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Oyibo P, Agbana T, van Lieshout L, Oyibo W, Diehl JC, Vdovine G. An automated slide scanning system for membrane filter imaging in diagnosis of urogenital schistosomiasis. J Microsc 2024; 294:52-61. [PMID: 38291833 DOI: 10.1111/jmi.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
Traditionally, automated slide scanning involves capturing a rectangular grid of field-of-view (FoV) images which can be stitched together to create whole slide images, while the autofocusing algorithm captures a focal stack of images to determine the best in-focus image. However, these methods can be time-consuming due to the need for X-, Y- and Z-axis movements of the digital microscope while capturing multiple FoV images. In this paper, we propose a solution to minimise these redundancies by presenting an optimal procedure for automated slide scanning of circular membrane filters on a glass slide. We achieve this by following an optimal path in the sample plane, ensuring that only FoVs overlapping the filter membrane are captured. To capture the best in-focus FoV image, we utilise a hill-climbing approach that tracks the peak of the mean of Gaussian gradient of the captured FoVs images along the Z-axis. We implemented this procedure to optimise the efficiency of the Schistoscope, an automated digital microscope developed to diagnose urogenital schistosomiasis by imaging Schistosoma haematobium eggs on 13 or 25 mm membrane filters. Our improved method reduces the automated slide scanning time by 63.18% and 72.52% for the respective filter sizes. This advancement greatly supports the practicality of the Schistoscope in large-scale schistosomiasis monitoring and evaluation programs in endemic regions. This will save time, resources and also accelerate generation of data that is critical in achieving the targets for schistosomiasis elimination.
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Affiliation(s)
- Prosper Oyibo
- Delft Center for Systems and Control, Delft University of Technology, Delft, The Netherlands
| | - Tope Agbana
- Delft Center for Systems and Control, Delft University of Technology, Delft, The Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wellington Oyibo
- Centre for Transdisciplinary Research for Malaria & Neglected Tropical Diseases, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Gleb Vdovine
- Delft Center for Systems and Control, Delft University of Technology, Delft, The Netherlands
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Makau-Barasa L, Assefa L, Aderogba M, Bell D, Solomon J, Urude RO, Nebe OJ, A-Enegela J, Damen JG, Popoola S, Diehl JC, Vdovine G, Agbana T. Performance evaluation of the AiDx multi-diagnostic automated microscope for the detection of schistosomiasis in Abuja, Nigeria. Sci Rep 2023; 13:14833. [PMID: 37684541 PMCID: PMC10491799 DOI: 10.1038/s41598-023-42049-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023] Open
Abstract
In this research, we report on the performance of automated optical digital detection and quantification of Schistosoma haematobium provided by AiDx NTDx multi-diagnostic Assist microscope. Our study was community-based, and a convenient sampling method was used in 17 communities in Abuja Nigeria, based on the disease prevalence information extracted from the baseline database on schistosomiasis, NTD Division, of the Federal Ministry of Health. At baseline, samples from 869 participants were evaluated of which 358 (34.1%) tested S. haematobium positive by the reference diagnostic standard. Registered images from the fully automated (autofocusing, scanning, image registration and processing, AI image analysis and automatic parasite count) AiDx assist microscope were analyzed. The Semi automated (autofocusing, scanning, image registration & processing and manual parasite count) and the fully automated AiDx Assist showed comparable sensitivities and specificities of [90.3%, 98%] and [89%, 99%] respectively. Overall, estimated egg counts of the semi-automated & fully automated AiDx Assist correlated significantly with the egg counts of conventional microscopy (r = 0.93, p ≤ 0.001 and r = 0.89, p ≤ 0.001 respectively). The AiDx Assist device performance is consistent with requirement of the World Health Organization diagnostic target product profile for monitoring, evaluation, and surveillance of Schistosomiasis elimination Programs.
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Affiliation(s)
| | - Liya Assefa
- The Ending Neglected Diseases (END) Fund, New York, USA
| | | | | | - Jacob Solomon
- NTD Division, Federal Ministry of Health, Abuja, Nigeria
| | | | | | | | - James G Damen
- Medical Lab Department, University of Jos, Jos, Nigeria
| | | | | | - Gleb Vdovine
- Delft University of Technology, Delft, The Netherlands
| | - Temitope Agbana
- AiDx Medical Bv, Pijnacker, The Netherlands.
