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Human cone-pigment spectral sensitivities and the reflectances of natural surfaces.

The evolution of visual pigment spectral sensitivities is probably influenced by the reflectance spectra of surfaces in the animal's environment. These reflectances, we conjecture, fall into three main classes: i. Most inorganic and many organic surfaces, including tree bark, dead leaves and animal melanin pigmentation, whose reflectance increases gradually as a function of wavelength. ii. Living leaves, which contain chlorophyll, have a sharp reflectance peak at about 555 nm. iii. Flowers, fruit and other signaling colours that have co-evolved with animal vision typically do not reflect strongly at the same wavelength as leaves, and present a colour contrast against a leafy background. These three spectral functions we call 'grey-red', 'leaf-green' and 'leaf-contrast' respectively. This simple categorisation allows us to interpret the spectral tuning of human cone pigments in a way that might not seem possible given the wide variety of colours present in nature. In particular L-(red) cones will capture the highest possible proportion of photons reflected by leaves, and M-(green) cones will capture about 10% fewer photons both from leaves and from 'grey-red' surfaces. These observations have some clear implications for our understanding of the evolution of trichomacy and the trade-off between chromatic and luminance vision in Old-World Primates.

Humans

Skin reflectance pulse oximetry: in vivo measurements from the forearm and calf.

This study describes the results from a series of human experiments demonstrating the ability to measure arterial hemoglobin oxygen saturation (SaO2) from the forearm and calf using a reflectance pulse oximeter sensor. A special optical reflectance sensor that includes a heating element was interfaced to a temperature controller and a commercial Data-scope ACCUSAT pulse oximeter that was adapted for this study to perform as a reflectance pulse oximeter. The reflectance pulse oximeter sensor was evaluated in a group of 10 healthy adult volunteers during steady-state hypoxia. Hypoxia was induced by gradually lowering the inspired fraction of oxygen in the breathing gas mixture from 100 to 12%. Simultaneous SaO2 measurements obtained from the forearm and calf with two identical reflectance pulse oximeters were compared with SaO2 values measured by a finger sensor that was interfaced to a standard Datascope ACCUSAT transmittance pulse oximeter. The equations for the best-fitted linear regression lines between the percent reflectance, SpO2(r), and transmittance, SpO2(t), values in the range between 73 and 100% were SpO2(r) = -7.06 + 1.09 SpO2(t) for the forearm (n = 91, r = 0.95) and SpO2(r) = 7.78 + 0.93 SpO2(t) for the calf (n = 93, r = 0.88). The regression analysis of the forearm data revealed a mean +/- SD error of 2.47 +/- 1.66% (SaO2 = 90-100%), 2.35 +/- 2.45% (SaO2 = 80-89%), and 2.42 +/- 1.20% (SaO2 = 70-79%). The corresponding regression analysis of the calf data revealed a mean +/- SD error of 3.36 +/- 3.06% (SaO2 = 90-100%), 3.45 +/- 4.12% (SaO2 = 80-89%), and 2.97 +/- 2.75% (SaO2 = 70-79%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Experimental and clinical evaluation of a noninvasive reflectance pulse oximeter sensor.

