Automated Performance Assessment in Transoesophageal Echocardiography with Convolutional Neural Networks

Transoesophageal echocardiography (TEE) is a valuable diagnostic and monitoring imaging modality. Proper image acquisition is essential for diagnosis, yet current assessment techniques are solely based on manual expert review. This paper presents a supervised deep learning framework for automatically evaluating and grading the quality of TEE images. To obtain the necessary dataset, 38 participants of varied experience performed TEE exams with a high-fidelity virtual reality (VR) platform. Two Convolutional Neural Network (CNN) architectures, AlexNet and VGG, structured to perform regression, were finetuned and validated on manually graded images from three evaluators. Two different scoring strategies, a criteria-based percentage and an overall general impression, were used. The developed CNN models estimate the average score with a root mean square accuracy ranging between 84% − 93%, indicating the ability to replicate expert valuation. Proposed strategies for automated TEE assessment can have a significant impact on the training process of new TEE operators, providing direct feedback and facilitating the development of the necessary dexterous skills

BLOOD-FEEDING IN OVERWINTERING <i>CULEX TARSALIS</i> (DIPTERA: CULICIDAE) FROM MANITOBA

Diapause development in Culex tarsalis Coquillett has been characterized by reduced blood-feeding to complete termination of ovariole development at or before stage IIa (Bennington et al. 1958; Schaefer and Washino 1970; Schaefer et al. 1971; Bellamy and Corbet 1973; Mitchell 1979). The role that diapausing Culex species have in overwintering arboviruses has been examined (Eldridge 1966, 1968; Eldridge et al. 1972; Reeves 1974; Eldridge and Bailey 1979; Mitchell 1979). Gonotrophic dissociation and its implications for survival of the vector and virus has been reviewed by Washino (1977). Eldridge (1966) indicated gonotrophic dissociation was possible in Culex pipiens L. incubated at low temperature and short daylength and later reported failure of ovarioles of prehibernating C. pipiens to mature following a blood meal (Eldridge and Bailey 1979). Eldridge et al. (1972) reported that Culex restuans Theobald exhibited gonotrophic dissociation in response to conditioning by short daylength and low temperature. Mitchell (1981) has reported blood-feeding and gonotrophic dissociation in a significant portion of diapausing Culex tarsalis from Colorado, when females were kept at 15°C and at short daylength conditions.</jats:p

P048: Profiling the burdens of working nights. Traditional 8-hour nights vs staggered 6-hour casino shifts in an academic emergency department

Introduction: Emergency physicians (EP) often work at undesirable hours. In response to deleterious effects on quality of life for EPs, traditional 2300-0700 night shifts have been replaced at some centres with staggered 6-hour casino shifts (22:00-04:00 and 04:00-10:00). Though purported to allow for better sleep and recovery patterns, no evidence exists to support the benefits on sleep or quality of life that is used to justify a casino shift model. Using a before and after survey model, this study examines the impact of overhauling night work from a traditional 8-hour shift to casino shifts on the quality of life and job satisfaction of EPs working in an academic emergency department (ED). Methods: In 2010, an initial online, 37-item survey, was sent to all EPs working in the ED, just prior to the transition to casino shifts. 6 years following the transition, a slightly modified 37-item survey was again distributed to all current EPs working at that same centre. Participants rated their level of agreement on a 7-point Likert scale regarding questions related to night work. Results from the two surveys were compared. Results: 43 2010- and 47 2016-surveys were completed. In 2016, recovery to baseline function after a single early shift (22:00-04:00) was most common after 1 day at 52.4%, and after multiple early shifts was ≥2 days at 66.7%. Recovery after a single late shift (04:00-10:00) was most common at 1 day at 54.8%, and after multiple late shifts was ≥2 days at 59.5%. This was in contrast to 2010, when 55.8% recovered from a single traditional night shift after 1 day, and 95.3% required ≥2 days to recover from multiple traditional night shifts. In relation to casino shifts, 40.5% of respondents stated that night shifts are the greatest drawback of their job, compared to 79.1% previously. A minority of respondents felt that teaching (36.5%), diagnostic test interpretation (23.2%), and quality of handover (33.5%) were inferior on early and late night shifts compared to other shifts (74.4%, 58.1%, and 60.5% for traditional night shifts respectively).95.0% of respondents preferred casino over traditional night shifts. Conclusion: There were self-reported improvements in all domains following the implementation of casino shifts.</jats:p