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Vishal Lakshminarayanan,1 Aswathy Ravikumar,1 Harini Sriraman,1 Sujatha Alla,2 Vijay Kumar Chattu3– 5 1School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, TN, India; 2Department of Engineering Management & Systems Engineering, Frank Batten College of Engineering, Old Dominion University, Norfolk, VA, 23529, USA; 3Center for Technology and Innovations, Global Health Research and Innovations Canada, Toronto, Ontario, M1J 2W8, Canada; 4Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; 5Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, IndiaCorrespondence: Harini Sriraman, School of Computer Science Engineering, Vellore Institute of Technology, Chennai, TN, India, Tel +91 044-39931228, Fax +91-044-39932555, Email harini.s@vit.ac.inAbstract: Intellectual capital is a scarce resource in the healthcare industry. Making the most of this resource is the first step toward achieving a completely intelligent healthcare system. However, most existing centralized and deep learning-based systems are unable to adapt to the growing volume of global health records and face application issues. To balance the scarcity of healthcare resources, the emerging trend of IoMT (Internet of Medical Things) and edge computing will be very practical and cost-effective. A full examination of the transformational role of intelligent edge computing in the IoMT era to attain health care equity is offered in this research. Intelligent edge computing-aided distribution and collaborative information management is a possible approach for a long-term digital healthcare system. Furthermore, IEC (Intelligent Edge Computing) encourages digital health data to be processed only at the edge, minimizing the amount of information exchanged with central servers/the internet. This significantly increases the privacy of digital health data. Another critical component of a sustainable healthcare system is affordability in digital healthcare. Affordability in digital healthcare is another key component of a sustainable healthcare system. Despite its importance, it has received little attention due to its complexity. In isolated and rural areas where expensive equipment is unavailable, IEC with AR / VR, also known as edge device shadow, can play a significant role in the inexpensive data collection process. Healthcare equity becomes a reality by combining intelligent edge device shadows and edge computing.Keywords: internet of things, machine learning, distributed computing, equitable healthcare, digital health

Janarthanam Jothi Balaji,1 Rajiv Raman,2 Vasudevan Lakshminarayanan3 1Department of Optometry, Medical Research Foundation, Chennai, Tamil Nadu, 600006, India; 2Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, 600006, India; 3Theoretical and Experimental Epistemology Lab, School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, CanadaCorrespondence: Janarthanam Jothi Balaji, Department of Optometry, Medical Research Foundation, 18, College Road, Nungambakkam, Chennai, Tamil Nadu, 600006, India, Tel +91 44-42271500, Email jothibalaji@gmail.comBackground: Posterior vitreous detachment (PVD) can result in serious pathologic events at the vitreoretinal interface. This study aims to assess the relationship between PVD, macular thickness (MT), and the foveal avascular zone (FAZ) in myopic eyes.Methods: This retrospective study evaluated 63 myopic subjects’ data who were examined between January 1 and June 30, 2019. The myopes were grouped on a severity scale, namely mild, moderate, high, and very high using their spherical equivalent (SE). The PVD classification was based on OCT images. The status of the PVD and MT were evaluated with the Macular Cube 200× 200 images, the FAZ with an OCTA Angioplex, and the dimensions were calculated using a customized algorithm.Results: The study population (114 eyes) had a median (range) age was 26.00 (22.00– 28.00) years and the females constituted 62.3% of the dataset. In this population, 10 eyes had no PVD in any quadrant, and 73 eyes had incomplete PVD in all four quadrants. The inferior quadrant had the maximum rate of PVD occurrences and the nasal quadrant had the least number of occurrences. High myopic eyes exhibited significantly increased low foveal volume (p = < 0.01). The inferior part of the para- and perimacular area showed a significant thinning in very high myopic eyes (p = < 0.050). The very high myopic eyes showed a significant alteration of FAZ’s circularity index (p = 0.002).Conclusion: In high and very high myopic eyes, an increasing trend of partial PVD is seen, most commonly in the inferior quadrant. A significant alteration in foveal volume and circularity index of the FAZ is seen in high and very high myopic eyes.Keywords: posterior vitreous detachment, foveal avascular zone, OCT, macular thickness, myopia