The objective of this study was to evaluate a new reflectance pulse oximeter sensor. The prototype sensor consists of 8 light-emitting diode (LED) chips (4 at 665 nm and 4 at 820 nm) and a photodiode chip mounted on a single substrate. The 4 LED chips for each wavelength are spaced at 90-degree intervals around the substrate and at an equal radial distance from the photodiode chip. An optical barrier between the photodiode and LED chips prevents a direct coupling effect between them. Near-infrared LEDs (940 nm) in the sensor warm the tissue. The microthermocouple mounted on the sensor surface measures the temperature of the skin-sensor interface and maintains it at a present level by servoregulating the current in the 940-nm LEDs. An animal study and a clinical study were performed. In the animal study, 5 mongrel dogs (weight, 10-20 kg) were anesthetized, mechanically ventilated, and cannulated. In each animal, arterial oxygen saturation (SaO2) was measured continuously by a standard transmission oximeter probe placed on the dog's earlobe and a reflectance oximeter sensor placed on the dog's tongue. In the first phase of the experiment, signals from the reflectance sensor were recorded while the dog was immersed in ice water until its body temperature decreased to 30 degrees C. In the second phase, the animal's body temperature was normal, and the oxygen content of the ventilator was varied to alter the SaO2. In the clinical study, 18 critically ill patients were monitored perioperatively with the prototype reflectance sensor. The first phase of the study investigated the relationship between local skin temperature and the accuracy of oximeter readings with the reflectance sensor. Each measurement was taken at a high saturation level as a function of local skin temperature. The second phase of the study compared measurements of oxygen saturation by a reflectance oximeter (SpO2[r]) with those made by a co-oximeter (SaO2[IL]) and a standard transmission oximeter (SpO2[t]). Linear regression analysis was used to determine the degree of correlation between (1) the pulse amplitude and skin temperature; (2) SpO2(r) and SaO2(IL); and (3) SpO2(t) and SaO2(IL). Student's t test was used to determine the significance of each correlation. The mean and standard deviation of the differences were also computed. In the animal study, pulse amplitude levels increased concomitantly with skin temperature (at 665 nm, r = 0.9424; at 820 nm, r = 0.9834; p < 0.001) and SpO2(r) correlated well with SaO2(IL) (r = 0.982; SEE = 2.54%; p < 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult

Reflection and transmission pulse oximetry during compromised peripheral perfusion.

The performance of a reflection pulse oximeter and a transmission pulse oximeter was assessed during open-heart surgery when cardiac output, peripheral temperature, pulse pressure, and systolic pressure were low and vascular resistance was high. Before and after extracorporeal circulation (ECC) there was no difference in ability of the sensors to obtain readings and no difference in the accuracy of those readings. During partial ECC, especially after coronary artery bypass grafting, the reflection sensor gave readings earlier and at a lower pulse pressure. In addition, the transmission sensor failed to give any readings for 2 patients on partial ECC, for whom the reflection sensor did give readings. The accuracy of heart rate (HR) data was comparable for both sensors before ECC; however, during partial ECC, the reflection sensor tended to give values closer to the electrocardiographic HR. The accuracy of saturation data given by the reflection oximeter was comparable to that of the transmission oximeter. It is concluded that the accuracy of the saturation and HR data provided by the two methods of pulse oximetry are comparable, but that the reflection sensor is more likely to obtain readings under conditions of poorer peripheral circulation.

Adult

Dynamic optical property changes: implications for reflectance feedback control of photocoagulation.

During laser treatment, coagulation affects the optical properties of the tissue. In particular, the formation of a white lesion significantly increases the scattering coefficient. This change in the optical properties in turn affects the laser light distribution in the tissue. The white lesion formed during photocoagulation of the retina has a dynamic effect upon reflection and fluence rate. This problem has been simulated on a model medium consisting of a thin absorbing layer covered with a 1 cm thick layer of albumin. The albumin layer is subdivided into coagulated (white) and uncoagulated (clear) layers. The optical properties of each layer have been determined and these values have been used to model light distribution in the medium. One-dimensional adding-doubling and three-dimensional Monte Carlo methods have provided light distributions in the medium for varying thicknesses of the coagulated albumin. Computed fluence reaching the absorbing layer decreased in the presence of a 275 microns or thicker coagulated layer. The coagulated layer attenuates light because it is highly scattering; however, this scattering also leads to a sub-surface peak in fluence rate at a level higher than the incident fluence. The latter effect outweighed the former for coagulated layer thicknesses less than 275 microns. Computed reflectance of argon laser light from a semi-infinite coagulated region initially increased linearly as a function of thickness. As the coagulation thickness increased beyond 4-5 optical depths, the reflectance approached a constant value, R infinity, at 9 optical depths (2 mm). Experimentally measured total reflectance is shown to be an inadequate indicator of the thickness of a lesion (finite coagulated volume); however, central reflectance from a lesion measured with a CCD camera confirmed the computed trends. These results provide a theoretical foundation for control of lesion thickness using reflectance images.

