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Network-Aware 5G Edge Computing for Object Detection: Augmenting Wearables to “See” More, Farther and Faster

Yuan, Zhongzheng; Azzino, Tommy; Hao, Yu; Lyu, Yixuan; Pei, Haoyang; Boldini, Alain; Mezzavilla, Marco; Beheshti, Mahya; Porfiri, Maurizio; Hudson, Todd; Seiple, William; Fang, Yi; Rangan, Sundeep; Wang, Yao; Rizzo, J. R.
Advanced wearable devices are increasingly incorporating high-resolution multi-camera systems. As state-of-the-art neural networks for processing the resulting image data are computationally demanding, there has been a growing interest in leveraging fifth generation (5G) wireless connectivity and mobile edge computing for offloading this processing closer to end-users. To assess this possibility, this paper presents a detailed simulation and evaluation of 5G wireless offloading for object detection in the case of a powerful, new smart wearable called VIS4ION, for the Blind-and-Visually Impaired (BVI). The current VIS4ION system is an instrumented book-bag with high-resolution cameras, vision processing, and haptic and audio feedback. The paper considers uploading the camera data to a mobile edge server to perform real-time object detection and transmitting the detection results back to the wearable. To determine the video requirements, the paper evaluates the impact of video bit rate and resolution on object detection accuracy and range. A new street scene dataset with labeled objects relevant to BVI navigation is leveraged for analysis. The vision evaluation is combined with a full-stack wireless network simulation to determine the distribution of throughputs and delays with real navigation paths and ray-tracing from new high-resolution 3D models in an urban environment. For comparison, the wireless simulation considers both a standard 4G-Long Term Evolution (LTE) sub-6-GHz carrier and high-rate 5G millimeter-wave (mmWave) carrier. The work thus provides a thorough and detailed assessment of edge computing for object detection with mmWave and sub-6-GHz connectivity in an application with both high bandwidth and low latency requirements.
ISSN: 2169-3536
CID: 5189272

Reduction in Mammography Screening for Breast Cancer Among Visually Impaired Women

Wu, Annie M; Morse, Alan R; Seiple, William H; Talwar, Nidhi; Hansen, Sean O; Lee, Paul P; Stein, Joshua D
PURPOSE/OBJECTIVE:Timely receipt of mammograms to screen for breast cancer in accordance with the United States Preventive Services Task Force (USPSTF) recommendations can substantially reduce morbidity and mortality. The purpose of this study is to assess whether odds of receiving screening mammograms are similar for women with and without visual impairment. DESIGN/METHODS:Retrospective longitudinal cohort study. PARTICIPANTS/METHODS:1044 females, 65-72 years of age, enrolled in fee-for-service Medicare from January 1, 2008 to December 31, 2015. METHODS:We matched patients with no vision loss (NVL), partial vision loss (PVL), and severe vision loss (SVL) 1:1:1 based on age, race, time in Medicare, urbanicity of residence, and overall health. Women with pre-existing breast cancer were excluded. Multivariable conditional logistic regression modeling compared the odds of receiving screening mammography within a 2-year follow-up period among the 3 groups. MAIN OUTCOMES MEASURES/METHODS:Proportion receiving mammography and adjusted odds ratios (OR) of receiving mammography within 2 years of follow-up among the groups. RESULTS:A total of 1044 patients were matched (348 in each group). The mean ± SD age at the index date was 69.0 ± 1.5 years for all 3 groups. The proportion of women receiving ≥ 1 mammogram within the 2-year follow-up period was 69.0% (n=240), 56.9% (n=198), and 56.0% (n=195) for the NVL, PVL and SVL groups, respectively (p=0.0005). The mean ± SD number of mammograms received per patient during the 5-year period (3-year look-back plus 2-year follow-up period) was 3.1 ± 2.0, 2.5 ± 2.0, and 2.3 ± 2.1 for the NVL, PVL and SVL groups, respectively (p<0.0001). Women with SVL had 42% decreased odds (OR=0.58; 95% CI: 0.37-0.90, p=0.01), and those with PVL had 44% decreased odds (OR=0.56; CI:0.36-0.87, p=0.009) of receiving mammography during the follow-up period compared to those with NVL. CONCLUSIONS:Women with visual impairment were significantly less likely to receive mammography to screen for breast cancer than their non-visually-impaired counterparts. Clinicians should look for ways to help ensure that patients with visual impairment receive mammograms and other preventive screenings as recommended by the USPSTF.
PMID: 32682837
ISSN: 1549-4713
CID: 4531812

The global crisis of visual impairment: an emerging global health priority requiring urgent action [Editorial]

Rizzo, John-Ross; Beheshti, Mahya; Hudson, Todd E; Mongkolwat, Pattanasak; Riewpaiboon, Wachara; Seiple, William; Ogedegbe, Olugbenga G; Vedanthan, Rajesh
PMID: 33332166
ISSN: 1748-3115
CID: 4718052

