Mobile Phone Based Clinical Microscopy for Global Health Applications

Light microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases. In many regions of the world, however, the required equipment is either unavailable or insufficiently portable, and operators may not possess adequate training to make full use of the images obtained. Counterintuitively, these same regions are often well served by mobile phone networks, suggesting the possibility of leveraging portable, camera-enabled mobile phones for diagnostic imaging and telemedicine. Toward this end we have built a mobile phone-mounted light microscope and demonstrated its potential for clinical use by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with LED excitation. In all cases resolution exceeded that necessary to detect blood cell and microorganism morphology, and with the tuberculosis samples we took further advantage of the digitized images to demonstrate automated bacillus counting via image analysis software. We expect such a telemedicine system for global healthcare via mobile phone – offering inexpensive brightfield and fluorescence microscopy integrated with automated image analysis – to provide an important tool for disease diagnosis and screening, particularly in the developing world and rural areas where laboratory facilities are scarce but mobile phone infrastructure is extensive.     

Quantitative Imaging with a Mobile Phone Microscope

Use of optical imaging for medical and scientific applications requires accurate quantification of features such as object size, color, and brightness. High pixel density cameras available on modern mobile phones have made photography simple and convenient for consumer applications; however, the camera hardware and software that enables this simplicity can present a barrier to accurate quantification of image data. This issue is exacerbated by automated settings, proprietary image processing algorithms, rapid phone evolution, and the diversity of manufacturers. If mobile phone cameras are to live up to their potential to increase access to healthcare in low-resource settings, limitations of mobile phone–based imaging must be fully understood and addressed with procedures that minimize their effects on image quantification. Here we focus on microscopic optical imaging using a custom mobile phone microscope that is compatible with phones from multiple manufacturers. We demonstrate that quantitative microscopy with micron-scale spatial resolution can be carried out with multiple phones and that image linearity, distortion, and color can be corrected as needed. Using all versions of the iPhone and a selection of Android phones released between 2007 and 2012, we show that phones with greater than 5 MP are capable of nearly diffraction-limited resolution over a broad range of magnifications, including those relevant for single cell imaging. We find that automatic focus, exposure, and color gain standard on mobile phones can degrade image resolution and reduce accuracy of color capture if uncorrected, and we devise procedures to avoid these barriers to quantitative imaging. By accommodating the differences between mobile phone cameras and the scientific cameras, mobile phone microscopes can be reliably used to increase access to quantitative imaging for a variety of medical and scientific applications.     

Low-Cost Cryo-Light Microscopy Stage Fabrication for Correlated Light/Electron Microscopy

The coupling of cryo-light microscopy (cryo-LM) and cryo-electron microscopy (cryo-EM) poses a number of advantages for understanding cellular dynamics and ultrastructure. First, cells can be imaged in a near native environment for both techniques. Second, due to the vitrification process, samples are preserved by rapid physical immobilization rather than slow chemical fixation. Third, imaging the same sample with both cryo-LM and cryo-EM provides correlation of data from a single cell, rather than a comparison of "representative samples". While these benefits are well known from prior studies, the widespread use of correlative cryo-LM and cryo-EM remains limited due to the expense and complexity of buying or building a suitable cryogenic light microscopy stage. Here we demonstrate the assembly, and use of an inexpensive cryogenic stage that can be fabricated in any lab for less than $40 with parts found at local hardware and grocery stores. This cryo-LM stage is designed for use with reflected light microscopes that are fitted with long working distance air objectives. For correlative cryo-LM and cryo-EM studies, we adapt the use of carbon coated standard 3-mm cryo-EM grids as specimen supports. After adsorbing the sample to the grid, previously established protocols for vitrifying the sample and transferring/handling the grid are followed to permit multi-technique imaging. As a result, this setup allows any laboratory with a reflected light microscope to have access to direct correlative imaging of frozen hydrated samples.     