Argon

Comparison of reflection and transmission pulse oximetry after open-heart surgery.

OBJECTIVE: To determine if there was a difference between reflection and transmission pulse oximeters in their ability to regain data display after hypothermia in patients recovering from open-heart surgery. DESIGN: Prospective, randomized, controlled study. PATIENTS: Nineteen adult patients scheduled for open-heart surgery were studied immediately after surgery in the ICU. INTERVENTIONS: Transmission and reflection sensors were used in random order in two simultaneously monitoring identical oximeters and probes. The time difference at the start of display between the oximeters was measured and the skin temperatures in the region of the probes, cardiac index, systolic BP, pulse pressure, and systemic vascular resistance index were recorded. RESULTS: The mean skin temperatures at the probe sites differed significantly (p = .001) at the moment of data acquisition. The mean forehead, ear lobe, and fingertip temperatures (simultaneously measured) were 33.9 degrees C, 31.8 degrees C, and 28.8 degrees C, respectively. The hemodynamic variables were comparable at the moment when the oximeters resumed display. The reflection probe was the first to resume function in 12 patients and the transmission probe was the first to resume function in four patients (p less than .02). The bias of the reflection probe was 1.4% (SD 2.2) and that of the transmission probe was -0.4% (SD 2.7). All the patients were normoxic throughout the study. CONCLUSION: The forehead reflection probe regained signal detection earlier than the transmission probe on the ear lobe in patients with compromised peripheral blood flow and cool periphery. This finding may be due to higher skin temperature at the reflection probe site, since the systemic hemodynamic conditions were equal at the time of the data acquisition of both sensors.

Adult

Resentful and reflective coping with arbitrary authority and blood pressure: Detroit.

Two hypotheses about coping with an arbitrary authority, an angry boss, were tested: (1) styles of handling anger vary with social status, and (2) these styles are in turn related to blood pressure levels. Two styles of coping were tested: model R-R, Resentful vs. Reflective, and model I/O/R, Anger-In, Anger-Out, and Reflective. Handling an angry boss by Reflection is reported by more women than men, by those in middle-class areas rather than lower class, and does not vary by race. Working class report more use of Anger-Out than middle class who in turn report more use of Reflection. In general, the Anger-In response did not vary by race, sex, or area of residence (12-18%). For model R-R, Reflection of boss's anger was related to lower blood pressure when compared to Resentful responses, within sex, race, and residence groups. For model I/O/R, working-class, high stress persons who expressed Anger-Out showed the highest mean levels. Reflection is an appraisal response related to vascular and neural deceleration in stress experiments. This mode can be learned, and may aid in handling daily emotional-loaded stimuli to control blood pressure, along with learning a relaxation response.

Adaptation, Psychological

Anxiety, accuracy and reflection: the limits of professional development.

Reflection is a key concept in the development and maintenance of nursing expertise in theory and practice, yet commentators have rarely examined difficulties associated with it. This paper describes the role of reflection in nursing and relates it to information-processing accounts of human memory. The issues raised by the role of memory in mediating reflection are discussed, in the context of an examination of the importance of accuracy in reflection-on-practice. It is argued that anxiety is of particular importance in mediating accurate reflection. Whilst it is concluded that reflection is inherently flawed, a range of tactics to enhance it are explored, with particular emphasis on anxiety reduction and reduction of the burden of the memory task.

Anxiety

Skin reflectance in the newborn infant.

Skin reflectance in red, green, and blue light was measured at the sternum of 99 Caucasian infants ranging in gestational age from 26 to 44 weeks. Skin reflectance was consistently higher in female infants, but this difference was not statistically significant. Highly significant (P less than 0.001) increases in reflectance at all wave lengths were found when sternal reflectance during the first 48 hr of life was related to gestational age. The dispersion of data points about the regression line does not permit this method to be relied upon as the sole means of determining gestational age of infants. Serial studies indicate that reflectance increases in premature infants not given phototherapy, whereas premature infants receiving phototherapy show a fall in reflectance for the duration of therapy. This suggests that phototherapy may cause tanning of the skin.