- Delft University of Technology, Delft, The Netherlands.
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Oyibo P, Meulah B, Bengtson M, van Lieshout L, Oyibo W, Diehl JC, Vdovine G, Agbana T. Two-stage automated diagnosis framework for urogenital schistosomiasis in microscopy images from low-resource settings. J Med Imaging (Bellingham) 2023; 10:044005. [PMID: 37554627 PMCID: PMC10405291 DOI: 10.1117/1.jmi.10.4.044005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE Automated diagnosis of urogenital schistosomiasis using digital microscopy images of urine slides is an essential step toward the elimination of schistosomiasis as a disease of public health concern in Sub-Saharan African countries. We create a robust image dataset of urine samples obtained from field settings and develop a two-stage diagnosis framework for urogenital schistosomiasis. APPROACH Urine samples obtained from field settings were captured using the Schistoscope device, and S. haematobium eggs present in the images were manually annotated by experts to create the SH dataset. Next, we develop a two-stage diagnosis framework, which consists of semantic segmentation of S. haematobium eggs using the DeepLabv3-MobileNetV3 deep convolutional neural network and a refined segmentation step using ellipse fitting approach to approximate the eggs with an automatically determined number of ellipses. We defined two linear inequality constraints as a function of the overlap coefficient and area of a fitted ellipses. False positive diagnosis resulting from over-segmentation was further minimized using these constraints. We evaluated the performance of our framework on 7605 images from 65 independent urine samples collected from field settings in Nigeria, by deploying our algorithm on an Edge AI system consisting of Raspberry Pi + Coral USB accelerator. RESULT The SH dataset contains 12,051 images from 103 independent urine samples and the developed urogenital schistosomiasis diagnosis framework achieved clinical sensitivity, specificity, and precision of 93.8%, 93.9%, and 93.8%, respectively, using results from an experienced microscopist as reference. CONCLUSION Our detection framework is a promising tool for the diagnosis of urogenital schistosomiasis as our results meet the World Health Organization target product profile requirements for monitoring and evaluation of schistosomiasis control programs.
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Affiliation(s)
- Prosper Oyibo
- Delft University of Technology, Delft Center for Systems and Control, Faculty of Mechanical, Maritime, and Materials Engineering, Delft, The Netherlands
- University of Lagos, College of Medicine, Centre for Malaria Diagnosis, NTD Research, Training, and Policy/ANDI Centre of Excellence for Malaria Diagnosis, Lagos, Nigeria
| | - Brice Meulah
- Leiden University Medical Centre, Department of Parasitology, Leiden, The Netherlands
- Centre de Recherches Medicales des Lambaréné, CERMEL, Lambarene, Gabon
| | - Michel Bengtson
- Leiden University Medical Centre, Department of Parasitology, Leiden, The Netherlands
| | - Lisette van Lieshout
- Leiden University Medical Centre, Department of Parasitology, Leiden, The Netherlands
| | - Wellington Oyibo
- University of Lagos, College of Medicine, Centre for Malaria Diagnosis, NTD Research, Training, and Policy/ANDI Centre of Excellence for Malaria Diagnosis, Lagos, Nigeria
| | - Jan-Carel Diehl
- Delft University of Technology, Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft, The Netherlands
| | - Gleb Vdovine
- Delft University of Technology, Delft Center for Systems and Control, Faculty of Mechanical, Maritime, and Materials Engineering, Delft, The Netherlands
| | - Tope Agbana
- Delft University of Technology, Delft Center for Systems and Control, Faculty of Mechanical, Maritime, and Materials Engineering, Delft, The Netherlands
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Makau-Barasa L, Assefa L, Aderogba MO, Bell D, Solomon J, Abba A, A-Enegela J, Damen JG, Popoola S, Diehl JC, Vdovine G, Agbana T. Image-Based Awareness Campaign and Community Mobilization in the Control of Schistosomiasis. Trop Med Infect Dis 2023; 8:309. [PMID: 37368727 DOI: 10.3390/tropicalmed8060309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/10/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Community awareness and participation in mass screening is critical for schistosomiasis control. This study assessed the impact of sharing anonymized image-based positive test results on the uptake of screening during community mobilization outreach. We conducted an observational study to compare the population response to standard and image-based strategies in 14 communities in Abuja, Nigeria. Six hundred and ninety-one (341 females, 350 males) individuals participated in this study. We analyzed the response ratio, relative increase, and sample collection time. The potential treatment uptake and change in social behavior were determined based on a semi-structured questionnaire. The mean response ratio of the image-based strategy was 89.7% representing a significantly higher ratio than the 27.8%, which was observed under the standard mobilization approach (p ≤ 0.001). The image-based method was associated with 100% of the participants agreeing to provide urine samples, 94% willing to be treated, 89% claiming to have been invited to participate in the study by a friend, and 91% desiring to change a predisposing behavioral habit. These findings indicate that image-based community awareness campaigns may increase the population's perception about schistosomiasis transmission and treatment. This raises new possibilities for local resource mobilization to expand services in reaching the last mile in schistosomiasis control.