VK Viekash,1 Janarthanam Jothi Balaji,2 Vasudevan Lakshminarayanan3 1Department of Instrumentation and Control Engineering, National Institute of Technology, Tiruchirappalli, Tamil Nadu, 620015, India; 2Department of Optometry, Medical Research Foundation, Chennai, Tamil Nadu, 600 006, India; 3Theoretical and Experimental Epistemology Lab, School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, N2L 3G1, CanadaCorrespondence: Janarthanam Jothi Balaji Tel +91 44-42271500Email jothibalaji@gmail.comIntroduction: Various ocular diseases and high myopia influence the anatomical reference point Foveal Avascular Zone (FAZ) dimensions. Therefore, it is important to segment and quantify the FAZs dimensions accurately. To the best of our knowledge, there is no automated tool or algorithms available to segment the FAZ’s deep retinal layer. The paper describes a new open-access software with a Graphical User Interface (GUI) and compares the results with the ground truth (manual segmentation).Methods: Ninety-three healthy normal subjects included 30 emmetropia and 63 myopic subjects without any sight-threatening retinal conditions, were included in the study. The 6mm x 6mm using the Angioplex protocol (Cirrus 5000 Carl Zeiss Meditec Inc., Dublin, CA) was used, and all the images were aligned with the centre of the fovea. Each FAZ image corresponding to dimensions 420× 420 pixels were used in this study. These FAZ image dimensions for the superficial and deep layers were quantified using the New Automated Software Method (NAM). The NAM-based FAZ dimensions were validated with the ground truth.Results: The age distribution for all 93 subjects was 28.02 ± 10.79 (range, 10.0– 66.0) years. For normal subjects mean ± SD age distribution was 32.13 ± 16.27 years. Similarly, the myopia age distribution was 26.06 ± 6.06 years. The NAM had an accuracy of 91.40%. Moreover, the NAM on superficial layer FAZ gave a Dice Similarity Coefficient (DSC) score of 0.94 and Structural Similarity Index Metric (SSIM) of 0.97, while the NAM on deep layer FAZ gave a DSC score of 0.96 and SSIM of 0.98.Conclusion: A clinician-based GUI software was designed and tested on the FAZ images from deep and superficial layers. The NAM outperformed the device’s inbuilt algorithm when measuring the superficial layer. This open-source software package is in the public domain and can be downloaded online.Keywords: image processing, foveal avascular zone, optical coherence tomography angiography, superficial retinal layer, deep retinal layer

Janarthanam Jothi Balaji,1 Vasudevan Lakshminarayanan2 1Department of Optometry, Medical Research Foundation, Chennai, Tamil Nadu, 600006, India; 2Theoretical and Experimental Epistemology Lab, School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, CanadaCorrespondence: Janarthanam Jothi BalajiDepartment of Optometry, Medical Research Foundation, Chennai, Tamil Nadu, 600006, IndiaTel +91-44-4227-1500Fax +91-44-2825-4180Email jothibalaji@gmail.comIntroduction: Optic disc tilt (ODT) or tilted optic disc is a common finding in the general population. It is due to anomalous development caused by the malclosure of the embryonic optic fissure. ODT is commonly associated with high myopia as well as other conditions. In recent days, the common method to image the optic disc (OD) is by optical coherence tomography (OCT). To the best of our knowledge, there are no datasets of ODT available in the public domain. This dataset aims to make open access raw ODT OCT images to test out new image processing segmentation algorithms.Methods: This dataset of ODT images contains both horizontal and vertical cross-sectional images obtained using spectral-domain optical coherence tomography (SD-OCT, Cirrus 5000, Carl Zeiss Meditec Inc., Dublin, CA). The optic disc cube 200× 200 program was used and all the images are aligned with the center of the optic nerve head. This dataset includes images from both clinically normal (20 eyes) and myopic subjects (101 eyes).Results: The dataset consists of clear (121) and manually marked (121) images resulting in a total of 242 images. The age distribution for all subjects combined is 27.24 ± 9.28 (range, 11.0– 69.0) years. For normal subjects mean ± SD age distribution is 32.40 ± 17.23 years. Similarly, the myopia age distribution is 26.22 ± 6.37 years. Ground truth images, ie, manually segmented by a clinical expert are provided along with other meta-data includes age, gender, laterality, refractive error classification, spherical equivalent (SE), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length (AXL).Conclusion: This open, public database is online at the ICPSR website of the University of Michigan. The dataset can be used to test and validate newly developed automated segmentation algorithms.Keywords: optic disc tilt, high myopia, image segmentation, image database, ophthalmology, optical coherence tomography

