Adaptive neuro-fuzzy inference systems (ANFIS) for supervised classification of competence in MIS based on psychomotor skills

INTRODUCTION: Objective assessment of motor skills has become an important challenge in minimally invasive surgery (MIS) training.Currently, there is no gold standard defining and determining the residents' surgical competence.To aid in the decision process, we analyze the validity of a supervised classifier to determine the degree of MIS competence based on assessment of psychomotor skills METHODOLOGY: The ANFIS is trained to classify performance in a box trainer peg transfer task performed by two groups (expert/non expert). There were 42 participants included in the study: the non-expert group consisted of 16 medical students and 8 residents (< 10 MIS procedures performed), whereas the expert group consisted of 14 residents (> 10 MIS procedures performed) and 4 experienced surgeons. Instrument movements were captured by means of the Endoscopic Video Analysis (EVA) tracking system. Nine motion analysis parameters (MAPs) were analyzed, including time, path length, depth, average speed, average acceleration, economy of area, economy of volume, idle time and motion smoothness. Data reduction was performed by means of principal component analysis, and then used to train the ANFIS net. Performance was measured by leave one out cross validation. RESULTS: The ANFIS presented an accuracy of 80.95%, where 13 experts and 21 non-experts were correctly classified. Total root mean square error was 0.88, while the area under the classifiers' ROC curve (AUC) was measured at 0.81. DISCUSSION: We have shown the usefulness of ANFIS for classification of MIS competence in a simple box trainer exercise. The main advantage of using ANFIS resides in its continuous output, which allows fine discrimination of surgical competence. There are, however, challenges that must be taken into account when considering use of ANFIS (e.g. training time, architecture modeling). Despite this, we have shown discriminative power of ANFIS for a low-difficulty box trainer task, regardless of the individual significances between MAPs. Future studies are required to confirm the findings, inclusion of new tasks, conditions and sample population.

Desing and Validation of a Light Inference System to Support Embedded Context Reasoning

Embedded context management in resource-constrained devices (e.g. mobile phones, autonomous sensors or smart objects) imposes special requirements in terms of lightness for data modelling and reasoning. In this paper, we explore the state-of-the-art on data representation and reasoning tools for embedded mobile reasoning and propose a light inference system (LIS) aiming at simplifying embedded inference processes offering a set of functionalities to avoid redundancy in context management operations. The system is part of a service-oriented mobile software framework, conceived to facilitate the creation of context-aware applications—it decouples sensor data acquisition and context processing from the application logic. LIS, composed of several modules, encapsulates existing lightweight tools for ontology data management and rule-based reasoning, and it is ready to run on Java-enabled handheld devices. Data management and reasoning processes are designed to handle a general ontology that enables communication among framework components. Both the applications running on top of the framework and the framework components themselves can configure the rule and query sets in order to retrieve the information they need from LIS. In order to test LIS features in a real application scenario, an ‘Activity Monitor’ has been designed and implemented: a personal health-persuasive application that provides feedback on the user’s lifestyle, combining data from physical and virtual sensors. In this case of use, LIS is used to timely evaluate the user’s activity level, to decide on the convenience of triggering notifications and to determine the best interface or channel to deliver these context-aware alerts.d

Design and Validation of a Light Inference System to Support Embedded Context Reasoning

Embedded context management in resource-constrained devices (e.g. mobile phones, autonomous sensors or smart objects) imposes special requirements in terms of lightness for data modelling and reasoning. In this paper, we explore the state-of-the-art on data representation and reasoning tools for embedded mobile reasoning and propose a light inference system (LIS) aiming at simplifying embedded inference processes offering a set of functionalities to avoid redundancy in context management operations. The system is part of a service-oriented mobile software framework, conceived to facilitate the creation of context-aware applications?it decouples sensor data acquisition and context processing from the application logic. LIS, composed of several modules, encapsulates existing lightweight tools for ontology data management and rule-based reasoning, and it is ready to run on Java-enabled handheld devices. Data management and reasoning processes are designed to handle a general ontology that enables communication among framework components. Both the applications running on top of the framework and the framework components themselves can configure the rule and query sets in order to retrieve the information they need from LIS. In order to test LIS features in a real application scenario, an ?Activity Monitor? has been designed and implemented: a personal health-persuasive application that provides feedback on the user?s lifestyle, combining data from physical and virtual sensors. In this case of use, LIS is used to timely evaluate the user?s activity level, to decide on the convenience of triggering notifications and to determine the best interface or channel to deliver these context-aware alerts.

