In recent years, deep learning has shown very competitive performance in seizure detection. However, most of the currently used methods either convert electroencephalogram (EEG) signals into spectral images and employ 2D-CNNs, or split the one-dimensional (1D) features of EEG signals into many segments and employ 1D-CNNs. Moreover, these investigations are further constrained by the absence of consideration for temporal links between time series segments or spectrogram images. Therefore, we propose a Dual-Modal Information Bottleneck (Dual-modal IB) network for EEG seizure detection. The network extracts EEG features from both time series and spectrogram dimensions, allowing information from different modalities to pass through the Dual-modal IB, requiring the model to gather and condense the most pertinent information in each modality and only share what is necessary. Specifically, we make full use of the information shared between the two modality representations to obtain key information for seizure detection and to remove irrelevant feature between the two modalities. In addition, to explore the intrinsic temporal dependencies, we further introduce a bidirectional long-short-term memory (BiLSTM) for Dual-modal IB model, which is used to model the temporal relationships between the information after each modality is extracted by convolutional neural network (CNN). For CHB-MIT dataset, the proposed framework can achieve an average segment-based sensitivity of 97.42%, specificity of 99.32%, accuracy of 98.29%, and an average event-based sensitivity of 96.02%, false detection rate (FDR) of 0.70/h. We release our code at https://github.com/LLLL1021/Dual-modal-IB.

OBJECTIVE: We quantify the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examine whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic. MATERIALS AND METHODS: Despite much discussion at the theoretic level, the existing literature provides little empirical understanding of barriers to using CDS in ambulatory care. We analyze data from 821 clinics in 117 medical groups, based on in Minnesota Community Measurement's annual Health Information Technology Survey (2014-2016). We examine clinics' use of 7 CDS tools, along with 7 barriers in 3 areas (resource, user acceptance, and technology). Employing linear probability models, we examine factors associated with CDS barriers. RESULTS: Clinics in health systems used more CDS tools than did clinics not in systems (24 percentage points higher in automated reminders), but they also reported more barriers related to resources and user acceptance (26 percentage points higher in barriers to implementation and 33 points higher in disruptive alarms). Barriers related to workflow redesign increased in clinics affiliated with health systems (33 points higher). Rural clinics were more likely to report barriers to training. CONCLUSIONS: CDS barriers related to resources and user acceptance remained substantial. Health systems, while being effective in promoting CDS tools, may need to provide further assistance to their affiliated ambulatory clinics to overcome barriers, especially the requirement to redesign workflow. Rural clinics may need more resources for training.

Feature selection plays a vital role in the detection and discrimination of epileptic seizures in electroencephalogram (EEG) signals. The state-of-the-art EEG classification techniques commonly entail the extraction of the multiple features that would be fed into classifiers. For some techniques, the feature selection strategies have been used to reduce the dimensionality of the entire feature space. However, most of these approaches focus on the performance of classifiers while neglecting the association between the feature and the EEG activity itself. To enhance the inner relationship between the feature subset and the epileptic EEG task with a promising classification accuracy, we propose a machine learning-based pipeline using a novel feature selection algorithm built upon a knockoff filter. First, a number of temporal, spectral, and spatial features are extracted from the raw EEG signals. Second, the proposed feature selection algorithm is exploited to obtain the optimal subgroup of features. Afterwards, three classifiers including [Formula: see text]-nearest neighbor (KNN), random forest (RF) and support vector machine (SVM) are used. The experimental results on the Bonn dataset demonstrate that the proposed approach outperforms the state-of-the-art techniques, with accuracy as high as 99.93% for normal and interictal EEG discrimination and 98.95% for interictal and ictal EEG classification. Meanwhile, it has achieved satisfactory sensitivity (95.67% in average), specificity (98.83% in average), and accuracy (98.89% in average) over the Freiburg dataset.

Multispectral imaging (MSI) provides a sequence of en-face fundus spectral slices and allows for the examination of structures and signatures throughout the thickness of retina to characterize diabetic retinopathy (DR) lesions comprehensively. Manual interpretation of MSI images is commonly conducted by qualitatively analyzing both the spatial and spectral properties of multiple spectral slices. Meanwhile, there exist few computer-based algorithms that can effectively exploit the spatial and spectral information of MSI images for the diagnosis of DR. We propose a new approach that can quantify the spatial-spectral features of MSI retinal images for automatic DR lesion segmentation. It combines a generalized low-rank approximation of matrices with a supervised regularization term to generate low-dimensional spatial-spectral representations using the feature vectors in all spectral slices. Experimental results showed that the proposed approach is very effective for the segmentation of DR lesions in MSI images, which suggests it as an interesting tool for assisting ophthalmologists in diagnosing, analyzing, and managing DR lesions in MSI.

Consumers facing barriers to healthcare access may use online health information seeking and online communication with physicians, but the empirical relationship has not been sufficiently analyzed. Our study examines the association of barriers to healthcare access with consumers' health-related information searching on the internet, use of health chat groups, and email communication with physicians, using data from 27,210 adults from the 2009 National Health Interview Survey. Individuals with financial barriers to healthcare access, difficulty getting timely appointments with doctors, and conflicts in scheduling during clinic hours are more likely to search for general health information online than those without these access barriers. Those unable to get timely appointments with physicians are more likely to participate in health chat groups and email physicians. The internet may offer a low-cost source of health information and could help meet the heightened demand for health-related information among those facing access barriers to care.

This paper presents BCube, a new network architecture specifically designed for shipping-container based, modular data centers. At the core of the BCube architecture is its server-centric network structure, where servers with multiple network ports connect to multiple layers of COTS (commodity off-the-shelf) mini-switches. Servers act as not only end hosts, but also relay nodes for each other. BCube supports various bandwidth-intensive applications by speeding-up one-to-one, one-to-several, and one-to-all traffic patterns, and by providing high network capacity for all-to-all traffic.