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Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule MD 2014 Thomas Jefferson University

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule Md

Department of Emergency Medicine Faculty Papers

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a ...


Subperiosteal Hematoma Of Orbit An Interesting Case Report And Review Of Literature, Balasubramanian Thiagarajan 2014 SelectedWorks

Subperiosteal Hematoma Of Orbit An Interesting Case Report And Review Of Literature, Balasubramanian Thiagarajan

Balasubramanian Thiagarajan

Subperiosteal Hematoma orbit is an uncommon disorder which may occur following injury to orbit. Of course there are other causes that cause this condition as well. This condition has been reported in young adults. This case report discusses a patient who developed subperiosteal hematoma following trivial injury to orbit. Since this condition had occurred following trivial injury to orbit diagnosis was not made pre operatively. It was discovered only on the table. A high index of suspicion and an accurate history is necessary to identify this condition. This case is being reported not only for its rarity but also to ...


Integrated Approach For Accurate Localization Of Optic Disc And Macula, Vaanathi Sundaresan, Keerthi Ram, Niranjan Joshi, Mohanasankar Sivaprakasam, Rashmin Gandhi 2014 University of Iowa

Integrated Approach For Accurate Localization Of Optic Disc And Macula, Vaanathi Sundaresan, Keerthi Ram, Niranjan Joshi, Mohanasankar Sivaprakasam, Rashmin Gandhi

Ophthalmic Medical Image Analysis

The location of three main anatomical structures in the retina namely the optic disc, the vascular arch, and the macula is significant for the analysis of retinal images. Presented here is a novel method that uses an integrated approach to automatically localize the optic disc and the macula with very high accuracy even in the presence of confounders such as lens artifacts, glare, bright pathologies and acquisition variations such as non-uniform illumination, blur and poor contrast. Evaluated on a collective set of 579 diverse pathological images from various publicly available datasets, our method achieves sensitivity > 99% and normalized localization error < 5% for optic disc and macula localization.


Computer-Aided Diagnosis System For The Assessment Of Retinal Vascular Changes, Behdad Dashtbozorg, Ana Maria Mendonca, Susana Penas, Aurelio Campilho 2014 University of Iowa

Computer-Aided Diagnosis System For The Assessment Of Retinal Vascular Changes, Behdad Dashtbozorg, Ana Maria Mendonca, Susana Penas, Aurelio Campilho

Ophthalmic Medical Image Analysis

This paper presents an automatic application that provides several retinal image analysis functionalities, namely vessel segmentation, vessel width estimation, artery/vein classification and optic disc segmentation. A pipeline of these methods allows the computation of important vessel related indexes, namely the Central Retinal Arteriolar Equivalent (CRAE), Central Retinal Venular Equivalent (CRVE) and Arteriolar-to-Venular Ratio (AVR), as well as various geometrical features associated with vessel bifurcations. The results for AVR estimation were assessed using the images of INSPIRE-AVR dataset; for this dataset, the mean error of the measured AVR values with respect to the reference was identical to the one achieved ...


Computer-Aided Diagnosis System For The Assessment Of Retinal Vascular Changes, Behdad Dashtbozorg, Ana Maria Mendonca, Susana Penas, Aurelio Campilho 2014 University of Iowa

Computer-Aided Diagnosis System For The Assessment Of Retinal Vascular Changes, Behdad Dashtbozorg, Ana Maria Mendonca, Susana Penas, Aurelio Campilho

Ophthalmic Medical Image Analysis

This paper presents an automatic application that provides several retinal image analysis functionalities, namely vessel segmentation, vessel width estimation, artery/vein classification and optic disc segmentation. A pipeline of these methods allows the computation of important vessel related indexes, namely the Central Retinal Arteriolar Equivalent (CRAE), Central Retinal Venular Equivalent (CRVE) and Arteriolar-to-Venular Ratio (AVR), as well as various geometrical features associated with vessel bifurcations. The results for AVR estimation were assessed using the images of INSPIRE-AVR dataset; for this dataset, the mean error of the measured AVR values with respect to the reference was identical to the one achieved ...