Gestational Age

Noninvasive measurement of arterial oxyhemoglobin saturation with a heated and a non-heated skin reflectance pulse oximeter sensor.

The feasibility of measuring arterial oxyhemoglobin saturation (SaO2) noninvasively using a skin reflectance pulse oximeter sensor attached to the scalp, neck, and thigh regions of anesthetized swine was investigated. The optical reflectance sensor used consisted of a pair of red and infrared light-emitting diodes and a concentric array of six identical photodiodes. Two prototype sensor assemblies were evaluated: one assembly housed only the optical sensor, whereas the other also included a miniature heater. Measurements made from the scalp and neck regions were obtained with the non-heated skin reflectance sensor, and measurements from the thigh were made with the heated prototype. Each sensor was interfaced to a commercial transmittance pulse oximeter adapted to perform as a reflectance pulse oximeter. SaO2 values obtained by the reflectance pulse oximeters (SpO2(r) were compared simultaneously with SaO2 values obtained from arterial blood samples and analyzed in vitro with a CO-oximeter. The equations for the best-fitted linear regression lines describing the relationships between SpO2(r) and SaO2 values in the range between 30 and 100% were: SpO2(r) = 10.7 + 0.90 (SaO2), n = 321, r = 0.97; SpO2(r) = 16.72 + 0.82 (SaO2), n = 217, r = 0.95; and SpO2(r) = 20.21 + 0.77 (SaO2), n = 37, r = 0.97 for the neck, thigh, and scalp measurements, respectively. The regression analysis revealed significant correlation and a relatively small standard error of estimate (SEE = 4.05% for the neck, 4.79% for the thigh, and 3.50% for the scalp measurements). This study demonstrated the feasibility of measuring SaO2 noninvasively over a wide range of values utilizing the principle of reflectance pulse oximetry.

Animals

Arterial compliance and wave reflection.

Left ventricular "afterload" is the wall stress developed during systole by the ejecting ventricle. For any given ventricular conformation, this is given by the time course of pressure change in the left ventricle during ejection, and is approximated by the pressure measured in the ascending aorta. For a given flow ejection from the left ventricle, pressure generated in the ascending aorta is determined by the ascending aortic impedance. Impedance in turn is dependent on three properties of the systemic circulation--resistance, compliance and wave reflection. In conventional studies of left ventricular load and hypertension, attention is usually focussed entirely on peripheral resistance. Recent studies have shown a poor relationship between left ventricular mass and peripheral resistance, but a better relationship with compliance and indices of wave reflection. Hence compliance (or its inverse, aortic stiffness) and wave reflection must be considered in evaluating hypertension (especially "systolic hypertension") and the effects of drugs on ventricular load. Under ideal circumstances, as seen in youth, aortic compliance is high and wave reflection late, with the consequence that aortic systolic pressure is low and pressure is boosted throughout early diastole. With progressive aortic degeneration as seen with aging and in hypertension, systolic pressure in increased both directly by decreased compliance, and indirectly by early return of wave reflection. The effect of early wave reflection is not apparent from recordings of brachial systolic or diastolic pressure, but can be inferred from indirectly recorded carotid pressure, or from contour of the peripheral pressure wave.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries

Quantitative assessment of ultrasonic myocardial reflectivity in hypertrophic cardiomyopathy.