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Affiliation(s)
| | - Liya Assefa
- The Ending Neglected Diseases (END) Fund, New York, NY 10016, USA
| | - Moses O Aderogba
- The Ending Neglected Diseases (END) Fund, New York, NY 10016, USA
| | - David Bell
- Independent Consultant, Lake Jackson, TX 77566, USA
| | | | | | | | - James G Damen
- Medical Lab Department, University of Jos, Jos 930001, Nigeria
| | | | - Jan-Carel Diehl
- Sustainable Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands
| | - Gleb Vdovine
- AiDx Medical Bv, 2641 KM Pijnacker, The Netherlands
- Sustainable Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands
| | - Temitope Agbana
- AiDx Medical Bv, 2641 KM Pijnacker, The Netherlands
- Sustainable Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands
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Intriago Zambrano JC, Diehl JC, Ertsen MW. Discourses on the adoption of the Barsha pump: A Q methodology study in Nepal and Indonesia. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.989753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Improved water management is an important strategy to support smallholder farming, and thus to foster food security and improved livelihoods. Within this strategy, technologies like water pumps, especially those operating on renewable energies, are key, as they are more environmentally sound and affordable alternatives. Their successful and sustained uptake is a complex process—largely dependent on the adopter and its surrounding context—usually overlooked by traditional linear technology-transfer approaches. By means of Q methodology, we explored cross-cultural discourses around the adoption of the Barsha pump (BP), a self-reliant hydro-mechanical device that does not require any external input than flowing water to operate. We administered the method to 43 (non-)farmer respondents linked to Nepali and Indonesian smallholder farming systems. We identified three relevant discourses, one of them bipolar in nature. These three groups accounted for 39, 36, and 28% of the total explained variance of our study. The first one identified BP's potential early adopters. The second discourse embodied the (stereotypical) highly dependent smallholder. The last one characterized (contrasting) views around the BP as an enabler of potential service-oriented business models to achieve wellbeing. These results reflect the need for a shift of mindset toward new ways of understanding technological change in smallholder settings. On the one side, simplistic one-size-fits-all models cannot connect to the diversity of issues and opinions as we found. On the other side, it is virtually impossible to produce tailored solutions to satisfy each of those individual realities. We propose possible adoption pathways that may lead to the exploration of innovative and adaptable business models that serve the diversity of smallholder farming needs more effectively.
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Samenjo KT, Bengtson M, Onasanya A, Zambrano JCI, Oladunni O, Oladepo O, van Engelen J, Diehl JC. Stakeholders’ Perspectives on the Application of New Diagnostic Devices for Urinary Schistosomiasis in Oyo State, Nigeria: A Q-Methodology Approach. Glob Health Sci Pract 2022; 10:GHSP-D-21-00780. [PMID: 36041843 PMCID: PMC9426976 DOI: 10.9745/ghsp-d-21-00780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
New diagnostic devices for schistosomiasis should be designed to function best within the local endemic health care context and support stakeholders at various levels of the health care system in performing the tasks to help control and eventually eliminate schistosomiasis. Urinary schistosomiasis is a waterborne parasitic infection caused by Schistosoma haematobium that affects approximately 30 million people annually in Nigeria. Treatment and eradication of this infection require effective diagnostics. However, current diagnostic tests have critical shortcomings and consequently are of limited value to stakeholders throughout the health care system who are involved in targeting the diagnosis and subsequent control of schistosomiasis. New diagnostic devices that fit the local health care infrastructure and support the different stakeholder diagnostic strategies remain a critical need. This study focuses on understanding, by means of Q-methodology, the context of use and application of a new diagnostic device that is needed to effectively diagnose urinary schistosomiasis in Oyo State, Nigeria. Q-methodology is a technique that investigates subjectivity by exploring how stakeholders rank-order opinion statements about a phenomenon. In this study, 40 statements were administered to evaluate stakeholder perspectives on the context of use and application of potential new diagnostic devices and how these perspectives or viewpoints are shared with other stakeholders. Potential new diagnostic devices will need to be deployable to remote or distant communities, be affordable, identify and confirm infection status before treatment in patients whose diagnosis of urinary schistosomiasis is based on self-reporting, and equip health care facilities with diagnostic devices optimized for the local setting while requiring local minimal infrastructural settings. Similarly, the context of use and application of a potential new diagnostic device for urinary schistosomiasis is primarily associated with the tasks stakeholders throughout the health care system perform or procedures employed. These findings will guide the development of new diagnostic devices for schistosomiasis that match the contextual landscape and diagnostic strategies in Oyo.