Achiko-D350: A Dataset For Early Amd Detection And Drusen Segmentation, Huiying Liu, Yanwu Xu, Damon W.K. Wong, Augustinus Laude, Tock Ham Lim, Jiang Liu 2014 University of Iowa

Achiko-D350: A Dataset For Early Amd Detection And Drusen Segmentation, Huiying Liu, Yanwu Xu, Damon W.K. Wong, Augustinus Laude, Tock Ham Lim, Jiang Liu

Ophthalmic Medical Image Analysis

Age related macular degeneration is the third leading cause of global blindness. Its prevalence is increasing in these years for the coming of ”aging population”. Early detection and grading can prevent it from becoming severe and protect vision. Drusen is an important indicator for AMD. Thus automatic drusen detection and segmentation has attracted much research attention in the past years. However, a barrier handicapping the research of drusen segmentation is the lack of a public dataset and test platform. To address this issue, in this paper, we publish a dataset, named ACHIKO-D350, with manually marked drusen boundary. ACHIKO-D350 includes 254 ...


Quantification Of The Retinal Vascular Network Structure: Towards Effective Monitoring Of Vessel Architecture Modulation In Diabetic Retinopathy, Delia Cabrera Debuc, William E. Smidy 2014 University of Iowa

Quantification Of The Retinal Vascular Network Structure: Towards Effective Monitoring Of Vessel Architecture Modulation In Diabetic Retinopathy, Delia Cabrera Debuc, William E. Smidy

Ophthalmic Medical Image Analysis

Diabetic retinopathy is the most common diabetic eye disease leading to vision loss. Disturbances have been detected in many aspects of ocular circulation in diabetes. However, hemodynamic and vessel architectural modulation have not been extensively investigated in DR. Therefore, an objective test for the early diagnosis, progression and therapeutic evaluation of DR based on vascular remodeling may aid to identify the individuals at great risk for vision threatening problems. In this paper, we present a methodology to characterize the microvascular network structure in diabetic individuals. Our preliminary results may pave the path towards effective monitoring of vessel architecture modulation in ...


Achiko-M Database For High Myopia Analysis And Its Evaluation, Fengshou Yin, Ruoying Li, Zhuo Zhang, Jun Cheng, Yanwu Xu, Damon Wee Kee Wong, Ngan Meng Tan, Ying Quan, Ai Ping Yow, Gopalakrishnan Kavitha, Guozhen Xu, Jiang Liu 2014 University of Iowa

Achiko-M Database For High Myopia Analysis And Its Evaluation, Fengshou Yin, Ruoying Li, Zhuo Zhang, Jun Cheng, Yanwu Xu, Damon Wee Kee Wong, Ngan Meng Tan, Ying Quan, Ai Ping Yow, Gopalakrishnan Kavitha, Guozhen Xu, Jiang Liu

Ophthalmic Medical Image Analysis

Myopia is the leading public health concern with high prevalence in developed countries. In this paper, we present the ACHIKO-M fundus image database with both myopic and emmetropic cases for high myopia study. The database contains 705 myopic subjects and 151 normal subjects with both left eye and right eye images for each subject. In addition, various clinical data is also available, allowing correlation study of different risk factors. We evaluated two state-of-the-art automated myopia detection algorithms on this database to show how it can be used. Both methods achieve more than 90% accuracy for myopia diagnosis. We will also ...


Tortuosity Classification Of Corneal Nerves Images Using A Multiple-Scale-Multiple-Window Approach, Roberto Annunziata, Ahmad Kheirkhah, Shruti Aggarwal, Bernardo M. Cavalcanti, Pedram Hamrah, Emanuele Trucco 2014 University of Iowa

Tortuosity Classification Of Corneal Nerves Images Using A Multiple-Scale-Multiple-Window Approach, Roberto Annunziata, Ahmad Kheirkhah, Shruti Aggarwal, Bernardo M. Cavalcanti, Pedram Hamrah, Emanuele Trucco

Ophthalmic Medical Image Analysis

Classify in vivo confocal microscopy corneal images by tortuosity is complicated by the presence of variable numbers of fibres of different tortuosity level. Instead of designing a function combining manually selected features into a single coefficient, as done in the literature, we propose a supervised approach which selects automatically the most relevant combination of shape features from a pre-defined dictionary. To our best knowledge, we are the first to consider features at different spatial scales and show experimentally their relevance in tortuosity modelling. Our results, obtained with a set of 100 images and 20 fold cross-validation, suggest that multinomial logistic ...