Low-speed longitudinal controllers for mass-produced cars: A comparative study

Four longitudinal control techniques are compared: a classical Proportional-Integral (PI) control; an advanced technique-called the i-PI-that adds an intelligent component to the PI; a fuzzy controller based on human experience; and an adaptive-network-based fuzzy inference system. The controllers were designed to tackle one of the challenging topics as yet unsolved by the automotive sector: managing autonomously a gasoline-propelled vehicle at very low speeds. The dynamics involved are highly nonlinear and constitute an excellent test-bed for newly designed controllers. A Citroën C3 Pluriel car was modified to permit autonomous action on the accelerator and the brake pedals-i.e., longitudinal control. The controllers were tested in two stages. First, the vehicle was modeled to check the controllers' feasibility. Second, the controllers were then implemented in the Citroën, and their behavior under the same conditions on an identical real circuit was compared.

The Balanced Cross-Layer Design Routing Algorithm in Wireless Sensor Networks Using Fuzzy Logic

Recently, the cross-layer design for the wireless sensor network communication protocol has become more and more important and popular. Considering the disadvantages of the traditional cross-layer routing algorithms, in this paper we propose a new fuzzy logic-based routing algorithm, named the Balanced Cross-layer Fuzzy Logic (BCFL) routing algorithm. In BCFL, we use the cross-layer parameters’ dispersion as the fuzzy logic inference system inputs. Moreover, we give each cross-layer parameter a dynamic weight according the value of the dispersion. For getting a balanced solution, the parameter whose dispersion is large will have small weight, and vice versa. In order to compare it with the traditional cross-layer routing algorithms, BCFL is evaluated through extensive simulations. The simulation results show that the new routing algorithm can handle the multiple constraints without increasing the complexity of the algorithm and can achieve the most balanced performance on selecting the next hop relay node. Moreover, the Balanced Cross-layer Fuzzy Logic routing algorithm can adapt to the dynamic changing of the network conditions and topology effectively.

Conceptual framework for the design, implementation and validation of psychomotor skills’ assessment systems in minimally invasive surgery