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Juan Carlo Intriago Zambrano
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, Netherlands
| | - Opeyemi Oladunni
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Hinrichs-Krapels S, Diehl JC, Hunfeld N, van Raaij E. Towards sustainability for medical devices and consumables: The radical and incremental challenges in the technology ecosystem. J Health Serv Res Policy 2022; 27:253-254. [PMID: 35739079 DOI: 10.1177/13558196221110416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Erik van Raaij
- 6984Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
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Oyibo P, Jujjavarapu S, Meulah B, Agbana T, Braakman I, van Diepen A, Bengtson M, van Lieshout L, Oyibo W, Vdovine G, Diehl JC. Schistoscope: An Automated Microscope with Artificial Intelligence for Detection of Schistosoma haematobium Eggs in Resource-Limited Settings. Micromachines 2022; 13:mi13050643. [PMID: 35630110 PMCID: PMC9146062 DOI: 10.3390/mi13050643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023]
Abstract
For many parasitic diseases, the microscopic examination of clinical samples such as urine and stool still serves as the diagnostic reference standard, primarily because microscopes are accessible and cost-effective. However, conventional microscopy is laborious, requires highly skilled personnel, and is highly subjective. Requirements for skilled operators, coupled with the cost and maintenance needs of the microscopes, which is hardly done in endemic countries, presents grossly limited access to the diagnosis of parasitic diseases in resource-limited settings. The urgent requirement for the management of tropical diseases such as schistosomiasis, which is now focused on elimination, has underscored the critical need for the creation of access to easy-to-use diagnosis for case detection, community mapping, and surveillance. In this paper, we present a low-cost automated digital microscope—the Schistoscope—which is capable of automatic focusing and scanning regions of interest in prepared microscope slides, and automatic detection of Schistosoma haematobium eggs in captured images. The device was developed using widely accessible distributed manufacturing methods and off-the-shelf components to enable local manufacturability and ease of maintenance. For proof of principle, we created a Schistosoma haematobium egg dataset of over 5000 images captured from spiked and clinical urine samples from field settings and demonstrated the automatic detection of Schistosoma haematobium eggs using a trained deep neural network model. The experiments and results presented in this paper collectively illustrate the robustness, stability, and optical performance of the device, making it suitable for use in the monitoring and evaluation of schistosomiasis control programs in endemic settings.
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Affiliation(s)
- Prosper Oyibo
- Delft Center for Systems and Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands; (P.O.); (T.A.); (G.V.)
- ANDI Centre of Excellence for Malaria Diagnosis, College of Medicine, University of Lagos, Lagos 101017, Nigeria;
| | - Satyajith Jujjavarapu
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands; (S.J.); (I.B.)
| | - Brice Meulah
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (B.M.); (A.v.D.); (M.B.); (L.v.L.)
- Centre de Recherches Medicales des Lambaréné, CERMEL, Lambarene BP 242, Gabon
| | - Tope Agbana
- Delft Center for Systems and Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands; (P.O.); (T.A.); (G.V.)
| | - Ingeborg Braakman
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands; (S.J.); (I.B.)
| | - Angela van Diepen
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (B.M.); (A.v.D.); (M.B.); (L.v.L.)
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (B.M.); (A.v.D.); (M.B.); (L.v.L.)
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (B.M.); (A.v.D.); (M.B.); (L.v.L.)
| | - Wellington Oyibo
- ANDI Centre of Excellence for Malaria Diagnosis, College of Medicine, University of Lagos, Lagos 101017, Nigeria;
| | - Gleb Vdovine
- Delft Center for Systems and Control, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands; (P.O.); (T.A.); (G.V.)