An Automated Framework Of Inner Segment/Outer Segment Defect Detection For Retinal Sd-Oct Images, Weifang Zhu, Fei Shi, Dehui Xiang, Enting Gao, Liyun Wang, Haoyun Chen, Xinjian Chen 2014 University of Iowa

An Automated Framework Of Inner Segment/Outer Segment Defect Detection For Retinal Sd-Oct Images, Weifang Zhu, Fei Shi, Dehui Xiang, Enting Gao, Liyun Wang, Haoyun Chen, Xinjian Chen

Ophthalmic Medical Image Analysis

The integrity of inner segment/outer segment (IS/OS) has high correlation with lower visual acuity in patients suffering from blunt trauma. An automated 3D IS/OS defect detection method based on the SD-OCT images was proposed. First, 11 surfaces were automatically segmented using the multiscale 3D graph-search approach. Second, the sub-volumes between surface 7 and 8 containing IS/OS region around the fovea (diameter of mm) were extracted and flattened based on the segmented retinal pigment epithelium layer. Third, 5 kinds of texture based features were extracted for each voxel. A KNN classifier was trained and each voxel was ...


Detection Of Retinal Hemorrhages In The Presence Of Blood Vessels, Garima Gupta, Keerthi Ram, S. Kulasekaran, Niranjan Joshi, Mohanasankar Sivaprakasam, Rashmin Gandhi 2014 University of Iowa

Detection Of Retinal Hemorrhages In The Presence Of Blood Vessels, Garima Gupta, Keerthi Ram, S. Kulasekaran, Niranjan Joshi, Mohanasankar Sivaprakasam, Rashmin Gandhi

Ophthalmic Medical Image Analysis

Segmentation of hemorrhages helps in improving the efficiency of computer assisted image analysis of diseases like diabetic retinopathy and hypertensive retinopathy. Hemorrhages are blood leakages lying in close proximity to blood vessels, which makes their delineation from blood vessels challenging. We use multiresolution morphological processing with a view of achieving perceptual grouping of the hemorrhagic candidates occurring in variable shapes, sizes and textures. We propose a novel method of suppression of candidates lying on blood vessels while attaining a good segmentation of true hemorrhages including the ones attached to the vessels. Evaluated on 191 images having different degrees of pathological ...


Comparison Of Image Registration Methods For Composing Spectral Retinal Images, Lauri Laaksonen, Ela Claridge, Pauli Falt, Markku Hauta-Kasari, Hannu Uusitalo, Lasse Lensu 2014 University of Iowa

Comparison Of Image Registration Methods For Composing Spectral Retinal Images, Lauri Laaksonen, Ela Claridge, Pauli Falt, Markku Hauta-Kasari, Hannu Uusitalo, Lasse Lensu

Ophthalmic Medical Image Analysis

Spectral retinal images have signficant potential for improving the early detection and visualization of subtle changes due to eye diseases and many systemic diseases. High resolution in both the spatial and the spectral domain can be achieved by capturing a set of narrowband channel images from which the spectral images are composed. With imaging techniques where the eye movement between the acquisition of the images is unavoidable, image registration is required. In this paper, the applicability of the state-of-the-art image registration methods for the composition of spectral retinal images is studied. The registration methods are quantitatively compared using synthetic channel ...