ASSIST: Evaluating the Usability and Performance of an Indoor Navigation Assistant for Blind and Visually Impaired People

Nair, Vishnu; Olmschenk, Greg; Seiple, William H; Zhu, Zhigang
This paper describes the interface and testing of an indoor navigation app - ASSIST - that guides blind & visually impaired (BVI) individuals through an indoor environment with high accuracy while augmenting their understanding of the surrounding environment. ASSIST features personalized interfaces by considering the unique experiences that BVI individuals have in indoor wayfinding and offers multiple levels of multimodal feedback. After an overview of the technical approach and implementation of the first prototype of the ASSIST system, the results of two pilot studies performed with BVI individuals are presented - a performance study to collect data on mobility (walking speed, collisions, and navigation errors) while using the app, and a usability study to collect user evaluation data on the perceived helpfulness, safety, ease-of-use, and overall experience while using the app. Our studies show that ASSIST is useful in providing users with navigational guidance, improving their efficiency and (more significantly) their safety and accuracy in wayfinding indoors. Findings and user feedback from the studies confirm some of the previous results, while also providing some new insights into the creation of such an app, including the use of customized user interfaces and expanding the types of information provided.
PMID: 32790580
ISSN: 1949-3614
CID: 4556612

Decreasing Avoidable Vision Loss: Identifying Antecedents of Adherence

Morse, Alan R; Seiple, William H
Adherence to medication treatment protocols and active participation by individuals in their medical care are important for all patients, but especially for those with chronic conditions such as vision loss. Adherence is crucial for decreasing avoidable vision loss. Failure to take medications as prescribed and keep scheduled appointments reduces treatment effectiveness, increases complications and results in poorer outcomes. Reasons for nonadherence vary by diagnosis and include not understanding the importance of adherence, low health literacy, lack of adequate self-efficacy, low level of activation and behavioral issues including depression. Patients may lack information about their condition and its prognosis, available treatment alternatives, and other essential information such as how to monitor their eye condition, what to do if vision deteriorates and how to get needed community-based help. Each of these factors impedes patients' ability to engage with their physician and participate in their own care. The ability of individuals with vision loss to actively and effectively manage their health care, ie, activation, has been understudied. When patients are involved with their own care, their care experience, and most importantly, their outcomes, are improved. Identifying antecedents of adherence may help provide disease- and patient-specific pathways to reduce avoidable vision loss.
PMID: 33173271
ISSN: 1177-5467
CID: 4665132

The Relationship Between Cognitive Status and Known Single Nucleotide Polymorphisms in Age-Related Macular Degeneration

Murphy, Caitlin; Johnson, Aaron P; Koenekoop, Robert K; Seiple, William; Overbury, Olga
Recent literature has reported a higher occurrence of cognitive impairment among individuals with Age-related Macular Degeneration (AMD) compared to older adults with normal vision. This pilot study explored potential links between single nucleotide polymorphisms (SNPs) in AMD and cognitive status. Individuals with AMD (N = 21) and controls (N = 18) were genotyped for the SNPs CFHY402H, ARMS2A69S and FADS1 rs174547. Cognitive status was evaluated using the Montreal Cognitive Assessment. The two groups differed significantly on which subscales were most difficult. The control group had difficulty with delayed recall while those with AMD had difficulty on delayed recall in addition to abstraction and orientation. Homozygous carriers of the FADS1 rs174547 SNP had significantly lower scores than heterozygotes or non-carriers on the MoCA. The results suggest that the FADS1 SNP may play a role in visual impairment/cognitive impairment comorbidity as reflected in the poorer cognitive scores among homozygotes with AMD compared to those carrying only one, or no copies of the SNP.
PMID: 33178008
ISSN: 1663-4365
CID: 4689302