Asmaa Bakroon,1 Vasudevan Lakshminarayanan1–3 1Theoretical and Experimental Epistemology Laboratory, School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada; 2Departments of Physics and Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada; 3Department of Computer Engineering, University of Waterloo, Waterloo, ON, Canada Abstract: There is a rapid increase in the number of individuals with high-functioning autism (HFA). Research on motion perception in HFA has shown deficits in processing motion information at the higher visual cortical areas (V5/middle temporal). Several hypotheses have been put forth to explain these deficits as being due to enhanced processing of small details at the expense of the global picture or as a global integration abnormality. However, there is a lot of variability in the results obtained from experiments designed to study motion in adults with autism. These could be due to the inherent diagnostic differences within even the same range of the autism spectrum and/or due to comparison of different experimental paradigms whose processing by the same visual neural areas could be different. In this review, we discuss the various results on motion processing in HFA, as well as the theories of motion perception in autism. Keywords: autism-spectrum disorder, high-functioning autism, motion perception, biological motion, form perception, random-dot kinematogram, local motion, global motion

Ahmed Almazroa,1,2 Weiwei Sun,3 Sami Alodhayb,4 Kaamran Raahemifar,5 Vasudevan Lakshminarayanan6 1King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; 2Ophthalmology and Visual Science Department, University of Michigan, Ann Arbor, MI, USA; 3School of Resource and Environmental Sciences, Wuhan University, Wuchang, Wuhan, Hubei, China; 4Bin Rushed Ophthalmic Center, Riyadh, Saudi Arabia; 5Department of Electrical and Computer Engineering, University of Ryerson, Toronto, ON, 6School of Optometry, University of Waterloo, ON, Canada Abstract: Segmenting the optic disc (OD) is an important and essential step in creating a frame of reference for diagnosing optic nerve head pathologies such as glaucoma. Therefore, a reliable OD segmentation technique is necessary for automatic screening of optic nerve head abnormalities. The main contribution of this paper is in presenting a novel OD segmentation algorithm based on applying a level set method on a localized OD image. To prevent the blood vessels from interfering with the level set process, an inpainting technique was applied. As well an important contribution was to involve the variations in opinions among the ophthalmologists in detecting the disc boundaries and diagnosing the glaucoma. Most of the previous studies were trained and tested based on only one opinion, which can be assumed to be biased for the ophthalmologist. In addition, the accuracy was calculated based on the number of images that coincided with the ophthalmologists’ agreed-upon images, and not only on the overlapping images as in previous studies. The ultimate goal of this project is to develop an automated image processing system for glaucoma screening. The disc algorithm is evaluated using a new retinal fundus image dataset called RIGA (retinal images for glaucoma analysis). In the case of low-quality images, a double level set was applied, in which the first level set was considered to be localization for the OD. Five hundred and fifty images are used to test the algorithm accuracy as well as the agreement among the manual markings of six ophthalmologists. The accuracy of the algorithm in marking the optic disc area and centroid was 83.9%, and the best agreement was observed between the results of the algorithm and manual markings in 379 images. Keywords: optic disc, image segmentation, RIGA dataset, glaucoma, level set, image inpainting

