A foundation model for generalizable disease detection from retinal images

[Absctract]: Medical artificial intelligence (AI) offers great potential for recognizing signs of health conditions in retinal images and expediting the diagnosis of eye diseases and systemic disorders1. However, the development of AI models requires substantial annotation and models are usually task-specific with limited generalizability to different clinical applications2. Here, we present RETFound, a foundation model for retinal images that learns generalizable representations from unlabelled retinal images and provides a basis for label-efficient model adaptation in several applications. Specifically, RETFound is trained on 1.6 million unlabelled retinal images by means of self-supervised learning and then adapted to disease detection tasks with explicit labels. We show that adapted RETFound consistently outperforms several comparison models in the diagnosis and prognosis of sight-threatening eye diseases, as well as incident prediction of complex systemic disorders such as heart failure and myocardial infarction with fewer labelled data. RETFound provides a generalizable solution to improve model performance and alleviate the annotation workload of experts to enable broad clinical AI applications from retinal imaging.We thank P. Rawlinson for project management, C. Green and L. Wickham for information governance expertise, and A. Wenban, S. St John-Green and M. Barnfield for information technology support. This work is supported by Engineering and Physical Sciences Research Council grant nos. EP/M020533/1, EP/R014019/1 and EP/V034537/1, as well as the NIHR UCLH Biomedical Research Centre. S.K.W. is supported by a Medical Research Council Clinical Research Training Fellowship (grant no. MR/TR000953/1). P.A.K. is supported by a Moorfields Eye Charity Career Development Award (grant no. R190028A) and a UK Research & Innovation Future Leaders Fellowship (grant no. MR/T019050/1). For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising.United Kingdom. Engineering and Physical Sciences Research Council; EP/M020533/1United Kingdom. Engineering and Physical Sciences Research Council; EP/R014019/1United Kingdom. Engineering and Physical Sciences Research Council; EP/V034537/1United Kingdom. Medical Research Council; MR/TR000953/1United Kingdom. Moorfields Eye Charity; R190028AUnited Kingdom. Future Leaders Fellowships; MR/T019050/

Predicting the sound insulation of lightweight sandwich panels

The sound insulation of three sandwich panels was modelled using simple sound insulation prediction methods, but the agreement between theory and experiment was not very good. The effective Young's modulus was determined over a wide frequency from the resonant frequencies of three beams of different lengths. The effective Young's modulus was found to reduce with increasing frequency as has been predicted in the literature. This decrease is due to the core starting to shear rather than bend because its Young's modulus is much less than the Young's moduli of the skins. Unfortunately the agreement between theory and experiment was still not very good. This is because many of the prediction frequencies occur in the critical frequency dip because of the variation of the Young's modulus with frequency

How to Reseed Utah Range Lands

Additional low cost forage is urgently needed by Utah\u27s range livestock industry. Seeding of depleted tracts in accordance with recently developed methods and principles will help supply this forage and is entirely feasible. Where the value of the increased forage will repay the cost of planting, careful reseeding of selected sites is fully justified. The important part that reseeding can play in restoring ranges to their former capacity has been demonstrated. Although satisfactory results can be obtained on many sites during average or better years, much more study is needed to insure consistent success in abnormal years and to extend reseeding to all ranges where it is needed. Present information, even when correctly applied, cannot eliminate failures, However, the chances for success will be best if the procedures and principles that have been developed are applied with discrimination and close attention is given to detail

Preserving Evolutionary History with Improved Confidence

We thank Faith (2019) and Mindell (2019) for their insightful perspectives on our study of the impact of phylogenetic imputation on the assessment of evolutionary distinctiveness (ED; Isaac et al., 2007). As Mindell highlights, the finding that ED scores for species on a phylogeny are remarkably robust despite having species missing from that phylogeny is encouraging; our results suggest that we can be confident in moving forward with prioritization of the species for which we have data. This is important because in some cases, for example, it may take considerable time to obtain samples from the missing species, resulting in further delay before the ED scores for those species already sampled can be used to inform management decisions. We cautioned, however, that the ED scores for those missing species may be imputed imprecisely, and so we gave guidelines for working with imputed species’ ED scores. With this in mind, we offer some additional thoughts resulting from the commentaries of Mindell and Faith

International Surgical Outcomes Study (ISOS) sub-study: post-operative infection (Statistical Analysis Plan)

This study will is a pre-specified secondary analysis of the International's Surgical Outcomes Study (ISOS). The aims of this analysis is to describe the prevalence of post-operative infection in an international sample of surgical patients. We will also investigate risk factors for the development of infection and the association between infection and morbidity and mortality following elective surgery

Human Factor and Usability Testing of a Binocular Optical Coherence Tomography System

PURPOSE: To perform usability testing of a binocular optical coherence tomography (OCT) prototype to predict its function in a clinical setting, and to identify any potential user errors, especially in an elderly and visually impaired population. METHODS: Forty-five participants with chronic eye disease (mean age 62.7 years) and 15 healthy controls (mean age 53 years) underwent automated eye examination using the prototype. Examination included 'whole-eye' OCT, ocular motility, visual acuity measurement, perimetry, and pupillometry. Interviews were conducted to assess the subjective appeal and ease of use for this cohort of first-time users. RESULTS: All participants completed the full suite of tests. Eighty-one percent of the chronic eye disease group, and 79% of healthy controls, found the prototype easier to use than common technologies, such as smartphones. Overall, 86% described the device to be appealing for use in a clinical setting. There was no statistically significant difference in the total time taken to complete the examination between participants with chronic eye disease (median 702 seconds) and healthy volunteers (median 637 seconds) (P = 0.81). CONCLUSION: On their first use, elderly and visually impaired users completed the automated examination without assistance. Binocular OCT has the potential to perform a comprehensive eye examination in an automated manner, and thus improve the efficiency and quality of eye care. TRANSLATIONAL RELEVANCE: A usable binocular OCT system has been developed that can be administered in an automated manner. We have identified areas that would benefit from further development to guide the translation of this technology into clinical practice

Tyre wear particles are toxic for us and the environment

This briefing paper discusses the current knowledge on the effects of tyre wear particles on our health and environment, highlights the need for an ambitious research agenda to build further understanding of the impacts on people and nature and develop solutions, and includes recommendations for policymakers