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The neonatal brain is a vulnerable organ, and lesions due to hemorrhage and/or ischemia occur frequently in preterm neonates. Even though neuroprotective therapies exist, there is no tool available to detect the ischemic lesions. To address this problem, we have recently designed and built the new time-domain near-infrared optical tomography (TD NIROT) system - Pioneer. Here we present the results of a phantom study of the system performance. We used silicone phantoms to mimic risky situations for brain lesions: hemorrhage and hypoxia. Employing Pioneer, we were able to reconstruct accurately both position and optical properties of these inhomogeneities.

BACKGROUND In modern society, we are increasingly exposed to numerous sources of blue light, including screens (e.g., TVs, computers, laptops, smartphones, tablets) and light from fluorescent and LED lamps. Due to this wide range of applications, the effects of blue light exposure (BLE) on the human physiology need to be thoroughly studied. AIM To investigate the impact of long-term BLE on frontal and occipital human cerebral hemodynamics and oxygenation using functional near-infrared spectroscopy (fNIRS) neuroimaging. MATERIALS AND METHODS 32 healthy right-handed subjects (20 females, 12 males; age: 23.8 ± 2.2 years) were exposed to blue LED light for 15 minutes. Before (baseline, 8 min) and after (recovery, 10 min) the BLE, subjects were in darkness. We measured the concentration changes of oxyhemoglobin ([O$_{2}$Hb]) and deoxyhemoglobin ([HHb]) at the prefrontal cortex (PFC) and visual cortex (VC) by fNIRS during the experiment. Subjects were then classified into different groups based on their hemodynamic response pattern of [O$_{2}$Hb] at the PFC and VC during BLE. RESULTS On the group level (32 subjects), we found an increase in [O$_{2}$Hb] and a decrease in [HHb] at both cortices during BLE. Evoked changes of [O$_{2}$Hb] were higher at the VC compared to the PFC. Eight different hemodynamic response patterns were detected in the subgroup analysis, while an increase of [O$_{2}$Hb] in both cortices was the most common pattern (8 out of 32 cases, 25%) during BLE. DISCUSSION AND CONCLUSION Our study showed that the hemodynamic and oxygenation changes at the PFC and VC during BLE (i) were generally higher in the VC compared to the PFC, (ii) showed an intersubject variability with respect to their magnitudes and shapes, and (iii) can be classified into eight groups. We conclude that blue light affects humans differently. It is essential to consider this when assessing the impact of the BLE on society.

The randomized clinical trial, SafeBoosC III, evaluates the effect of treatment guided by cerebral tissue oximetry monitoring in extremely preterm infants. Treatment should be considered, when cerebral oxygen saturation (StO2) drops below a predefined hypoxic threshold. This threshold value differs between different brands of instruments. To achieve high external validity, in this pragmatic trial all commercially available cerebral tissue oximeters have been accepted, provided their specific hypoxic threshold value has been determined in phantom studies. Since most companies produce sensors with an adhesive surface on the patient-contacting side, in the phantom studies these sensors were applied according to the specifications, i.e., the glossy cover was removed from the sensor. However, since the skin of preterm infants is particularly fragile, some neonatologists keep this cover on the adhesive sensors, to avoid the risk of skin injury when removing the sensor. Therefore, the aim of this study was to determine whether keeping this cover on leads to different StO2 values. To evaluate the effect of the cover, we performed multiple deoxygenations in a blood-lipid phantom and compared an INVOS neonatal sensor (Medtronic), with and without the cover, to a reference oximeter (OxiplexTS, ISS). As expected, the relationship of the StO2 between the INVOS neonatal sensor and OxiplexTS was linear (r2 = 0.999) with and without cover, but the cover influenced the linear equation: StO2_INVOS_cover = 1.133*StO2_ISS + 7.1 as opposed to StO2_INVOS_nocover = 1.103*StO2_ISS + 12.0. Furthermore, the hypoxic SafeBoosC III threshold differed as well: 60.3% with cover and 63.8% without cover. In conclusion, keeping the adhesive cover on an INVOS neonatal sensor results in lower measured values. At the hypoxic threshold, this is more than 3% (from 60.3% to 63.8%), and therefore, if clinicians keep the cover on the sensor, they need to be aware of this difference.