagation.Tesi

Minimally invasive clinical monitoring and data transference in cardiac patients

'Wet' electrodes used in electrocardiography (ECG), are applied to the surface of the skin to record cardiac activity. Over time, water-based electrolytic gels between the electrodes and skin dehydrate, reducing signal quality. Microneedle-electrodes negate the need for conductive gels and potentially improve signal fidelity by circumventing the stratum corneum and contacting the underlying conductive epidermal layers. This thesis aimed to assess the wearability and functionality of microneedle-electrodes in cardiac signal acquisition. Epoxy, 500μm-length microneedles were applied to excised skin models to assess insertion performance. Increasing downward application force increased microneedle penetration efficiency from 79%±8.20 (5N) to 87%±13.32 (15N). The microneedle application technique also had an impact on penetration efficiency, with impact insertion (93%±5.75) proving more effective than manual downward force (71%±22.01). Metallised versions of the epoxy microneedles were integrated into a commercial electrode and compared to conventional wet electrodes in human volunteers. Wet electrodes recorded higher quality signals than microneedle-electrodes in healthy human participants (1.6dB difference between the electrode types). This clinical data informed the development of an in vitro laboratory skin model to assess the influence of microneedle-electrode parameters on a simulated ECG signal. Increasing microneedle length from 500μm (25.2dB±3.25) to 600μm (24.3dB±2.31) did not result in a sustained improvement in signal quality (p>0.05). Bespoke second-generation microneedle-electrodes were manufactured allowing an improved signal quality to be maintained over the recording period (17.3dB±2.11 compared to 15.0dB±1.97 for wet electrodes; p>0.05) in the laboratory model. Human participant studies assessed their wearability and functionality. At rest, the metallised epoxy (23.2dB±5.79) and bespoke (22.5dB±7.57) microneedle-electrode performance was comparable to wet electrodes (24.9dB±6.44) (p>0.05). Under active conditions, the signal-to-noise ratio declined for all electrodes and ECG traces highlighted increased motion artifacts. Participants preferred wet electrodes and highlighted seven key wearability themes. Further optimisation of microneedle-electrodes for ECG monitoring is therefore, warranted

A Corpus-driven Approach toward Teaching Vocabulary and Reading to English Language Learners in U.S.-based K-12 Context through a Mobile App

In order to decrease teachers’ decisions of which vocabulary the focus of the instruction should be upon, a recent line of research argues that pedagogically-prepared word lists may offer the most efficient order of learning vocabulary with an optimized context for instruction in each of four K-12 content areas (math, science, social studies, and language arts) through providing English Language Learners (ELLs) with the most frequent words in each area. Educators and school experts have acknowledged the need for developing new materials, including computerized enhanced texts and effective strategies aimed at improving ELLs’ mastery of academic and STEM-related lexicon. Not all words in a language are equal in their role in comprehending the language and expressing ideas or thoughts. For this study, I used a corpus-driven approach which is operationalized by applying a text analysis method. For the purpose of this research study, I made two corpora, Teacher’s U.S. Corpus (TUSC) and Science and Math Academic Corpus for Kids (SMACK) with a focus on word lemma rather than inflectional and derivational variants of word families. To create the corpora, I collected and analyzed a total of 122 textbooks used commonly in the states of Florida and California. Recruiting, scanning and converting of textbooks had been carried out over a period of more than two years from October 2014 to March 2017. In total, this school corpus contains 10,519,639 running words and 16,344 lemmas saved in 16,315 word document pages. From the corpora, I developed six word lists, namely three frequency-based word lists (high-, mid-, and low-frequency), academic and STEM-related word lists, and essential word list (EWL). I then applied the word lists as the database and developed a mobile app, Vocabulary in Reading Study – VIRS, (available on App Store, Android and Google Play) alongside a website (www.myvirs.com). Also, I developed a new K-12 dictionary which targets the vocabulary needs of ELLs in K-12 context. This is a frequency-based dictionary which categorizes words into three groups of high, medium and low frequency words as well as two separate sections for academic and STEM words. The dictionary has 16,500 lemmas with derivational and inflectional forms

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement

A Systematic Review and Meta-Analysis of the Incidence of Injury in Professional Female Soccer

The epidemiology of injury in male professional football is well documented and has been used as a basis to monitor injury trends and implement injury prevention strategies. There are no systematic reviews that have investigated injury incidence in women’s professional football. Therefore, the extent of injury burden in women’s professional football remains unknown. PURPOSE: The primary aim of this study was to calculate an overall incidence rate of injury in senior female professional soccer. The secondary aims were to provide an incidence rate for training and match play. METHODS: PubMed, Discover, EBSCO, Embase and ScienceDirect electronic databases were searched from inception to September 2018. Two reviewers independently assessed study quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement using a 22-item STROBE checklist. Seven prospective studies (n=1137 professional players) were combined in a pooled analysis of injury incidence using a mixed effects model. Heterogeneity was evaluated using the Cochrane Q statistic and I2. RESULTS: The epidemiological incidence proportion over one season was 0.62 (95% CI 0.59 - 0.64). Mean total incidence of injury was 3.15 (95% CI 1.54 - 4.75) injuries per 1000 hours. The mean incidence of injury during match play was 10.72 (95% CI 9.11 - 12.33) and during training was 2.21 (95% CI 0.96 - 3.45). Data analysis found a significant level of heterogeneity (total Incidence, X2 = 16.57 P < 0.05; I2 = 63.8%) and during subsequent sub group analyses in those studies reviewed (match incidence, X2 = 76.4 (d.f. = 7), P <0.05; I2 = 90.8%, training incidence, X2 = 16.97 (d.f. = 7), P < 0.05; I2 = 58.8%). Appraisal of the study methodologies revealed inconsistency in the use of injury terminology, data collection procedures and calculation of exposure by researchers. Such inconsistencies likely contribute to the large variance in the incidence and prevalence of injury reported. CONCLUSIONS: The estimated risk of sustaining at least one injury over one football season is 62%. Continued reporting of heterogeneous results in population samples limits meaningful comparison of studies. Standardising the criteria used to attribute injury and activity coupled with more accurate methods of calculating exposure will overcome such limitations