Multiple Ocular Diseases Detection By Graph Regularized Multi-Label Learning, Xiangyu Chen, Yanwu Xu, Lixin Duan, Zhuo Zhang, Damon Wing Kee Wong, Jiang Liu 2014 University of Iowa

Multiple Ocular Diseases Detection By Graph Regularized Multi-Label Learning, Xiangyu Chen, Yanwu Xu, Lixin Duan, Zhuo Zhang, Damon Wing Kee Wong, Jiang Liu

Ophthalmic Medical Image Analysis

We develop a general framework for multiple ocular diseases diagnosis, based on Graph Regularized Multi-label Learning (GRML). Glaucoma, Pathological Myopia (PM), and Age-related Macular Degeneration (AMD) are three leading ocular diseases in the world. By exploiting the correlations among these three diseases, a novel GRML scheme is investigated for a simultaneous detection of these three leading ocular diseases for a given fundus image. We validate our GRML framework by conducting extensive experiments on SiMES dataset. The results show area under curve (AUC) of the receiver operating characteristic curve in multiple ocular diseases detection are much better than traditional popular algorithms ...


Uncertainty Assessment Of Vessels Width Measurement From Intensity Profile Model Fitting In Fundus Images, Fantin Girard, Conrad Kavalec, Houssem Ben Tahar, Farida Cheriet 2014 University of Iowa

Uncertainty Assessment Of Vessels Width Measurement From Intensity Profile Model Fitting In Fundus Images, Fantin Girard, Conrad Kavalec, Houssem Ben Tahar, Farida Cheriet

Ophthalmic Medical Image Analysis

Arteriolar-to-venular diameter ratio (AVR) is an important clinical measurement that allows to characterize retinal vascular abnormalities. A reliable AVR measurement requires accurate and reproducible width measurement. However, in order to measure the vessel width automatically, an approximation of the intensity profile is required by fitting a model. The aim of the proposed study is to assess the uncertainties introduced in the vessel width measurements when choosing a specific distribution as an intensity profile model. Different models are described and an automatic vessel width measurement procedure is presented. The uncertainty introduced by each model is evaluated by computing the standard deviation ...


Registration Of Sd-Oct En-Face Images With Color Fundus Photographs Based On Local Patch Matching, Sijie Niu, Qiang Chen, Honglie Shen, Luis de Sisternes, Daniel L. Rubin 2014 University of Iowa

Registration Of Sd-Oct En-Face Images With Color Fundus Photographs Based On Local Patch Matching, Sijie Niu, Qiang Chen, Honglie Shen, Luis De Sisternes, Daniel L. Rubin

Ophthalmic Medical Image Analysis

Registration of multi-modal retinal images is very significant to integrate information gained from different modalities for a reliable diagnosis of retinal diseases by ophthalmologists. However, accurate image registration is a challenging, we propose an algorithm for registration of summed-voxel projection images (SVPIs) with color fundus photographs (CFPs) based on local patch matching. SVPIs are evenly split into 16 local image blocks for extracting matching point pairs by searching local maximization of the similarity function. These matching point pairs are used for a coarse registration and then a search region of feature matching points is redefined for a more accurate registration ...


Automated Detection And Classification Of Nuclei In Immunohistochemical Stainings For Fuchs' Endothelial Corneal Dystrophy, Thomas Janssens, An-Katrien De Roo, Beatrijs Foets, Joost J. van den Oord, Greet Van den Berghe, Fabian Guiza 2014 University of Iowa

Automated Detection And Classification Of Nuclei In Immunohistochemical Stainings For Fuchs' Endothelial Corneal Dystrophy, Thomas Janssens, An-Katrien De Roo, Beatrijs Foets, Joost J. Van Den Oord, Greet Van Den Berghe, Fabian Guiza

Ophthalmic Medical Image Analysis

Fuchs’ endothelial corneal dystrophy (FECD) is a degenerative disease that affects the elderly population, and which lacks a unifying pathogenic theory and tangible drug targets. Immunohistochemical stainings can be used to identify proteins involved in the pathogenesis of FECD. We introduce a method for the automatic quantification of the ratio of stained cells starting from full high-resolution cornea images. First, the endothelium is extracted using entropy information in a low-resolution resampling. Then, within the endothelium, we heuristically detect and classify nuclei based on their size, color, and the color of the surrounding cytoplasm. This method achieves comparable results to manual ...