Association of Vision Loss With Hospital Use and Costs Among Older Adults

Morse, Alan R; Seiple, William; Talwar, Nidhi; Lee, Paul P; Stein, Joshua D
Importance/UNASSIGNED:Patients with vision loss who are hospitalized for common illnesses are often not identified as requiring special attention. This perception, however, may affect the outcomes, resource use, and costs for these individuals. Objective/UNASSIGNED:To assess whether the mean hospitalization lengths of stay, readmission rates, and costs of hospitalization differed between individuals with vision loss and those without when they are hospitalized for similar medical conditions. Design, Setting, and Participants/UNASSIGNED:This analysis of health care claims data used 2 sources: Medicare database and Clinformatics DataMart. Individuals with vision loss were matched 1:1 to those with no vision loss (NVL), on the basis of age, years from initial hospitalization, sex, race/ethnicity, urbanicity of residence, and overall health. Both groups had the same health insurance (Medicare or a commercial health plan), and all had been hospitalized for common illnesses. Vision loss was categorized as either partial vision loss (PVL) or severe vision loss (SVL). Data were analyzed from April 2015 through April 2018. Main Outcomes and Measures/UNASSIGNED:The outcomes were lengths of stay, readmission rates, and health care costs during hospitalization and 90 days after discharge. Multivariable logistic and linear regression models were built to identify factors associated with these outcomes among the NVL, PVL, and SVL groups. Results/UNASSIGNED:Among Medicare beneficiaries, 6165 individuals with NVL (with a mean [SD] age of 82.0 [8.3] years, and 3833 [62.2%] of whom were female) were matched to 6165 with vision loss. Of those with vision loss, 3401 (55.2%) had PVL and 2764 (44.8%) had SVL. In the Clinformatics DataMart database, 5929 individuals with NVL (with a mean [SD] age of 73.7 [15.1] years, and 3587 [60.5%] of whom were female) were matched to 5929 individuals with vision loss. Of the commercially insured enrollees with vision loss, 3515 (59.3%) had PVL and 2414 (40.7%) had SVL. Medicare enrollees with SVL, compared with those with NVL, had longer mean lengths of stay (6.48 vs 5.26 days), higher readmission rates (23.1% vs 18.7%), and higher hospitalization and 90-day postdischarge costs ($64 711 vs $61 060). Compared with those with NVL, Medicare beneficiaries with SVL had 4% longer length of stay (estimated ratio, 1.04; 95% CI, 1.01-1.07; P = .02), 22% higher odds of readmission (odds ratio, 1.22; 95% CI, 1.06-1.41; P = .007), and 12% higher costs (estimated cost ratio, 1.12; 95% CI, 1.06-1.18; P < .001). Similar findings were obtained for those with commercial health insurance. When these findings were extrapolated to hospitalizations of patients with vision loss nationwide, an estimated amount of more than $500 million in additional costs annually were spent caring for these patients. Conclusions and Relevance/UNASSIGNED:These findings suggest that opportunities for improving outcomes and reducing costs exist in addressing patients' vision loss and concomitant functional difficulties during hospitalization and thereafter.
PMID: 30946451
ISSN: 2168-6173
CID: 3815062

Outcomes After Comprehensive Vision Rehabilitation Using Vision-related Quality of Life Questionnaires: Impact of Vision Impairment and National Eye Institute Visual Functioning Questionnaire

Selivanova, Alexandra; Fenwick, Eva; Man, Ryan; Seiple, William; Jackson, Mary Lou
SIGNIFICANCE/CONCLUSIONS:This research is significant because, although vision-related quality of life (VRQoL) is improved after vision rehabilitation (VR), patients with certain characteristics respond less positively on VRQoL measures, and this should inform future care. PURPOSE/OBJECTIVE:The purposes of this study were to evaluate how two VRQoL questionnaires compare in measuring change in patient-reported outcomes after VR and to determine if patient characteristics or occupational therapy (OT) predict higher scores after rehabilitation. METHODS:In a prospective clinical cohort study, 109 patients with low vision completed the Impact of Vision Impairment (IVI) and the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and after VR. Comprehensive VR included consultation with an ophthalmologist and OT if required. The relationships of six baseline characteristics (age, sex, visual acuity, contrast sensitivity, field loss, diagnosis) and OT were assessed with VRQoL scores using multivariable logistic regression. RESULTS:The mean (SD) age was 68.5 (19.2) years, and 61 (56%) were female. After rehabilitation, increases in scores were observed in all IVI subscales (reading [P < .001], mobility [P = .002], well-being [P = .0003]) and all NEI VFQ-25 subscales (functional [P = .01], socioemotional [P = .003]). Those who were referred to OT but did not attend and those who had hemianopia/field loss were less likely to have higher VRQoL in IVI mobility and well-being. Those attending OT for more than 3 hours were less likely to have better scores in emotional NEI VFQ. Men were less likely to have increased scores in functional and emotional NEI VFQ, whereas those with diagnoses of nonmacular diseases had higher odds of having increased scores on the emotional NEI VFQ (all, P < .05). CONCLUSION/CONCLUSIONS:Both the IVI and the NEI VFQ-25 detected change in patients' VRQoL after rehabilitation. Most of the patient characteristics we considered predicted a lower likelihood of increased scores in VRQoL.
PMID: 30589760
ISSN: 1538-9235
CID: 3560432

Association between Vision Loss and Screening Mammography among Women with Medicare [Meeting Abstract]

Wu, Annie Mao; Morse, Alan R.; Seiple, William H.; Talwar, Nidhi; Hansen, Sean; Lee, Paul P.; Stein, Joshua D.
ISSN: 0146-0404
CID: 4154422

The Effects of Feedback on Eye Movement Control Training [Meeting Abstract]

Seiple, William H.; Babaeva, Inna; Kilbride, Paul; Morse, Alan R.
ISSN: 0146-0404
CID: 4154372