Automated detection of proliferative retinopathy in clinical practice

Timely intervention for diabetic retinopathy (DR) lessens the possibility of blindness and can save considerable costs to health systems. To ensure that interventions are timely and effective requires methods of screening and monitoring pathological changes, including assessing outcomes. Fractal analysis, one method that has been studied for assessing DR, is potentially relevant in today’s world of telemedicine because it provides objective indices from digital images of complex patterns such as are seen in retinal vasculature, which is affected in DR. We introduce here a protocol to distinguish between nonproliferative (NPDR) and proliferative (PDR) changes in retinal vasculature using a fractal analysis method known as local connected dimension (Dconn) analysis. The major finding is that compared to other fractal analysis methods, Dconn analysis better differentiates NPDR from PDR (p = 0.05). In addition, we are the first to show that fractal analysis can be used to differentiate between NPDR and PDR using automated vessel identification. Overall, our results suggest this protocol can complement existing methods by including an automated and objective measure obtainable at a lower level of expertise that experts can then use in screening for and monitoring DR

Damage detection via shortest-path network sampling

Large networked systems are constantly exposed to local damages and failures that can alter their functionality. The knowledge of the structure of these systems is, however, often derived through sampling strategies whose effectiveness at damage detection has not been thoroughly investigated so far. Here, we study the performance of shortest-path sampling for damage detection in large-scale networks. We define appropriate metrics to characterize the sampling process before and after the damage, providing statistical estimates for the status of nodes (damaged, not damaged). The proposed methodology is flexible and allows tuning the trade-off between the accuracy of the damage detection and the number of probes used to sample the network. We test and measure the efficiency of our approach considering both synthetic and real networks data. Remarkably, in all of the systems studied, the number of correctly identified damaged nodes exceeds the number of false positives, allowing us to uncover the damage precisely

Router-level community structure of the Internet Autonomous Systems

The Internet is composed of routing devices connected between them and organized into independent administrative entities: the Autonomous Systems. The existence of different types of Autonomous Systems (like large connectivity providers, Internet Service Providers or universities) together with geographical and economical constraints, turns the Internet into a complex modular and hierarchical network. This organization is reflected in many properties of the Internet topology, like its high degree of clustering and its robustness. In this work, we study the modular structure of the Internet router-level graph in order to assess to what extent the Autonomous Systems satisfy some of the known notions of community structure. We show that the modular structure of the Internet is much richer than what can be captured by the current community detection methods, which are severely affected by resolution limits and by the heterogeneity of the Autonomous Systems. Here we overcome this issue by using a multiresolution detection algorithm combined with a small sample of nodes. We also discuss recent work on community structure in the light of our results

Abnormal Remodeling of Subcutaneous Small Arteries Is Associated With Early Diastolic Impairment in Metabolic Syndrome

Background Small artery pathophysiology is frequently invoked as a cause of obesity‐related diastolic heart failure. However, evidence to support this hypothesis is scant, particularly in humans. Methods and Results To address this, we studied human small artery structure and function in obesity and looked for correlations between vascular parameters and diastolic function. Seventeen obese patients with metabolic syndrome and 5 control participants underwent echocardiography and subcutaneous gluteal fat biopsy. Small arteries were isolated from the biopsy and pressure myography was used to study endothelial function and wall structure. In comparison with the control group, small arteries from obese participants exhibited significant endothelial dysfunction, assessed as the vasodilatory response to acetylcholine and also pathological growth of the wall. For the obese participants, multiple regression analysis revealed an association between left atrial volume and both the small artery wall thickness (β=0.718, P =0.02) and wall‐to‐lumen ratio (β=0.605, P =0.02). Furthermore, the E:E′ ratio was associated with wall‐to‐lumen ratio (β=0.596, P =0.02) and inversely associated with interleukin‐6 (β=−0.868, P =0.03). By contrast, endothelial function did not correlate with any of the echocardiographic parameters studied. Conclusions Although the small arteries studied were not cardiac in origin, our results support a role for small artery remodeling in the development of diastolic dysfunction in humans. Further direct examination of the structure and function of the myocardial resistance vasculature is now warranted, to elucidate the temporal association between metabolic risk factors, small artery injury, and diastolic impairment. </jats:sec

A novel method of using accelerometry for upper limb FES control.

This paper reports on a novel approach to using a 3-axis accelerometer to capture body segment angle for upper limb functional electrical stimulation (FES) control. The approach calculates the angle between the accelerometer x -axis and the gravity vector, while avoiding poor sensitivity at certain angles and minimizing errors when true acceleration is relatively large in comparison to gravity. This approach was incorporated into a state-machine controller which is used for the real-time control of FES during up- per limb functional task performance. An experimental approach was used to validate the new method. Two participants with different upper limb impairments resulting from a stroke carried out four different FES-assisted tasks. Comparisons were made between angle calculated from arm-mounted accelerometer data using our algorithm and angle calculated from limb-mounted reflective marker data. After removal of coordinate misalignment error, mean error across tasks and subjects ranged between 1.4 and 2.9 °. The approach shows promise for use in the control of upper limb FES and other human movement applications where true acceleration is relatively small in comparison with gravity

Steering hyper-giants' traffic at scale

Large content providers, known as hyper-giants, are responsible for sending the majority of the content traffic to consumers. These hyper-giants operate highly distributed infrastructures to cope with the ever-increasing demand for online content. To achieve 40 commercial-grade performance of Web applications, enhanced end-user experience, improved reliability, and scaled network capacity, hyper-giants are increasingly interconnecting with eyeball networks at multiple locations. This poses new challenges for both (1) the eyeball networks having to perform complex inbound traffic engineering, and (2) hyper-giants having to map end-user requests to appropriate servers. We report on our multi-year experience in designing, building, rolling-out, and operating the first-ever large scale system, the Flow Director, which enables automated cooperation between one of the largest eyeball networks and a leading hyper-giant. We use empirical data collected at the eyeball network to evaluate its impact over two years of operation. We find very high compliance of the hyper-giant to the Flow Director’s recommendations, resulting in (1) close to optimal user-server mapping, and (2) 15% reduction of the hyper-giant’s traffic overhead on the ISP’s long-haul links, i.e., benefits for both parties and end-users alike.EC/H2020/679158/EU/Resolving the Tussle in the Internet: Mapping, Architecture, and Policy Making/ResolutioNe