公众镜头里的北京动物园

从没想过,在普通人的镜头里,动物园竟是如此多面,定格在取景框中的不仅仅是动物,从如画的湖畔风光到坐着轮椅逛动物园的老人,从细心照顾动物的饲养员到给游客带来惊喜的新场馆,从厌倦了被人围观的棕熊到躺在扔满了饮料瓶的地上睡觉的老虎,从宣传爱心的志愿者到举着照相机的游客……画面中充溢的是人们对动物的关切,对生活敏锐的洞察。     

Geographic Variation in Access to Dog-Bite Care in Pakistan and Risk of Dog-Bite Exposure in Karachi: Prospective Surveillance Using a Low-Cost Mobile Phone System

Background

Dog-bites and rabies are under-reported in developing countries such as Pakistan and there is a poor understanding of the disease burden. We prospectively collected data utilizing mobile phones for dog-bite and rabies surveillance across nine emergency rooms (ER) in Pakistan, recording patient health-seeking behaviors, access to care and analyzed spatial distribution of cases from Karachi.

Methodology and Principal Findings

A total of 6212 dog-bite cases were identified over two years starting in February 2009 with largest number reported from Karachi (59.7%), followed by Peshawar (13.1%) and Hyderabad (11.4%). Severity of dog-bites was assessed using the WHO classification. Forty percent of patients had Category I (least severe) bites, 28.1% had Category II bites and 31.9% had Category III (most severe bites). Patients visiting a large public hospital ER in Karachi were least likely to seek immediate healthcare at non-medical facilities (Odds Ratio = 0.20, 95% CI 0.17–0.23, p-value<0.01), and had shorter mean travel time to emergency rooms, adjusted for age and gender (32.78 min, 95% CI 31.82–33.78, p-value<0.01) than patients visiting hospitals in smaller cities. Spatial analysis of dog-bites in Karachi suggested clustering of cases (Moran''s I = 0.02, p value<0.01), and increased risk of exposure in particular around Korangi and Malir that are adjacent to the city''s largest abattoir in Landhi. The direct cost of operating the mHealth surveillance system was USD 7.15 per dog-bite case reported, or approximately USD 44,408 over two years.

Conclusions

Our findings suggest significant differences in access to care and health-seeking behaviors in Pakistan following dog-bites. The distribution of cases in Karachi was suggestive of clustering of cases that could guide targeted disease-control efforts in the city. Mobile phone technologies for health (mHealth) allowed for the operation of a national-level disease reporting and surveillance system at a low cost.     

Mobile Phone Call Data as a Regional Socio-Economic Proxy Indicator

The advent of publishing anonymized call detail records opens the door for temporal and spatial human dynamics studies. Such studies, besides being useful for creating universal models for mobility patterns, could be also used for creating new socio-economic proxy indicators that will not rely only on the local or state institutions. In this paper, from the frequency of calls at different times of the day, in different small regional units (sub-prefectures) in Côte d''Ivoire, we infer users'' home and work sub-prefectures. This division of users enables us to analyze different mobility and calling patterns for the different regions. We then compare how those patterns correlate to the data from other sources, such as: news for particular events in the given period, census data, economic activity, poverty index, power plants and energy grid data. Our results show high correlation in many of the cases revealing the diversity of socio-economic insights that can be inferred using only mobile phone call data. The methods and the results may be particularly relevant to policy-makers engaged in poverty reduction initiatives as they can provide an affordable tool in the context of resource-constrained developing economies, such as Côte d''Ivoire''s.     

China Art by Phone: Mobile Movies

Jia ZhangKe's film Platform gives crystalline shape to a generation in a group of youth gathered around a tape-recorder in Fenyang city. The tape itself had come from Guangzhou and before that, presumably, from across the border with Hong Kong. Perhaps a Cantonese filtering, a local expression of Western and brand-name product that, viewed positively, marks the largest and most sweeping educational drive in China's history, the distribution and assimilation of fashion, DVDs, CDs, video, and design. This article seeks to know empirically the conditions that lay the groundwork for this educational drive, focusing on social transformation and the impact of digital technologies on theory, approach, practice, consumption. Clearly, mobility is important in this process of social transformation. Platform gives us images of the mobility of people, things, and ideas. This article also looks at the effects of the transport of people, things, and ideas and explores the cultural dimensions of social transformation. The article asks: What is mobility for artists and media producers? What are the urbanistic interconnections that emerge from an engagement with public space? These questions are explored around the social and cultural terrain of the mobile phone.