Ahmed Almazroa,1 Sami Alodhayb,2 Kaamran Raahemifar,3 Vasudevan Lakshminarayanan1 1School of Optometry and Vision Science, University of Waterloo, Canada; 2Binrushd Ophthalmic Center, Riyadh, Saudi Arabia; 3Department of Electrical Engineering, Ryerson University, Toronto, Canada Abstract: We introduce here a new technique for segmenting optic cup using two-dimensional fundus images. Cup segmentation is the most challenging part of image processing of the optic nerve head due to the complexity of its structure. Using the blood vessels to segment the cup is important. Here, we report on blood vessel extraction using first a top-hat transform and Otsu’s segmentation function to detect the curves in the blood vessels (kinks) which indicate the cup boundary. This was followed by an interval type-II fuzzy entropy procedure. Finally, the Hough transform was applied to approximate the cup boundary. The algorithm was evaluated on 550 fundus images from a large dataset, which contained three different sets of images, where the cup was manually marked by six ophthalmologists. On one side, the accuracy of the algorithm was tested on the three image sets independently. The final cup detection accuracy in terms of area and centroid was calculated to be 78.2% of 441 images. Finally, we compared the algorithm performance with manual markings done by the six ophthalmologists. The agreement was determined between the ophthalmologists as well as the algorithm. The best agreement was between ophthalmologists one, two and five in 398 of 550 images, while the algorithm agreed with them in 356 images. Keywords: optic cup, image segmentation, glaucoma, blood vessel kinks, fuzzy type-II thresholding, retinal fundus images, optic disk

The present study highlights the first time use of hybrid synergy electrocatalysis to design a cost effective, non-enzymatic ethanol sensor. The nanohybrid has been synthesized by decorating platinum palladium bimetallic nanoparticles (Pt-PdNPs) on graphene nanosheets (G/Pt-PdNPs). Field emission scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy, electrochemical measurements and UV-Vis spectrophotometry have been used to characterize the nanocomposite. An ethanol oxidation current of 332 [micro]A was obtained with the use of G/Pt- PdNPs modified glassy carbon electrode (GCE) that is 167 times higher than that of bare GCE in cyclic voltammetry studies with a potential scan rate of 50 mV/s in 0.1 M NaOH as the supporting electrolyte. Chronoamperometry studies have shown a distinct increase in the current for increasing concentration of ethanol with a wide range of linearity extending from 5 mM to 3 M and a detection limit of 1 mM with the use of G/Pt- PdNPs. Quantum mechanical modeling using density functional theory was used to arrive at the minimization energies of G/Pd, G/Pt and G/Pt-Pd in the presence and absence of ethanol. The improved catalytic activity of G/Pt-PdNPs nanocomposite for ethanol detection is on account of the cooperative effects of Pt and PdNPs, coupled with the high conducting nature of graphene. Keywords: ethanol sensor, graphene, palladium, platinum DOI: 10.1134/S1061934818030073, Ethanol determination plays an important role in medicine, forensic science, brewing, food fermentation, beverage industry, clinical laboratory and traffic safety [1]. Therefore development of a sensitive and selective ethanol sensor [...]

A laboratory experiment is described in which students fabricate disk-shaped gold and platinum microelectrodes with diameters of 10-50 [mu]m by sealing sodalime glass with metal microwires. The electrodes are characterized by performing cyclic voltammetry in aqueous and acetonitrile solution. Commercial microelectrodes are expensive (cost depends on the diameter of electrode) and may deter introduction of voltammetric experiments into laboratory classes at the undergraduate level. The students also fabricate a simple operational amplifier (op amp)-based potentiostat along with a low-current measuring device. This low-cost fabrication helps the students understand the details of instrumentation of a potentiostat with special knowledge in analog electronics. This experiment can be included in the electrochemistry laboratory course for undergraduate students. This experiment can also be incorporated into various undergraduate laboratory courses such as analytical chemistry, general chemistry, biochemistry, physical chemistry, and instrumentational methods of analysis. (Contains 1 table and 4 figures.)