Las técnicas de cirugía de mínima invasión (CMI) se están consolidando hoy en día como alternativa a la cirugía tradicional, debido a sus numerosos beneficios para los pacientes. Este cambio de paradigma implica que los cirujanos deben aprender una serie de habilidades distintas de aquellas requeridas en cirugía abierta. El entrenamiento y evaluación de estas habilidades se ha convertido en una de las mayores preocupaciones en los programas de formación de cirujanos, debido en gran parte a la presión de una sociedad que exige cirujanos bien preparados y una reducción en el número de errores médicos. Por tanto, se está prestando especial atención a la definición de nuevos programas que permitan el entrenamiento y la evaluación de las habilidades psicomotoras en entornos seguros antes de que los nuevos cirujanos puedan operar sobre pacientes reales. Para tal fin, hospitales y centros de formación están gradualmente incorporando instalaciones de entrenamiento donde los residentes puedan practicar y aprender sin riesgos. Es cada vez más común que estos laboratorios dispongan de simuladores virtuales o simuladores físicos capaces de registrar los movimientos del instrumental de cada residente. Estos simuladores ofrecen una gran variedad de tareas de entrenamiento y evaluación, así como la posibilidad de obtener información objetiva de los ejercicios. Los diferentes estudios de validación llevados a cabo dan muestra de su utilidad; pese a todo, los niveles de evidencia presentados son en muchas ocasiones insuficientes. Lo que es más importante, no existe un consenso claro a la hora de definir qué métricas son más útiles para caracterizar la pericia quirúrgica. El objetivo de esta tesis doctoral es diseñar y validar un marco de trabajo conceptual para la definición y validación de entornos para la evaluación de habilidades en CMI, en base a un modelo en tres fases: pedagógica (tareas y métricas a emplear), tecnológica (tecnologías de adquisición de métricas) y analítica (interpretación de la competencia en base a las métricas). Para tal fin, se describe la implementación práctica de un entorno basado en (1) un sistema de seguimiento de instrumental fundamentado en el análisis del vídeo laparoscópico; y (2) la determinación de la pericia en base a métricas de movimiento del instrumental. Para la fase pedagógica se diseñó e implementó un conjunto de tareas para la evaluación de habilidades psicomotoras básicas, así como una serie de métricas de movimiento. La validación de construcción llevada a cabo sobre ellas mostró buenos resultados para tiempo, camino recorrido, profundidad, velocidad media, aceleración media, economía de área y economía de volumen. Adicionalmente, los resultados obtenidos en la validación de apariencia fueron en general positivos en todos los grupos considerados (noveles, residentes, expertos). Para la fase tecnológica, se introdujo el EVA Tracking System, una solución para el seguimiento del instrumental quirúrgico basado en el análisis del vídeo endoscópico. La precisión del sistema se evaluó a 16,33ppRMS para el seguimiento 2D de la herramienta en la imagen; y a 13mmRMS para el seguimiento espacial de la misma. La validación de construcción con una de las tareas de evaluación mostró buenos resultados para tiempo, camino recorrido, profundidad, velocidad media, aceleración media, economía de área y economía de volumen. La validación concurrente con el TrEndo® Tracking System por su parte presentó valores altos de correlación para 8 de las 9 métricas analizadas. Finalmente, para la fase analítica se comparó el comportamiento de tres clasificadores supervisados a la hora de determinar automáticamente la pericia quirúrgica en base a la información de movimiento del instrumental, basados en aproximaciones lineales (análisis lineal discriminante, LDA), no lineales (máquinas de soporte vectorial, SVM) y difusas (sistemas adaptativos de inferencia neurodifusa, ANFIS). Los resultados muestran que en media SVM presenta un comportamiento ligeramente superior: 78,2% frente a los 71% y 71,7% obtenidos por ANFIS y LDA respectivamente. Sin embargo las diferencias estadísticas medidas entre los tres no fueron demostradas significativas. En general, esta tesis doctoral corrobora las hipótesis de investigación postuladas relativas a la definición de sistemas de evaluación de habilidades para cirugía de mínima invasión, a la utilidad del análisis de vídeo como fuente de información y a la importancia de la información de movimiento de instrumental a la hora de caracterizar la pericia quirúrgica. Basándose en estos cimientos, se han de abrir nuevos campos de investigación que contribuyan a la definición de programas de formación estructurados y objetivos, que puedan garantizar la acreditación de cirujanos sobradamente preparados y promocionen la seguridad del