The article considers the virtual public space of the mobile telephone now opening to cultural producers and consumers. In what way does the mobile telephone, as an instrument for dialogue, a marketing device, and a promotional tool, affect our perception of public space? This article examines several initiatives that bring the mobile phone and cultural production together. One of these is titled “Focus: This Moment,” a program of eight short films by eight contemporary Chinese film directors made for mobile phone and Internet distribution. Another is “Connect to Art,” initiated by Nokia in September 2004 in Helsinki, continued in Monaco in December 2004, and then furthered again in Shanghai in May 2006 with the unveiling of four works by Chinese contemporary artists: Ai Weiwei, Yang Fudong, Zhang Peili, and Feng Mengbo. The article considers how mobile phone movies modify and enrich our understanding of cinema. This is thus an enquiry into the impact of digital technology on the mature film industry. Furthermore, the article asks how public space is enfolded in multiple contextual discourses that create the mobility and interface of the mobile phone.     

Multidimensional Human Dynamics in Mobile Phone Communications

In today''s technology-assisted society, social interactions may be expressed through a variety of techno-communication channels, including online social networks, email and mobile phones (calls, text messages). Consequently, a clear grasp of human behavior through the diverse communication media is considered a key factor in understanding the formation of the today''s information society. So far, all previous research on user communication behavior has focused on a sole communication activity. In this paper we move forward another step on this research path by performing a multidimensional study of human sociality as an expression of the use of mobile phones. The paper focuses on user temporal communication behavior in the interplay between the two complementary communication media, text messages and phone calls, that represent the bi-dimensional scenario of analysis. Our study provides a theoretical framework for analyzing multidimensional bursts as the most general burst category, that includes one-dimensional bursts as the simplest case, and offers empirical evidence of their nature by following the combined phone call/text message communication patterns of approximately one million people over three-month period. This quantitative approach enables the design of a generative model rooted in the three most significant features of the multidimensional burst - the number of dimensions, prevalence and interleaving degree - able to reproduce the main media usage attitude. The other findings of the paper include a novel multidimensional burst detection algorithm and an insight analysis of the human media selection process.     

Place-Based Attributes Predict Community Membership in a Mobile Phone Communication Network

Social networks can be organized into communities of closely connected nodes, a property known as modularity. Because diseases, information, and behaviors spread faster within communities than between communities, understanding modularity has broad implications for public policy, epidemiology and the social sciences. Explanations for community formation in social networks often incorporate the attributes of individual people, such as gender, ethnicity or shared activities. High modularity is also a property of large-scale social networks, where each node represents a population of individuals at a location, such as call flow between mobile phone towers. However, whether or not place-based attributes, including land cover and economic activity, can predict community membership for network nodes in large-scale networks remains unknown. We describe the pattern of modularity in a mobile phone communication network in the Dominican Republic, and use a linear discriminant analysis (LDA) to determine whether geographic context can explain community membership. Our results demonstrate that place-based attributes, including sugar cane production, urbanization, distance to the nearest airport, and wealth, correctly predicted community membership for over 70% of mobile phone towers. We observed a strongly positive correlation (r = 0.97) between the modularity score and the predictive ability of the LDA, suggesting that place-based attributes can accurately represent the processes driving modularity. In the absence of social network data, the methods we present can be used to predict community membership over large scales using solely place-based attributes.     