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, 2628 CE Delft, The Netherlands; (S.J.); (I.B.)
- Correspondence: ; Tel.: +31-614-015-469
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van Grootheest D, Agbana T, Diehl JC, van Diepen A, Bezzubik V, Vdovin G. Large volume holographic imaging for biological sample analysis. J Biomed Opt 2021; 26:JBO-200299R. [PMID: 33423408 PMCID: PMC7850981 DOI: 10.1117/1.jbo.26.1.016502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
SIGNIFICANCE Particle field holography is a versatile technique to determine the size and distribution of moving or stationary particles in air or in a liquid without significant disturbance of the sample volume. Although this technique is applied in biological sample analysis, it is limited to small sample volumes, thus increasing the number of measurements per sample. In this work, we characterize the maximum achievable volume limit based on the specification of a given sensor to realize the development of a potentially low-cost, single-shot, large-volume holographic microscope. AIM We present mathematical formulas that will aid in the design and development and improve the focusing speed for the numerical reconstruction of registered holograms in particle field holographic microscopes. Our proposed methodology has potential application in the detection of Schistosoma haematobium eggs in human urine samples. APPROACH Using the Fraunhofer holography theory for opaque objects, we derived an exact formula for the maximum diffraction-limited volume for an in-line holographic setup. The proof-of-concept device built based on the derived formulas was experimentally validated with urine spiked with cultured Schistosoma haematobium eggs. RESULTS Results obtained show that for urine spiked with Schistosoma haematobium eggs, the volume thickness is limited to several millimeters due to scattering properties of the sample. The distances of the target particles could be estimated directly from the hologram fringes. CONCLUSION The methodology proposed will aid in the development of large-volume holographic microscopes.
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Affiliation(s)
- Derk van Grootheest
- Delft University of Technology, Delft Center for Systems and Controls, Delft, The Netherlands
| | - Temitope Agbana
- Delft University of Technology, Delft Center for Systems and Controls, Delft, The Netherlands
| | - Jan-Carel Diehl
- Delft University of Technology, Design for Sustainability, Delft, The Netherlands
| | - Angela van Diepen
- Leiden University Medical Center, Department of Parasitology, Leiden, The Netherlands
| | | | - Gleb Vdovin
- Delft University of Technology, Delft Center for Systems and Controls, Delft, The Netherlands
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Bengtson M, Bharadwaj M, Bosch AT, Nyakundi H, Matoke-Muhia D, Dekker C, Diehl JC. Matching Development of Point-of-Care Diagnostic Tests to the Local Context: A Case Study of Visceral Leishmaniasis in Kenya and Uganda. Glob Health Sci Pract 2020; 8:549-565. [PMID: 33008863 PMCID: PMC7541118 DOI: 10.9745/ghsp-d-20-00028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/11/2020] [Indexed: 01/18/2023]
Abstract
We provide a new protocol to connect how findings from field research on the local health care setting in resource-limited regions can inform researchers that are working toward developing a new point-of-care diagnostic test for neglected tropical diseases. The rapid growth of point-of-care (POC) diagnostic tests necessitates a clear vision of when, where, and why a new POC diagnostic test needs to be developed and how it can be used in a way that matches a local health care context. Here, we present an innovative approach toward developing a concept target product profile (CTPP), which is a new mapping tool that helps researchers match a new diagnostic test to a specific local health care context early in the research and development process. As a case study, we focus on the diagnosis of visceral leishmaniasis (VL) in rural resource-limited regions of Kenya and Uganda. Our stepwise approach integrates elements of design thinking and uses a combination of literature reviews and field research for a context analysis of local health care systems and practices. We then use visual thinking in the form of Gigamaps and patient journeys to identify use case scenarios and to present our findings from the field research to key stakeholders. The use case scenarios describe the diagnostic scope of a new POC test based on the feasibility of the new test, the local need, and the contextual fit. For our case study of VL, we identify 2 valuable use case scenarios, namely test-of-cure and screening and confirmation, and we formulate a CTPP. We anticipate that a CTPP will enable researchers to match a new POC diagnostic test during the research and development process to the local health care context in which it will be used.
