The importance of a device specific calibration for smartphone colorimetry

In order for a smartphone-based colorimetry system to be generalizable, it must be possible to account for results from multiple phones. A move from device-specific space to a device independent space such as XYZ space allows results to be compared, and means that the link between XYZ values and the physical parameter of interest needs only be determined once. We compare mapping approaches based on calibration data provided in image metadata, including the widely used open-source software dcraw, to a separate calibration carried out using a colorcard. The current version of dcraw is found to behave suboptimally with smartphones and should be used with care for mapping to XYZ. Other metadata approaches perform better, however the colorcard approach provides the best results. Several phones of the same model are compared and using an xy distance metric it is found that a device-specific calibration is required to maintain the desired precision

Minimising ambient illumination via ambient subtraction: Smartphone assessment of jaundice in liver patients via sclera images

Using smartphone images to quantify color presents a noninvasive way to assess jaundice and other color-related biomarkers of the human body. Here we focus on assessing jaundice through accurate bilirubin measurement in adult liver patients, the first time optical imaging has been applied to this cohort. These patients can suffer from very high levels of bilirubin, indicating their severity of liver disease. A smartphone assessment technique for jaundice based around the color of the sclera (white of the eye) extracted from images is being developed, as smartphone imaging enables cheap, non-invasive and quantitative readings. Variations in ambient light cause large changes to recorded pixel values so must be accounted for to ensure that any changes detected are due to changes in jaundice level. Here we suggest the use of an ambient subtraction approach to minimise the effects of ambient light. Pairs of flash/no-flash images are captured and the extracted values subtracted to yield data as though under a pure flash illumination. We present data demonstrating the technique with a group of healthy adult volunteers. We also present data from a patient study involving adults with liver disease. Images were captured and the bilirubin (jaundice) level predicted from these images before and after subtraction was compared to the ground truth value obtained via blood test. The linear correlation coefficient increased from 0.47 to 0.85 (p<0.001 in both cases) upon application of subtraction, demonstrating the effectiveness of the technique

Smartphone screening for neonatal jaundice via ambient-subtracted sclera chromaticity

Jaundice is a major cause of mortality and morbidity in the newborn. Globally, early identification and home monitoring are significant challenges in reducing the incidence of jaundice-related neurological damage. Smartphone cameras are promising as colour-based screening tools as they are low-cost, objective and ubiquitous. We propose a novel smartphone method to screen for neonatal jaundice by imaging the sclera. It does not rely on colour calibration cards or accessories, which may facilitate its adoption at scale and in less economically developed regions. Our approach is to explicitly address three confounding factors in relating colour to jaundice: (1) skin pigmentation, (2) ambient light, and (3) camera spectral response. (1) The variation in skin pigmentation is avoided by imaging the sclera. (2) With the smartphone screen acting as an illuminating flash, a flash/ no-flash image pair is captured using the front-facing camera. The contribution of ambient light is subtracted. (3) In principle, this permits a device- and ambient-independent measure of sclera chromaticity following a one-time calibration. We introduce the concept of Scleral-Conjunctival Bilirubin (SCB), in analogy with Transcutaneous Bilirubin (TcB). The scleral chromaticity is mapped to an SCB value. A pilot study was conducted in the UCL Hospital Neonatal Care Unit (n = 37). Neonates were imaged using a specially developed app concurrently with having a blood test for total serum bilirubin (TSB). The better of two models for SCB based on ambient-subtracted sclera chromaticity achieved r = 0.75 (p250μmol/L (area under receiver operating characteristic curve, AUROC, 0.86), and 92% (specificity 67%) in identifying newborns with TSB>205μmol/L (AUROC 0.85). These results are comparable to modern transcutaneous bilirubinometers

Screening neonatal jaundice based on the sclera color of the eye using digital photography

A new screening technique for neonatal jaundice is proposed exploiting the yellow discoloration in the sclera. It involves taking digital photographs of newborn infants' eyes (n = 110) and processing the pixel colour values of the sclera to predict the total serum bilirubin (TSB) levels. This technique has linear and rank correlation coefficients of 0.75 and 0.72 (both p<0.01) with the measured TSB. The mean difference ( ± SD) is 0.00 ± 41.60 µmol/l. The receiver operating characteristic curve shows that this technique can identify subjects with TSB above 205 µmol/l with sensitivity of 1.00 and specificity of 0.50, showing its potential as a screening device

The impact of aging on ciliary function and ultrastructive in human respiratory epithelium

Session - Respiratory & Critical Care Medicine: no. G-RC-8published_or_final_versio

The effects of aging on respiratory ciliary function

published_or_final_versio

Smartphone colorimetry using ambient subtraction: Application to neonatal jaundice screening in Ghana

A smartphone app to screen for neonatal jaundice has a large potential impact in reducing neonatal death and disability. Our app, neoSCB, uses a colour measurement of the sclera to make a screening decision. Although there are numerous benefits of a smartphone-based approach, smartphone colour measurement that is accurate and repeatable is a challenge. Using data from a clinical setting in Ghana, we compare sclera colour measurement using an ambient subtraction method to sclera colour measurement using a standard colour card method, and find they are comparable provided the subtracted signal-to-noise ratio (SSNR) is sufficient. Calculating a screening decision metric via the colour card method gave 100% sensitivity and 69% specificity (n=87), while applying the ambient subtraction method gave 100% sensitivity and 78% specificity (SSNR>3.5; n=50)

Jaundice Eye Color Index (JECI): quantifying the yellowness of the sclera in jaundiced neonates with digital photography

The sclera is arguably a better site than the skin to measure jaundice&#x2013;especially in dark-skinned patients&#x2013;since it is free of skin pigment (melanin), a major confounding factor. This work aims to show how the yellowness of the sclera can be quantified by digital photography in color spaces including the native RGB and CIE XYZ. We also introduce a new color metric we call &#x201C;Jaundice Eye Color Index&#x201D; (JECI) which allows the yellowness of jaundiced sclerae to be predicted for a specific total serum bilirubin level in the neonatal population

The impact of aging on ciliary function and ultrastructive in human respiratory epithelium

Session - Respiratory & Critical Care Medicine: no. G-RC-8published_or_final_versio