Mobile Phone Radiation Alters Proliferation of Hepatocarcinoma Cells

This study investigated the effects of intermittent exposure (15 min on, 15 min off for 1, 2, 3, or 4 h, at a specific absorption rate of 2 W/kg) to enhanced data rates for global system for mobile communication evolution-modulated radiofrequency radiation (RFR) at 900- and 1,800-MHz frequencies on the viability of the Hepatocarcinoma cells (Hep G2). Hep G2 cell proliferation was measured by a colorimetric assay based on the cleavage of the tetrazolium salt WST-1 by mitochondrial dehydrogenases in viable cells. Cell injury was evaluated by analyzing the levels of lactate dehydrogenase (LDH) and glucose released from lysed cells into the culture medium. Morphological observation of the nuclei was carried out by 4′,6-diamidino-2-phenylindole (DAPI) staining using fluorescence microscopy. In addition, TUNEL assay was performed to confirm apoptotic cell death. It was observed that cell viability, correlated with the LDH and glucose levels, changed according to the frequency and duration of RFR exposure. Four-hour exposure produced more pronounced effects than the other exposure durations. 1,800-MHz RFR had a larger impact on cell viability and Hep G2 injury than the RFR at 900 MHz. Morphological observations also supported the biochemical results indicating that most of the cells showed irregular nuclei pattern determined by using the DAPI staining, as well as TUNEL assay which shows DNA damage especially in the cells after 4 h of exposure to 1,800-MHz RFR. Our results indicate that the applications of 900- and 1,800-MHz (2 W/kg) RFR cause to decrease in the proliferation of the Hep G2 cells after 4 h of exposure. Further studies will be conducted on other frequency bands of RFR and longer duration of exposure.     

Stranger with a Camera

Stranger with. Camera. 2000. 60 minutes, color. video by Elizabeth Barret For more information, contact Appalshop Film Studios, 91 Madison Avenue, Whitesburg, KY 41858.     

手机支付在医院服务流程中的应用探讨

第三方手机支付平台正在打造的“未来医院计划”项目有望使患者可以在手机上完成挂号、候诊、缴费等环节，为患者就医提供便利。但与此同时，第三方手机支付平台也存在着如何克服支付主体资格不合法、支付安全无法保障以及患者隐私可能受到侵害等缺陷的难题。本文通过对第三方手机支付系统在医疗体系中应运的优缺点进行分析，旨在针对其在运作中存在的问题提出完善建议。     

Low-Cost Motility Tracking System (LOCOMOTIS) for Time-Lapse Microscopy Applications and Cell Visualisation

Direct visualisation of cells for the purpose of studying their motility has typically required expensive microscopy equipment. However, recent advances in digital sensors mean that it is now possible to image cells for a fraction of the price of a standard microscope. Along with low-cost imaging there has also been a large increase in the availability of high quality, open-source analysis programs. In this study we describe the development and performance of an expandable cell motility system employing inexpensive, commercially available digital USB microscopes to image various cell types using time-lapse and perform tracking assays in proof-of-concept experiments. With this system we were able to measure and record three separate assays simultaneously on one personal computer using identical microscopes, and obtained tracking results comparable in quality to those from other studies that used standard, more expensive, equipment. The microscopes used in our system were capable of a maximum magnification of 413.6×. Although resolution was lower than that of a standard inverted microscope we found this difference to be indistinguishable at the magnification chosen for cell tracking experiments (206.8×). In preliminary cell culture experiments using our system, velocities (mean µm/min ± SE) of 0.81±0.01 (Biomphalaria glabrata hemocytes on uncoated plates), 1.17±0.004 (MDA-MB-231 breast cancer cells), 1.24±0.006 (SC5 mouse Sertoli cells) and 2.21±0.01 (B. glabrata hemocytes on Poly-L-Lysine coated plates), were measured and are consistent with previous reports. We believe that this system, coupled with open-source analysis software, demonstrates that higher throughput time-lapse imaging of cells for the purpose of studying motility can be an affordable option for all researchers.     