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Affiliation(s)
- Michel Bengtson
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, The Netherlands
| | - Mitasha Bharadwaj
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, The Netherlands
| | - Astrid Ten Bosch
- Department of Sustainable Design Engineering, Section of Design for Sustainability, Faculty of Industrial Design Engineering, Delft University of Technology, The Netherlands
| | | | - Damaris Matoke-Muhia
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, Kenya
| | - Cees Dekker
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, The Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Section of Design for Sustainability, Faculty of Industrial Design Engineering, Delft University of Technology, The Netherlands.
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Agbana TE, Diehl JC, van Pul F, Khan SM, Patlan V, Verhaegen M, Vdovin G. Imaging & identification of malaria parasites using cellphone microscope with a ball lens. PLoS One 2018; 13:e0205020. [PMID: 30286150 PMCID: PMC6171928 DOI: 10.1371/journal.pone.0205020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/18/2018] [Indexed: 11/18/2022] Open
Abstract
We have optimized the design and imaging procedures, to clearly resolve the malaria parasite in Giemsa-stained thin blood smears, using simple low-cost cellphone-based microscopy with oil immersion. The microscope uses a glass ball as the objective and the phone camera as the tube lens. Our optimization includes the optimal choice of the ball lens diameter, the size and the position of the aperture diaphragm, and proper application of immersion, to achieve diagnostic capacity in a wide field of view. The resulting system is potentially applicable to low-cost in-the-field optical diagnostics of malaria as it clearly resolves micron-sized features and allows for analysis of parasite morphology in the field of 50 × 50 μm, and parasite detection in the field of at least 150 × 150 μm.
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Affiliation(s)
- Temitope E. Agbana
- Delft Center for Systems and Controls, Delft University of Technology, Delft, The Netherlands
- * E-mail:
| | - Jan-Carel Diehl
- Design for Sustainability, Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Fiona van Pul
- Parasitology and Immunologyparasitology Group, Leiden University Medical Center, Leiden, The Netherlands
| | - Shahid M. Khan
- Parasitology and Immunologyparasitology Group, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Michel Verhaegen
- Delft Center for Systems and Controls, Delft University of Technology, Delft, The Netherlands
| | - Gleb Vdovin
- Delft Center for Systems and Controls, Delft University of Technology, Delft, The Netherlands
- Flexible Optical BV, Rijswijk, The Netherlands
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12
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Kane JP, Malloy MJ, Ports TA, Phillips NR, Diehl JC, Havel RJ. Regression of coronary atherosclerosis during treatment of familial hypercholesterolemia with combined drug regimens. JAMA 1990; 264:3007-12. [PMID: 2243428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We conducted a randomized, controlled trial in 72 patients with heterozygous familial hypercholesterolemia to test whether reducing plasma low-density lipoprotein levels by diet and combined drug regimens can induce regression of coronary lesions. Four hundred fifty-seven lesions were measured before and after a 26-month interval by computer-based quantitative angiography. The primary outcome variable was within-patient mean change in percent area stenosis. Mean low-density lipoprotein cholesterol levels decreased from 7.32 +/- 1.5 to 4.45 +/- 1.6 mmol/L. The mean change in percent area stenosis among controls was +0.80, indicating progression, while the mean change for the treatment group was -1.53, indicating regression (P = .039 by two-tailed t test for the difference between groups). Regression among women, analyzed separately, was also significant. The change in percent area stenosis was correlated with low-density lipoprotein levels on trial. We conclude that reduction of low-density lipoprotein cholesterol levels can induce regression of atherosclerotic lesions of the coronary arteries in patients with familial hypercholesterolemia. The anticipation of benefit from treatment applies to women and men alike.
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Affiliation(s)
- J P Kane
- Cardiovascular Research Institute, University of California, San Francisco 94143-0130
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Uflacker R, Alves MA, Diehl JC. Gastrointestinal involvement in neurofibromatosis: angiographic presentation. Gastrointest Radiol 1985; 10:163-5. [PMID: 3922843 DOI: 10.1007/bf01893093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A large neurofibroma associated with gastrointestinal hemorrhage was demonstrated by visceral arteriography. The findings are correlated with those of resected pathologic specimen.
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14
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Uflacker R, Diehl JC. Successful embolization of a bleeding splenic artery pseudoaneurysm secondary to necrotizing pancreatitis. Gastrointest Radiol 1982; 7:379-82. [PMID: 7141194 DOI: 10.1007/bf01887676] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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