paciente en el quirófano. Abstract Minimally invasive surgery (MIS) techniques have become a standard in many surgical sub-specialties, due to their many benefits for patients. However, this shift in paradigm implies that surgeons must acquire a complete different set of skills than those normally attributed to open surgery. Training and assessment of these skills has become a major concern in surgical learning programmes, especially considering the social demand for better-prepared professionals and for the decrease of medical errors. Therefore, much effort is being put in the definition of structured MIS learning programmes, where practice with real patients in the operating room (OR) can be delayed until the resident can attest for a minimum level of psychomotor competence. To this end, skills’ laboratory settings are being introduced in hospitals and training centres where residents may practice and be assessed on their psychomotor skills. Technological advances in the field of tracking technologies and virtual reality (VR) have enabled the creation of new learning systems such as VR simulators or enhanced box trainers. These systems offer a wide range of tasks, as well as the capability of registering objective data on the trainees’ performance. Validation studies give proof of their usefulness; however, levels of evidence reported are in many cases low. More importantly, there is still no clear consensus on topics such as the optimal metrics that must be used to assess competence, the validity of VR simulation, the portability of tracking technologies into real surgeries (for advanced assessment) or the degree to which the skills measured and obtained in laboratory environments transfer to the OR. The purpose of this PhD is to design and validate a conceptual framework for the definition and validation of MIS assessment environments based on a three-pillared model defining three main stages: pedagogical (tasks and metrics to employ), technological (metric acquisition technologies) and analytical (interpretation of competence based on metrics). To this end, a practical implementation of the framework is presented, focused on (1) a video-based tracking system and (2) the determination of surgical competence based on the laparoscopic instruments’ motionrelated data. The pedagogical stage’s results led to the design and implementation of a set of basic tasks for MIS psychomotor skills’ assessment, as well as the definition of motion analysis parameters (MAPs) to measure performance on said tasks. Validation yielded good construct results for parameters such as time, path length, depth, average speed, average acceleration, economy of area and economy of volume. Additionally, face validation results showed positive acceptance on behalf of the experts, residents and novices. For the technological stage the EVA Tracking System is introduced. EVA provides a solution for tracking laparoscopic instruments from the analysis of the monoscopic video image. Accuracy tests for the system are presented, which yielded an average RMSE of 16.33pp for 2D tracking of the instrument on the image and of 13mm for 3D spatial tracking. A validation experiment was conducted using one of the tasks and the most relevant MAPs. Construct validation showed significant differences for time, path length, depth, average speed, average acceleration, economy of area and economy of volume; especially between novices and residents/experts. More importantly, concurrent validation with the TrEndo® Tracking System presented high correlation values (>0.7) for 8 of the 9 MAPs proposed. Finally, the analytical stage allowed comparing the performance of three different supervised classification strategies in the determination of surgical competence based on motion-related information. The three classifiers were based on linear (linear discriminant analysis, LDA), non-linear (support vector machines, SVM) and fuzzy (adaptive neuro fuzzy inference systems, ANFIS) approaches. Results for SVM show slightly better performance than the other two classifiers: on average, accuracy for LDA, SVM and ANFIS was of 71.7%, 78.2% and 71% respectively. However, when confronted, no statistical significance was found between any of the three. Overall, this PhD corroborates the investigated research hypotheses regarding the definition of MIS assessment systems, the use of endoscopic video analysis as the main source of information and the relevance of motion analysis in the determination of surgical competence. New research fields in the training and assessment of MIS surgeons can be proposed based on these foundations, in order to contribute to the definition of structured and objective learning programmes that guarantee the accreditation of well-prepared professionals and the promotion of patient safety in the OR.