用镜头去援助

Cristina Mittermeier的文字充满了诗意,然而镜头中却是深深的忧虑。她决心投入自己毕生的精力去保护地球上的自然资源之后,很快就意识到,用吸引眼球的图片比仅仅用科学更能有效应对环境所面临的挑战。关键的问题在于,对于自然保护摄影来说,使命感比技术更加重要。不仅要拍出经得起时间考验的照片,更要拍出能让自然界本身恒久存在下去的照片。这就是难度所在。她在雨林中的经历,完全可以写成一篇感人的小说,但是镜头说出了更为直接．更为强有力的故事,让人在感叹之余,想到了个体的生命和自然的家园那些无法割舍的关联,就像在都市的阳台上,可以看得见的亚马逊热带雨林。作为国际保护摄影师联盟的主席的Cristina Mittermeier,她所做的工作意义非凡,她正带动更多的人,从都市的阳台上走下来,走入亚马逊热带雨林,将人类忧虑的目光,一点点变成可以奶切实实拥抱的关爱。[编者按]     

Mobile Phone Use Behaviors and Postures on Public Transportation Systems

Mobile phones are common in our daily life, but the users’ preferences for postures or screen operating styles have not been studied. This was a cross-sectional and observational study. We randomly sampled passengers who used mobile phones on the Mass Rapid Transit (MRT) system in metropolitan Taipei. A checklist was used to observe their body postures and screen operating styles while sitting or standing. As a result, 1,230 subjects from 400 trips were observed. Overall, of all the passengers who were sitting, 41% of them were using mobile phones. The majority of the tasks involved browsing (84%) with their phones in a portrait orientation (93%). Different-hand holding/operating was the most commonly used operating style while sitting (46%) and same-hand holding/operating was the most common while standing (46%). The distribution of screen operating styles was significantly different for those sitting than for those standing and for different genders and age groups. The most frequently observed postures while sitting were having one’s trunk against a backrest, feet on the floor and with or without an arm supported (58%). As for the users who were standing, the both- and different-hands groups had a high proportion of arms unsupported, feet on the floor and either their trunk supported or not. In contrast, the same-hand group tended to have their trunk unsupported, were holding a pole or handstrap and had both feet on floor. Further studies are warranted to characterize the ergonomic exposure of these commonly used postures and operating styles, and our results will help guide the selection of experimental conditions for laboratory settings.     

Minimizing Leg-Hold Trapping Trauma for Otters With Mobile Phone Technology

ABSTRACT We present and evaluate a protocol for the capture of otters (Lutra lutra) using padded leg-hold traps coupled with Global System for Mobile communication (GSM) trap alarms. The trapping method was highly efficient, capturing 46 otters at 6.9 trap-nights each. Functioning alarms allowed us to remove 36 otters from their traps within 22 (SD = 14) minutes of capture. We caught 10 otters in trap sets with malfunctioning trap alarms and retrieved them the following morning, after ≤24 hours. Functioning alarms reduced the injuries suffered from an average cumulative score of 77.7 to just 5.5 on the International Organization for Standardization 10990-5 trauma scale (Z=-5.074, P ≤ 0.001). As a result, we strongly encourage the use of GSM trap alarms under the principle of refinement in animal experiments.     

Developing Prediction Equations and a Mobile Phone Application to Identify Infants at Risk of Obesity

Background

Advancements in knowledge of obesity aetiology and mobile phone technology have created the opportunity to develop an electronic tool to predict an infant’s risk of childhood obesity. The study aims were to develop and validate equations for the prediction of childhood obesity and integrate them into a mobile phone application (App).

Methods and Findings

Anthropometry and childhood obesity risk data were obtained for 1868 UK-born White or South Asian infants in the Born in Bradford cohort. Logistic regression was used to develop prediction equations (at 6±1.5, 9±1.5 and 12±1.5 months) for risk of childhood obesity (BMI at 2 years >91^st centile and weight gain from 0–2 years >1 centile band) incorporating sex, birth weight, and weight gain as predictors. The discrimination accuracy of the equations was assessed by the area under the curve (AUC); internal validity by comparing area under the curve to those obtained in bootstrapped samples; and external validity by applying the equations to an external sample. An App was built to incorporate six final equations (two at each age, one of which included maternal BMI). The equations had good discrimination (AUCs 86–91%), with the addition of maternal BMI marginally improving prediction. The AUCs in the bootstrapped and external validation samples were similar to those obtained in the development sample. The App is user-friendly, requires a minimum amount of information, and provides a risk assessment of low, medium, or high accompanied by advice and website links to government recommendations.

