Kaylen J. Pfisterer

Kaylen J. Pfisterer, Robert Amelard, Jennifer Boger et al.

Half of long-term care (LTC) residents are malnourished increasing hospitalization, mortality, morbidity, with lower quality of life. Current tracking methods are subjective and time consuming. This paper presents the automated food imaging and nutrient intake tracking (AFINI-T) technology designed for LTC. We propose a novel convolutional autoencoder for food classification, trained on an augmented UNIMIB2016 dataset and tested on our simulated LTC food intake dataset (12 meal scenarios; up to 15 classes each; top-1 classification accuracy: 88.9%; mean intake error: -0.4 mL$\pm$36.7 mL). Nutrient intake estimation by volume was strongly linearly correlated with nutrient estimates from mass ($r^2$ 0.92 to 0.99) with good agreement between methods ($σ$= -2.7 to -0.01; zero within each of the limits of agreement). The AFINI-T approach is a deep-learning powered computational nutrient sensing system that may provide a novel means for more accurately and objectively tracking LTC resident food intake to support and prevent malnutrition tracking strategies.

Kaylen J Pfisterer, Robert Amelard, Audrey G Chung et al.

Malnutrition is a multidomain problem affecting 54% of older adults in long-term care (LTC). Monitoring nutritional intake in LTC is laborious and subjective, limiting clinical inference capabilities. Recent advances in automatic image-based food estimation have not yet been evaluated in LTC settings. Here, we describe a fully automatic imaging system for quantifying food intake. We propose a novel deep convolutional encoder-decoder food network with depth-refinement (EDFN-D) using an RGB-D camera for quantifying a plate's remaining food volume relative to reference portions in whole and modified texture foods. We trained and validated the network on the pre-labelled UNIMIB2016 food dataset and tested on our two novel LTC-inspired plate datasets (689 plate images, 36 unique foods). EDFN-D performed comparably to depth-refined graph cut on IOU (0.879 vs. 0.887), with intake errors well below typical 50% (mean percent intake error: -4.2%). We identify how standard segmentation metrics are insufficient due to visual-volume discordance, and include volume disparity analysis to facilitate system trust. This system provides improved transparency, approximates human assessors with enhanced objectivity, accuracy, and precision while avoiding hefty semi-automatic method time requirements. This may help address short-comings currently limiting utility of automated early malnutrition detection in resource-constrained LTC and hospital settings.

Kaylen J. Pfisterer, Jennifer Boger, Alexander Wong

In computer vision research, especially when novel applications of tools are developed, ethical implications around user perceptions of trust in the underlying technology should be considered and supported. Here, we describe an example of the incorporation of such considerations within the long-term care sector for tracking resident food and fluid intake. We highlight our recent user study conducted to develop a Goldilocks quality horizontal prototype designed to support trust cues in which perceived trust in our horizontal prototype was higher than the existing system in place. We discuss the importance and need for user engagement as part of ongoing computer vision-driven technology development and describe several important factors related to trust that are relevant to developing decision-making tools.

Kaylen J. Pfisterer, Robert Amelard, Braeden Syrnyk et al.

With one in four individuals afflicted with malnutrition, computer vision may provide a way of introducing a new level of automation in the nutrition field to reliably monitor food and nutrient intake. In this study, we present a novel approach to modeling the link between color and vitamin A content using transmittance imaging of a pureed foods dilution series in a computer vision powered nutrient sensing system via a fine-tuned deep autoencoder network, which in this case was trained to predict the relative concentration of sweet potato purees. Experimental results show the deep autoencoder network can achieve an accuracy of 80% across beginner (6 month) and intermediate (8 month) commercially prepared pureed sweet potato samples. Prediction errors may be explained by fundamental differences in optical properties which are further discussed.

Kaylen J. Pfisterer, Robert Amelard, Audrey G. Chung et al.

Dysphagia affects 590 million people worldwide and increases risk for malnutrition. Pureed food may reduce choking, however preparation differences impact nutrient density making quality assurance necessary. This paper is the first study to investigate the feasibility of computational pureed food nutritional density analysis using an imaging system. Motivated by a theoretical optical dilution model, a novel deep neural network (DNN) was evaluated using 390 samples from thirteen types of commercially prepared purees at five dilutions. The DNN predicted relative concentration of the puree sample (20%, 40%, 60%, 80%, 100% initial concentration). Data were captured using same-side reflectance of multispectral imaging data at different polarizations at three exposures. Experimental results yielded an average top-1 prediction accuracy of 92.2+/-0.41% with sensitivity and specificity of 83.0+/-15.0% and 95.0+/-4.8%, respectively. This DNN imaging system for nutrient density analysis of pureed food shows promise as a novel tool for nutrient quality assurance.

Robert Amelard, Richard L Hughson, Danielle K Greaves et al.

Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pulse (JVP) waveform offers important clinical information about cardiac health, but is not routinely examined due to its invasive catheterisation procedure. Here, we demonstrate for the first time that the JVP can be consistently observed in a non-contact manner using a novel light-based photoplethysmographic imaging system, coded hemodynamic imaging (CHI). While traditional monitoring methods measure the JVP at a single location, CHI's wide-field imaging capabilities were able to observe the jugular venous pulse's spatial flow profile for the first time. The important inflection points in the JVP were observed, meaning that cardiac abnormalities can be assessed through JVP distortions. CHI provides a new way to assess cardiac health through non-contact light-based JVP monitoring, and can be used in non-surgical environments for cardiac assessment.

Robert Amelard, Christian Scharfenberger, Farnoud Kazemzadeh et al.

Photoplethysmography (PPG) devices are widely used for monitoring cardiovascular function. However, these devices require skin contact, which restrict their use to at-rest short-term monitoring using single-point measurements. Photoplethysmographic imaging (PPGI) has been recently proposed as a non-contact monitoring alternative by measuring blood pulse signals across a spatial region of interest. Existing systems operate in reflectance mode, of which many are limited to short-distance monitoring and are prone to temporal changes in ambient illumination. This paper is the first study to investigate the feasibility of long-distance non-contact cardiovascular monitoring at the supermeter level using transmittance PPGI. For this purpose, a novel PPGI system was designed at the hardware and software level using ambient correction via temporally coded illumination (TCI) and signal processing for PPGI signal extraction. Experimental results show that the processing steps yield a substantially more pulsatile PPGI signal than the raw acquired signal, resulting in statistically significant increases in correlation to ground-truth PPG in both short- ($p \in [<0.0001, 0.040]$) and long-distance ($p \in [<0.0001, 0.056]$) monitoring. The results support the hypothesis that long-distance heart rate monitoring is feasible using transmittance PPGI, allowing for new possibilities of monitoring cardiovascular function in a non-contact manner.