Metodologías de modelado, monitorización y asistencia robótica en neurorrehabilitación funcional de extremidad superior

La Organización Mundial de la Salud (OMS) prevé que para el año 2020, el Daño Cerebral Adquirido (DCA) estará entre las 10 causas más comunes de discapacidad. Estas lesiones, dadas sus consecuencias físicas, sensoriales, cognitivas, emocionales y socioeconómicas, cambian dramáticamente la vida de los pacientes y sus familias. Las nuevas técnicas de intervención precoz y el desarrollo de la medicina intensiva en la atención al DCA han mejorado notablemente la probabilidad de supervivencia. Sin embargo, hoy por hoy, las lesiones cerebrales no tienen ningún tratamiento quirúrgico que tenga por objetivo restablecer la funcionalidad perdida, sino que las terapias rehabilitadoras se dirigen hacia la compensación de los déficits producidos. Uno de los objetivos principales de la neurorrehabilitación es, por tanto, dotar al paciente de la capacidad necesaria para ejecutar las Actividades de Vida Diaria (AVDs) necesarias para desarrollar una vida independiente, siendo fundamentales aquellas en las que la Extremidad Superior (ES) está directamente implicada, dada su gran importancia a la hora de la manipulación de objetos. Con la incorporación de nuevas soluciones tecnológicas al proceso de neurorrehabilitación se pretende alcanzar un nuevo paradigma centrado en ofrecer una práctica personalizada, monitorizada y ubicua con una valoración continua de la eficacia y de la eficiencia de los procedimientos y con capacidad de generar conocimientos que impulsen la ruptura del paradigma de actual. Los nuevos objetivos consistirán en minimizar el impacto de las enfermedades que afectan a la capacidad funcional de las personas, disminuir el tiempo de incapacidad y permitir una gestión más eficiente de los recursos. Estos objetivos clínicos, de gran impacto socio-económico, sólo pueden alcanzarse desde una apuesta decidida en nuevas tecnologías, metodologías y algoritmos capaces de ocasionar la ruptura tecnológica necesaria que permita superar las barreras que hasta el momento han impedido la penetración tecnológica en el campo de la rehabilitación de manera universal. De esta forma, los trabajos y resultados alcanzados en la Tesis son los siguientes: 1. Modelado de AVDs: como paso previo a la incorporación de ayudas tecnológicas al proceso rehabilitador, se hace necesaria una primera fase de modelado y formalización del conocimiento asociado a la ejecución de las actividades que se realizan como parte de la terapia. En particular, las tareas más complejas y a su vez con mayor repercusión terapéutica son las AVDs, cuya formalización permitirá disponer de modelos de movimiento sanos que actuarán de referencia para futuros desarrollos tecnológicos dirigidos a personas con DCA. Siguiendo una metodología basada en diagramas de estados UML se han modelado las AVDs 'servir agua de una jarra' y 'coger un botella' 2. Monitorización ubícua del movimiento de la ES: se ha diseñado, desarrollado y validado un sistema de adquisición de movimiento basado en tecnología inercial que mejora las limitaciones de los dispositivos comerciales actuales (coste muy elevado e incapacidad para trabajar en entornos no controlados); los altos coeficientes de correlación y los bajos niveles de error obtenidos en los corregistros llevados a cabo con el sistema comercial BTS SMART-D demuestran la alta precisión del sistema. También se ha realizado un trabajo de investigación exploratorio de un sistema de captura de movimiento de coste muy reducido basado en visión estereoscópica, habiéndose detectado los puntos clave donde se hace necesario incidir desde un punto de vista tecnológico para su incorporación en un entorno real 3. Resolución del Problema Cinemático Inverso (PCI): se ha diseñado, desarrollado y validado una solución al PCI cuando el manipulador se corresponde con una ES humana estudiándose 2 posibles alternativas, una basada en la utilización de un Perceptrón Multicapa (PMC) y otra basada en sistemas Artificial Neuro-Fuzzy Inference Systems (ANFIS). La validación, llevada a cabo utilizando información relativa a los modelos disponibles de AVDs, indica que una solución basada en un PMC con 3 neuronas en la capa de entrada, una capa oculta también de 3 neuronas y una capa de salida con tantas neuronas como Grados de Libertad (GdLs) tenga el modelo de la ES, proporciona resultados, tanto de precisión como de tiempo de cálculo, que la hacen idónea para trabajar en sistemas con requisitos de tiempo real 4. Control inteligente assisted-as-needed: se ha diseñado, desarrollado y validado un algoritmo de control assisted-as-needed para una ortesis robótica con capacidades de actuación anticipatoria de la que existe un prototipo implementado en la actualidad. Los resultados obtenidos demuestran cómo el sistema es capaz de adaptarse al perfil disfuncional del paciente activando la ayuda en instantes anteriores a la ocurrencia de movimientos incorrectos. Esta estrategia implica un aumento en la participación del paciente y, por tanto, en su actividad muscular, fomentándose los procesos la plasticidad cerebral responsables del reaprendizaje o readaptación motora 5. Simuladores robóticos para planificación: se propone la utilización de un simulador robótico assisted-as-needed como herramienta de planificación de sesiones de rehabilitación personalizadas y con un objetivo clínico marcado en las que interviene una ortesis robotizada. Los resultados obtenidos evidencian como, tras la ejecución de ciertos algoritmos sencillos, es posible seleccionar automáticamente una configuración para el algoritmo de control assisted-as-needed que consigue que la ortesis se adapte a los criterios establecidos desde un punto de vista clínico en función del paciente estudiado. Estos resultados invitan a