The purpose of this study was to investigate the relation between acoustic properties of the myocardium and magnitude of left ventricular hypertrophy in patients with hypertrophic cardiomyopathy. An on-line radio frequency analysis system was used to obtain quantitative operator-independent measurements of the integrated backscatter signal of the ventricular septum and posterior free wall in 25 patients with hypertrophic cardiomyopathy and 25 normal age-matched control subjects. The integrated values of the radio frequency signal were normalized for the pericardial interface and expressed in percent. Tissue reflectivity was significantly increased in the hypertrophied ventricular septum, as well as in the nonhypertrophied posterior free wall, in patients with hypertrophic cardiomyopathy (58 +/- 15% and 37 +/- 12%, respectively) compared with values in normal subjects (33 +/- 10% and 18 +/- 5%, respectively; p less than 0.001). Furthermore, measurements of reflectivity of the septum or posterior free wall, or both, were beyond 2 SD of normal values in greater than 90% of the patients and were also abnormal in each of the five study patients who had only mild and localized left ventricular hypertrophy. No correlation was identified between myocardial tissue reflectivity and left ventricular wall thickness in the patients with hypertrophic cardiomyopathy (correlation coefficient r = 0.4; p = NS). These findings demonstrate that myocardial reflectivity is abnormal in most patients with hypertrophic cardiomyopathy and is largely independent of the magnitude of left ventricular hypertrophy. Moreover, quantitative analysis of ultrasonic reflectivity can differentiate patients with hypertrophic cardiomyopathy from normal subjects independently of clinical features and conventional echocardiographic measurements.

Adolescent

Propagation velocity and reflection of pressure waves in the canine coronary artery.

In this study the pressure wave velocity in the anterior descending branch of the left coronary artery (LADC) of the dog was measured by determining the delay time between pressure pulses along this artery. This method can only be applied if reflections of the pressure wave distal to the sites of pressure measurement are insignificant. From araldite casts of the coronary arteries the following relation between the diameter proximal to (dprox) and distal to (ddist 1, ddist 2) a bifurcation was found: dprox2.55 = ddist12.55 + ddist 22.55, indicating that reflections at a bifurcation areminimal. In dogs reflections were studied by inducing during diastole a pressure pulse in the aorta and measuring pressure and volume flow proximal to and pressure distal to a segment of the LADC at various levels of the coronary peripheral resistance. Reflection of high-frequency components (greater than 7 Hz) was found to be insignificant, allowing application of the above-mentioned method for measuring the wave-front velocity, which is insensitive to low-frequency reflection. At a pressure in the LADC of 13.3 kPa this velocity was 8.6 +/- 1.4 m.s-1 (mean +/- SD). The calculated dynamic cross-sectional stiffness (deltaP/(deltaA/A)) of the LADC was 97 +/- 11 kPa (mean +/- SE) at an arterial pressure of 13.3 kPa.

Animals

Determination of serum bilirubin by skin reflectance: effect of pigmentation.

A noninvasive optical technique by which serum bilrubin can be estimated from skin spectral reflectance measurements has been further investigated. The original work on 30 healthy, full-term white infants and an independent study on 14 white and 30 black infants demonstrate that the method has potential not only for clinical use, but also for the study of the transport of bilrubin to, from and within the skin. The objectives of the present study are to evaluate the method on a larger sample population with special attention to natural skin pigmentation effects and the development of a physical model of the tissue to explain the relationship between serum bilrubin concentration and skin reflectance. Reflectance spectra (380-800 nm) and concurrent serum bilirubin measurements were taken on a sample population of 58 white and 45 full-term black infants (1-3 days of age). Multiple linear regression analysis, comprised of six wavelengths gave a correlation coefficient, r = 0.831 for the white infant group. For the black infant group, a five wavelength analysis provided r = 0.877 with the standard error of estimate being +/- 1.46 mg/100 ml for both groups. The model for establishing a physical basis for the relationship shows that a transformed, normalized Kubelka-Monk function xi (460, 510, 420) is linearly related to serum bilrubin concentration. This function is determined from the spectral reflectance values at three wavelengths, 420, 460, and 510 nm. The wavelength combination is such that effects due to hemoglobin and melanin pigments are minimized. Regression analysis showed that r = 0.778 and r = 0.865 for the white and black infant groups, respectively, with standard error of estimates being +/- 1.4 mg/100 ml for both groups. Routine determinations of total serum bilrubin by laboratory methods have standard errors of estimate ranging from +/- 1 to 1.5 mg/100 ml. Thus, the method herein described shows that the relationship between skin reflectance and serum bilrubin in full-term infants is close to the acceptable limits for clinical use. Furthermore, this work shows that skin pigmentation does not obscure this relationship.

