BackgroundDiabetes mellitus is spreading throughout the world and diabetic individuals have been shown to often assess their food intake inaccurately; therefore, it is a matter of urgency to develop automated diet assessment tools. The recent availability of mobile phones with enhanced capabilities, together with the advances in computer vision, have permitted the development of image analysis apps for the automated assessment of meals. GoCARB is a mobile phone-based system designed to support individuals with type 1 diabetes during daily carbohydrate estimation. In a typical scenario, the user places a reference card next to the dish and acquires two images using a mobile phone. A series of computer vision modules detect the plate and automatically segment and recognize the different food items, while their 3D shape is reconstructed. Finally, the carbohydrate content is calculated by combining the volume of each food item with the nutritional information provided by the USDA Nutrient Database for Standard Reference.ObjectiveThe main objective of this study is to assess the accuracy of the GoCARB prototype when used by individuals with type 1 diabetes and to compare it to their own performance in carbohydrate counting. In addition, the user experience and usability of the system is evaluated by questionnaires.MethodsThe study was conducted at the Bern University Hospital, “Inselspital” (Bern, Switzerland) and involved 19 adult volunteers with type 1 diabetes, each participating once. Each study day, a total of six meals of broad diversity were taken from the hospital’s restaurant and presented to the participants. The food items were weighed on a standard balance and the true amount of carbohydrate was calculated from the USDA nutrient database. Participants were asked to count the carbohydrate content of each meal independently and then by using GoCARB. At the end of each session, a questionnaire was completed to assess the user’s experience with GoCARB.ResultsThe mean absolute error was 27.89 (SD 38.20) grams of carbohydrate for the estimation of participants, whereas the corresponding value for the GoCARB system was 12.28 (SD 9.56) grams of carbohydrate, which was a significantly better performance ( P=.001). In 75.4% (86/114) of the meals, the GoCARB automatic segmentation was successful and 85.1% (291/342) of individual food items were successfully recognized. Most participants found GoCARB easy to use.ConclusionsThis study indicates that the system is able to estimate, on average, the carbohydrate content of meals with higher accuracy than individuals with type 1 diabetes can. The participants thought the app was useful and easy to use. GoCARB seems to be a well-accepted supportive mHealth tool for the assessment of served-on-a-plate meals.

Individuals with type 1 diabetes (T1D) use prandial insulin doses to balance the effects of a meal.1 The meal's carbohydrate (CHO) content is a key factor in determining the optimal dose and maintaining normal blood glucose levels. According to clinical studies in insulin-depended children and adolescents, an error of ± 10 grams in CHO counting does not affect postprandial glycemia, 2 yet an error of ± 20 grams substantially impairs the postprandial control. Diabetics have to attend courses on CHO counting based on empirical rules; however even well trained patients face difficulties, according to studies. [4][5][6] In Brazeau et al, 4 the average error in CHO counting by 50 T1D adults was 15.4 ± 7.8 grams, while in Bishop et al 5 only 11 of 48 adolescent T1D patients estimated daily CHO with an error less than 10 grams. In a study involving children with T1D and their caregivers, CHO estimations were inaccurate by at least ± 15 grams for 27% of the meals. 6 The global spread of diabetes-together with the proven inability of diabetics to accurately assess their diet-raised the urgent need for automated tools and services that will support T1D patients with CHO counting. Recently, the ubiquity of smartphones with enhanced capabilities, along with recent advances in computer vision, has permitted the development of image analysis applications for automatic assessment of food intake. 7 The input of such a system consists of a few images or a short video of the upcoming meal, as captured by the user's smartphone. The data are then processed-either locally or on a remote server-to automatically assess the Abstract Background: Individuals with type 1 diabetes (T1D) have to count the carbohydrates (CHOs) of their meal to estimate the prandial insulin dose needed to compensate for the meal's effect on blood glucose levels. CHO counting is very challenging but also crucial, since an error of 20 grams can substantially impair postprandial control. Method: The GoCARB system is a smartphone application designed to support T1D patients with CHO counting of nonpacked foods. In a typical scenario, the user places a reference card next to the dish and acquires 2 images with his/her smartphone. From these images, the plate is detected and the different food items on the plate are automatically segmented and recognized, while their 3D shape is reconstructed. Finally, the food volumes are calculated and the CHO content is estimated by combining the previous results and using the USDA nutritional database. Results: To evaluate the proposed system, a set of 24 multi-food dishes was used. For each dish, 3 pairs of images were taken and for each pair, the system was applied 4 times. The mean absolute percentage error in CHO estimation was 10 ± 12%, which led to a mean absolute error of 6 ± 8 CHO grams for normal-sized dishes. Conclusion:The laboratory experiments demonstrated the feasibility of the GoCARB prototype system since the error was below the initial goal of 20 grams. However, further improvements and evaluation are needed pr...

51 counseling and counseling psychology faculty reported their allocation of time to various work activities and the number of manuscripts accepted for publication in the previous year. There was no gender difference in productivity. Time spent on teaching and service were comparable for high and low producers, but high producers reported spending 7 more hours per week working and spent that additional time on research. High producers spent twice as much time on research while producing seven times as many publications, suggesting a more effective use of research time. High producers' suggestions for efficient management of time are presented.

No abstract

No abstract