profundizar en el desarrollo de algoritmos más avanzados de selección de parámetros a partir de baterías de simulaciones Estos trabajos han servido para corroborar las hipótesis de investigación planteadas al inicio de la misma, permitiendo, asimismo, la apertura de nuevas líneas de investigación. Summary The World Health Organization (WHO) predicts that by the year 2020, Acquired Brain Injury (ABI) will be among the ten most common ailments. These injuries dramatically change the life of the patients and their families due to their physical, sensory, cognitive, emotional and socio-economic consequences. New techniques of early intervention and the development of intensive ABI care have noticeably improved the survival rate. However, in spite of these advances, brain injuries still have no surgical or pharmacological treatment to re-establish the lost functions. Neurorehabilitation therapies address this problem by restoring, minimizing or compensating the functional alterations in a person disabled because of a nervous system injury. One of the main objectives of Neurorehabilitation is to provide patients with the capacity to perform specific Activities of the Daily Life (ADL) required for an independent life, especially those in which the Upper Limb (UL) is directly involved due to its great importance in manipulating objects within the patients' environment. The incorporation of new technological aids to the neurorehabilitation process tries to reach a new paradigm focused on offering a personalized, monitored and ubiquitous practise with continuous assessment of both the efficacy and the efficiency of the procedures and with the capacity of generating new knowledge. New targets will be to minimize the impact of the sicknesses affecting the functional capabilitiies of the subjects, to decrease the time of the physical handicap and to allow a more efficient resources handling. These targets, of a great socio-economic impact, can only be achieved by means of new technologies and algorithms able to provoke the technological break needed to beat the barriers that are stopping the universal penetration of the technology in the field of rehabilitation. In this way, this PhD Thesis has achieved the following results: 1. ADL Modeling: as a previous step to the incorporation of technological aids to the neurorehabilitation process, it is necessary a first modelling and formalization phase of the knowledge associated to the execution of the activities that are performed as a part of the therapy. In particular, the most complex and therapeutically relevant tasks are the ADLs, whose formalization will produce healthy motion models to be used as a reference for future technological developments. Following a methodology based on UML state-chart diagrams, the ADLs 'serving water from a jar' and 'picking up a bottle' have been modelled 2. Ubiquitous monitoring of the UL movement: it has been designed, developed and validated a motion acquisition system based on inertial technology that improves the limitations of the current devices (high monetary cost and inability of working within uncontrolled environments); the high correlation coefficients and the low error levels obtained throughout several co-registration sessions with the commercial sys- tem BTS SMART-D show the high precision of the system. Besides an exploration of a very low cost stereoscopic vision-based motion capture system has been carried out and the key points where it is necessary to insist from a technological point of view have been detected 3. Inverse Kinematics (IK) problem solving: a solution to the IK problem has been proposed for a manipulator that corresponds to a human UL. This solution has been faced by means of two different alternatives, one based on a Mulilayer Perceptron (MLP) and another based on Artificial Neuro-Fuzzy Inference Systems (ANFIS). The validation of these solutions, carried out using the information regarding the previously generated motion models, indicate that a MLP-based solution, with an architecture consisting in 3 neurons in the input layer, one hidden layer of 3 neurons and an output layer with as many neurons as the number of Degrees of Freedom (DoFs) that the UL model has, is the one that provides the best results both in terms of precission and in terms of processing time, making in idoneous to be integrated within a system with real time restrictions 4. Assisted-as-needed intelligent control: an assisted-as-needed control algorithm with anticipatory actuation capabilities has been designed, developed and validated for a robotic orthosis of which there is an already implemented prototype. Obtained results demonstrate that the control system is able to adapt to the dysfunctional profile of the patient by triggering the assistance right before an incorrect movement is going to take place. This strategy implies an increase in the participation of the patients and in his or her muscle activity, encouraging the neural plasticity processes in charge of the motor learning 5. Planification with a robotic simulator: in this work a robotic simulator is proposed as a planification tool for personalized rehabilitation sessions under a certain clinical criterium. Obtained results indicate that, after the execution of simple parameter selection algorithms, it is possible to automatically choose a specific configuration that makes the assisted-as-needed control algorithm to adapt both to the clinical criteria and to the patient. These results invite researchers to work in the development of more complex parameter selection algorithms departing from simulation batteries Obtained results have been useful to corroborate the hypotheses set out at the beginning of this PhD Thesis. Besides, they have allowed the creation of new research lines in all the studied application fields.

