Serum tests, liver stiffness and artificial neural networks for diagnosing cirrhosis and portal hypertension

BACKGROUND The diagnostic performance of biochemical scores and artificial neural network models for portal hypertension and cirrhosis is not well established. AIMS To assess diagnostic accuracy of six serum scores, artificial neural networks and liver stiffness measured by transient elastography, for diagnosing cirrhosis, clinically significant portal hypertension and oesophageal varices. METHODS 202 consecutive compensated patients requiring liver biopsy and hepatic venous pressure gradient measurement were included. Several serum tests (alone and combined into scores) and liver stiffness were measured. Artificial neural networks containing or not liver stiffness as input variable were also created. RESULTS The best non-invasive method for diagnosing cirrhosis, portal hypertension and oesophageal varices was liver stiffness (C-statistics=0.93, 0.94, and 0.90, respectively). Among serum tests/scores the best for diagnosing cirrhosis and portal hypertension and oesophageal varices were, respectively, Fibrosis-4, and Lok score. Artificial neural networks including liver stiffness had high diagnostic performance for cirrhosis, portal hypertension and oesophageal varices (accuracy>80%), but were not statistically superior to liver stiffness alone. CONCLUSIONS Liver stiffness was the best non-invasive method to assess the presence of cirrhosis, portal hypertension and oesophageal varices. The use of artificial neural networks integrating different non-invasive tests did not increase the diagnostic accuracy of liver stiffness alone.

WEAVE: Efficient Geographical Routing in Large-Scale Networks

We propose WEAVE, a geographical 2D/3D routing protocol that maintains information on a small number of waypoints and checkpoints for forwarding packets to any destination. Nodes obtain the routing information from partial traces gathered in incoming packets and use a system of checkpoints along with the segments of routes to weave end-to-end paths close to the shortest ones. WEAVE does not generate any control traffic, it is suitable for routing in both 2D and 3D networks, and does not require any strong assumption on the underlying network graph such as the Unit Disk or a Planar Graph. WEAVE compares favorably with existing protocols in both testbed experiments and simulations.