Conclusions

Prediction equations for risk of childhood obesity have been developed and incorporated into a novel App, thereby providing proof of concept that childhood obesity prediction research can be integrated with advancements in technology.     

Changes in Urination According to the Sound of Running Water Using a Mobile Phone Application

ObjectiveThe sound of running water (SRW) has been effectively used for toilet training during toddlerhood. However, the effect of SRW on voiding functions in adult males with lower urinary tract symptoms (LUTS) has not been evaluated. To determine the effect of SRW on urination in male patients with LUTS, multiple voiding parameters of uroflowmetry with postvoid residual urine (PVR) were assessed according to the presence of SRW played by a mobile application.MethodsEighteen consecutive male patients with LUTS were prospectively enrolled between March and April 2014. Uroflowmetry with PVR measured by a bladder scan was randomly performed once weekly for two consecutive weeks with and without SRW in a completely sealed room after pre-checked bladder volume was scanned to be more than 150 cc. SRW was played with river water sounds amongst relaxed melodies from a smartphone mobile application.ResultsThe mean age of enrolled patients and their mean International Prostate Symptom Score (IPSS) were 58.9 ± 7.7 years (range: 46–70) and 13.1 ± 5.9, respectively. All patients had not been prescribed any medications, including alpha-blockers or anti-muscarinic agents, in the last 3 months. There was a significant increase in mean peak flow rate (PFR) with SRW in comparison to without SRW (15.7 mL/s vs. 12.3 mL/s, respectively, p = 0.0125). However, there were no differences in other uroflowmetric parameters, including PVR.ConclusionsThe study showed that SRW from a mobile phone application may be helpful in facilitating voiding functions by increasing PFR in male LUTS patients.     

EEG Changes Due to Experimentally Induced 3G Mobile Phone Radiation

The aim of this study was to investigate whether a 15-minute placement of a 3G dialing mobile phone causes direct changes in EEG activity compared to the placement of a sham phone. Furthermore, it was investigated whether placement of the mobile phone on the ear or the heart would result in different outcomes. Thirty-one healthy females participated. All subjects were measured twice: on one of the two days the mobile phone was attached to the ear, the other day to the chest. In this single-blind, cross-over design, assessments in the sham phone condition were conducted directly preceding and following the mobile phone exposure. During each assessment, EEG activity and radiofrequency radiation were recorded jointly. Delta, theta, alpha, slowbeta, fastbeta, and gamma activity was computed. The association between radiation exposure and the EEG was tested using multilevel random regression analyses with radiation as predictor of main interest. Significant radiation effects were found for the alpha, slowbeta, fastbeta, and gamma bands. When analyzed separately, ear location of the phone was associated with significant results, while chest placement was not. The results support the notion that EEG alterations are associated with mobile phone usage and that the effect is dependent on site of placement. Further studies are required to demonstrate the physiological relevance of these findings.     

Spatiotemporal Detection of Unusual Human Population Behavior Using Mobile Phone Data

With the aim to contribute to humanitarian response to disasters and violent events, scientists have proposed the development of analytical tools that could identify emergency events in real-time, using mobile phone data. The assumption is that dramatic and discrete changes in behavior, measured with mobile phone data, will indicate extreme events. In this study, we propose an efficient system for spatiotemporal detection of behavioral anomalies from mobile phone data and compare sites with behavioral anomalies to an extensive database of emergency and non-emergency events in Rwanda. Our methodology successfully captures anomalous behavioral patterns associated with a broad range of events, from religious and official holidays to earthquakes, floods, violence against civilians and protests. Our results suggest that human behavioral responses to extreme events are complex and multi-dimensional, including extreme increases and decreases in both calling and movement behaviors. We also find significant temporal and spatial variance in responses to extreme events. Our behavioral anomaly detection system and extensive discussion of results are a significant contribution to the long-term project of creating an effective real-time event detection system with mobile phone data and we discuss the implications of our findings for future research to this end.