Comparison Of Retinal Thickness Measurements Of Normal Eyes Between Topcon Algorithm And A Graph Based Algorithm, Enting Gao, Fei Shi, Weifang Zhu, Binyao Chen, Haoyu Chen, Xinjian Chen 2014 University of Iowa

Comparison Of Retinal Thickness Measurements Of Normal Eyes Between Topcon Algorithm And A Graph Based Algorithm, Enting Gao, Fei Shi, Weifang Zhu, Binyao Chen, Haoyu Chen, Xinjian Chen

Ophthalmic Medical Image Analysis

To assess the agreement between Topcon built-in algorithm and our developed graph based algorithm, the retinal thickness of 9-sectors on an Early Treatment of Diabetic Retinopathy Study(ETDRS) chart measurements for normal subjects was compared. A total of fifty eyes were enrolled in this study. The overall and sectoral thickness on ETDRS chart were calculated using Topcon built-in algorithm and our developed three-dimensional graph based algorithm. Correlation analysis and agreement analysis were performed between the commercial algorithm and our algorithm. A high degree of correlation was found between the results obtained from the two methods was from 0.856 to ...


Microaneurysms Detection Using A Novel Neighborhood Analysis, Ivo Soares, Miguel Castelo-Branco, Antonio M.G. Pinheiro 2014 University of Iowa

Microaneurysms Detection Using A Novel Neighborhood Analysis, Ivo Soares, Miguel Castelo-Branco, Antonio M.G. Pinheiro

Ophthalmic Medical Image Analysis

The earliest sign of the diabetic retinopathy is the appearance of small red dots in retinal fundus images, designated by microaneurysms. In this paper a scale-space based method is proposed for the microaneurysms detection. Initially, the method performs a segmentation of the retinal vasculature and defines a global set of microaneurysms candidates, using both coarser and finer scales. Using the finer scales, a set of microaneurysms candidates are analysed in terms of shape and size. Then, a set of gaussian-shaped matched filters are used to reduce the number of false microaneurysms candidates. Each candidate is labeled as a true microaneurysm ...


A Quadrature Filter Approach For Registration Accuracy Assessment Of Fundus Images, Kedir M. Adal, Rosalie Couvert, D. W. J. Meijer, Jose P. Martinez, Koenraad A. Vermeer, L. J. van Vliet 2014 University of Iowa

A Quadrature Filter Approach For Registration Accuracy Assessment Of Fundus Images, Kedir M. Adal, Rosalie Couvert, D. W. J. Meijer, Jose P. Martinez, Koenraad A. Vermeer, L. J. Van Vliet

Ophthalmic Medical Image Analysis

This paper presents a method to automatically assess the accuracy of image registration. It is applicable to images in which vessels are the main landmarks such as fundus images and angiography. The method simultaneously exploits not only the position, but also the intensity profile across the vasculatures. The accuracy measure is defined as the energy of the odd component of the 1D vessel profile in the difference image divided by the total energy of the corresponding vessels in the constituting images. Scale and orientation-selective quadrature filter banks have been employed to analyze the 1D signal profiles. Subsequently, the relative energy ...


Stable Registration Of Pathological 3d-Oct Scans Using Retinal Vessels, Jing Wu, Bianca S. Gerendas, Sebastian M. Waldstein, Georg Langs, Christian Simader, Ursula Schmidt-Erfurth 2014 University of Iowa

Stable Registration Of Pathological 3d-Oct Scans Using Retinal Vessels, Jing Wu, Bianca S. Gerendas, Sebastian M. Waldstein, Georg Langs, Christian Simader, Ursula Schmidt-Erfurth

Ophthalmic Medical Image Analysis

We propose a multiple scanner vendor registration method for pathological retinal 3D spectral domain optical coherence tomography volumes based on Myronenko’s Coherent Point Drift and our automated vessel shadow segmentation. Coherent point drift is applied to the segmented retinal vessel point sets used as landmarks to generate the registration parameters required. In contrast to other registration methods, our solution incorporates a landmark detection and extraction method that specifically limits the extraction of false positives and a registration method capable of handling any such noise in the landmark point sets. Our experiments show modified Hausdorff distance is reduced by a ...


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