Bilirubin

Saturation of colored samples at various levels of reflectance.

The dependence of saturation on the level of reflectance of colored surfaces was measured by numerical estimation and by matching judgments. Four sets of chromatic samples, one for each hue--blue, 460 nm, green, 510 nm, yellow, 580 nm, and red, 620 nm--within a range between 4% and 65% reflectance, were presented to the observers. The largest changes of saturation were observed at the high and low values of reflectance. The effect is more pronounced for the yellows than for the reds and greens, and relatively less apparent for the blues. For each hue, saturation grows faster at intermediate values of reflectance. The four families of saturation functions permitted us to draw a map of equal-purity contours. There are values of colorimetric purity for which saturation remains constant for all levels of reflectance.

Color Perception

Ageing and wave reflection.

AIM: To determine the effects of wave reflection on the increase in arterial pressure that occurs with age and its association with concomitant changes in both the magnitude and contour of the arterial pressure pulse. RESULTS OF DATA SURVEY: While age-related changes in mean pressure are similar in central and peripheral arteries, changes in pulse pressure and pulse waveform features are different. Because of the specific architectural, geometrical and elastic properties of the arterial vasculature, wave reflection plays an important role in determining peak pressure, the value usually specified as systolic pressure. While the late systolic increase usually determines peak systolic pressure in the central aorta, it is not necessarily related to the peak pressure in the periphery. Peak pressure depends on the timing and intensity of wave reflection, which is a function of the state of the peripheral microvasculature and the elastic properties of the large conduit arteries. Ageing causes changes in both the terminal and central vasculature, so that the intensity of the wave reflection and the transmission properties of arteries affect the arterial pulse to different degrees. Therefore, age-related changes that are observed in the central pressure pulse are different from those observed in the pulse when measured in a limb. Thus the contribution of wave reflection to the determination of peak arterial pressure is not the same at all locations. CONCLUSIONS: These findings have profound implications for therapeutic strategies aimed at altering systolic pressure and for a proper assessment of the alteration in cardiac load that occurs with age or with antihypertensive therapy, when measurements are taken in a limb.

Adult

Effect of perceptual processing strategies on problem solving of reflective and impulsive children.

Several studies employing the "20 questions" test reported that reflective children asked proportionally more constraint-seeking (CS) questions than did impulsive children. The finding was interpreted as supporting the generally accepted view that reflective children are more mature and more efficient problem solvers than impulsive children. Inexplicably, the reflectives' higher proportion of CS questions was not associated with fewer questions to solution, that is, with greater efficiency. The present study examined an alternative hypothesis that differences in performance of impulsive and reflective children on the "20 questions" test are due to individual differences in preferred perceptual processing strategy rather than in cognitive maturity of problem-solving strategy. Efficiency of performance of reflective and impulsive children was shown to be related to type of stimuli and experimental conditions employed, supporting a perceptual rather than cognitive-maturational interpretation.

Child

The effect of blood on ocular fundus reflectance and determination of some optical properties of retinal blood vessels.

Light reflected from 50 micrometer diameter spots on the fundi of two adult rhesus monkeys was measured as a function of wavelength in 10 nm jumps from 400 to 900 nm. The areas measured were a retinal artery and vein, areas of the disk, macula, and retina devoid of visible blood vessels, and the foveola. The eyes of the two monkeys were then exsanguinated, the blood vessels were filled with normal saline, and reflectances of the same spots on the fundi were again measured. The pairs of reflectance curves were compared and demonstrated that blood is not the major determinant of the characteristic shapes of the retinal tissue spectral reflectance curves. From the pre-exsanguination and postexsanguination data, the isolated retinal artery and vein wall reflectances were determined to be 0.020 and 0.009, respectively, their transmittances 0.837 and 0,977, and the fractions of light absorbed by them 0.143 and 0.014, respectively, in the visible spectral region below 500 nm.

Animals