Abstract: Endoscopic estimation of the degree of stenosis in central airway obstruction is subjective and highly variable. Objective: To determine the benefits of using SENSA (System for Endoscopic Stenosis Assessment), an image-based computational software, for obtaining objective stenosis index (SI) measurements among a group of expert bronchoscopists and general pulmonologists. Methods: A total of 7 expert bronchoscopists and 7 general pulmonologists were enrolled to validate SENSA usage. The SI obtained by the physicians and by SENSA were compared with a reference SI to set their precision in SI computation. We used SENSA to efficiently obtain this reference SI in 11 selected cases of benign stenosis. A Web platform with three user-friendly microtasks was designed to gather the data. The users had to visually estimate the SI from videos with and without contours of the normal and the obstructed area provided by SENSA. The users were able to modify the SENSA contours to define the reference SI using morphometric bronchoscopy. Results: Visual SI estimation accuracy was associated with neither bronchoscopic experience (p = 0.71) nor the contours of the normal and the obstructed area provided by the system (p = 0.13). The precision of the SI by SENSA was 97.7% (95% CI: 92.4-103.7), which is significantly better than the precision of the SI by visual estimation (p < 0.001), with an improvement by at least 15%. Conclusion: SENSA provides objective SI measurements with a precision of up to 99.5%, which can be calculated from any bronchoscope using an affordable scalable interface. Providing normal and obstructed contours on bronchoscopic videos does not improve physicians' visual estimation of the SI.

Abstract: Outlier detection is essential for optimal performance of machine learning methods and statistical predictive models. Their detection is especially determinant in small sample size unbalanced problems, since in such settings outliers become highly influential and significantly bias models. This particular experimental settings are usual in medical applications, like diagnosis of rare pathologies, outcome of experimental personalized treatments or pandemic emergencies. In contrast to population-based methods, neighborhood based local approaches compute an outlier score from the neighbors of each sample, are simple flexible methods that have the potential to perform well in small sample size unbalanced problems. A main concern of local approaches is the impact that the computation of each sample neighborhood has on the method performance. Most approaches use a distance in the feature space to define a single neighborhood that requires careful selection of several parameters, like the number of neighbors.
This work presents a local approach based on a local measure of the heterogeneity of sample labels in the feature space considered as a topological manifold. Topology is computed using the communities of a weighted graph codifying mutual nearest neighbors in the feature space. This way, we provide with a set of multiple neighborhoods able to describe the structure of complex spaces without parameter fine tuning. The extensive experiments on real-world and synthetic data sets show that our approach outperforms, both, local and global strategies in multi and single view settings.

Abstract: This paper presents a patient-sensitive simulation strategy capable of using the most efficient way the high-performance computational resources. The proposed strategy directly involves three different players: Computational Mechanics Scientists (CMS), Image Processing Scientists and Cardiologists, each one mastering its own expertise area within the project. This paper describes the general integrative scheme but focusing on the CMS side presents a massively parallel implementation of computational electrophysiology applied to cardiac tissue simulation. The paper covers different angles of the computational problem: equations, numerical issues, the algorithm and parallel implementation. The proposed methodology is illustrated with numerical simulations testing all the different possibilities, ranging from small domains up to very large ones. A key issue is the almost ideal scalability not only for large and complex problems but also for medium-size meshes. The explicit formulation is particularly well suited for solving this highly transient problems, with very short time-scale.

Abstract: Despite recovering a normal coronary flow after acute myocardial infarction, percutaneous coronary intervention does not guarantee a proper perfusion (irrigation) of the infarcted area. This damage in microcirculation integrity may detrimentally affect the patient survival. Visual assessment of the myocardium opacification in contrast angiography serves to define a subjective score of the microcirculation integrity myocardial blush analysis (MBA). Although MBA correlates with patient prognosis its visual assessment is a very difficult task that requires of a highly expertise training in order to achieve a good intraobserver and interobserver agreement. In this paper, we provide objective descriptors of the myocardium staining pattern by analyzing the spectrum of the image local statistics. The descriptors proposed discriminate among the different phenomena observed in the angiographic sequence and allow defining an objective score of the myocardial perfusion.

Abstract: An efficient snake formulation should conform to the idea of picking the smoothest curve among all the shapes approximating an object of interest. In current geodesic snakes, the regularizing curvature also affects the convergence stage, hindering the latter at concave regions. In the present work, we make use of characteristic functions to define a novel geodesic formulation that decouples regularity and convergence. This term decoupling endows the snake with higher adaptability to non-convex shapes. Convergence is ensured by splitting the definition of the external force into an attractive vector field and a repulsive one. In our paper, we propose to use likelihood maps as approximation of characteristic functions of object appearance. The better efficiency and accuracy of our decoupled scheme are illustrated in the particular case of feature space-based segmentation.