Towards a fuzzy-based multi-classifier selection module for activity recognition applications

Performing activity recognition using the information provided by the different sensors embedded in a smartphone face limitations due to the capabilities of those devices when the computations are carried out in the terminal. In this work a fuzzy inference module is implemented in order to decide which classifier is the most appropriate to be used at a specific moment regarding the application requirements and the device context characterized by its battery level, available memory and CPU load. The set of classifiers that is considered is composed of Decision Tables and Trees that have been trained using different number of sensors and features. In addition, some classifiers perform activity recognition regardless of the on-body device position and others rely on the previous recognition of that position to use a classifier that is trained with measurements gathered with the mobile placed on that specific position. The modules implemented show that an evaluation of the classifiers allows sorting them so the fuzzy inference module can choose periodically the one that best suits the device context and application requirements.

Quadcopter see and avoid using a fuzzy controller

Unmanned Aerial Vehicles (UAVs) industry is a fast growing sector. Nowadays, the market offers numerous possibilities for off-the-shelf UAVs such as quadrotors or fixed-wings. Until UAVs demonstrate advance capabilities such as autonomous collision avoidance they will be segregated and restricted to flight in controlled environments. This work presents a visual fuzzy servoing system for obstacle avoidance using UAVs. To accomplish this task we used the visual information from the front camera. Images are processed off-board and the result send to the Fuzzy Logic controller which then send commands to modify the orientation of the aircraft. Results from flight test are presented with a commercial off-the-shelf platform.

Supervised classification of minimally invasive surgery psychomotor competence based on instruments motion analysis

Background Objective assessment of psychomotor skills has become an important challenge in the training of minimally invasive surgical (MIS) techniques. Currently, no gold standard defining surgical competence exists for classifying residents according to their surgical skills. Supervised classification has been proposed as a means for objectively establishing competence thresholds in psychomotor skills evaluation. This report presents a study comparing three classification methods for establishing their validity in a set of tasks for basic skills’ assessment. Methods Linear discriminant analysis (LDA), support vector machines (SVM), and adaptive neuro-fuzzy inference systems (ANFIS) were used. A total of 42 participants, divided into an experienced group (4 expert surgeons and 14 residents with >10 laparoscopic surgeries performed) and a nonexperienced group (16 students and 8 residents with <10 laparoscopic surgeries performed), performed three box trainer tasks validated for assessment of MIS psychomotor skills. Instrument movements were captured using the TrEndo tracking system, and nine motion analysis parameters (MAPs) were analyzed. The performance of the classifiers was measured by leave-one-out cross-validation using the scores obtained by the participants. Results The mean accuracy performances of the classifiers were 71 % (LDA), 78.2 % (SVM), and 71.7 % (ANFIS). No statistically significant differences in the performance were identified between the classifiers. Conclusions The three proposed classifiers showed good performance in the discrimination of skills, especially when information from all MAPs and tasks combined were considered. A correlation between the surgeons’ previous experience and their execution of the tasks could be ascertained from results. However, misclassifications across all the classifiers could imply the existence of other factors influencing psychomotor competence.

Mejora postpradial de un controlador basado en reglas

La Diabetes mellitus es una enfermedad caracterizada por la insuficiente o nula producción de insulina por parte del páncreas o la reducida sensibilidad del organismo a esta hormona, que ayuda a que la glucosa llegue a los tejidos y al sistema nervioso para suministrar energía. La Diabetes tiene una mayor prevalencia en los países desarrollados debido a múltiples factores, entre ellos la obesidad, la vida sedentaria, y disfunciones en el sistema endocrino relacionadas con el páncreas. La Diabetes Tipo 1 es una enfermedad crónica e incurable, en la que son destruidas las células beta del páncreas, que producen la insulina, haciéndose necesaria la administración de insulina de forma exógena para controlar los niveles de glucosa en sangre. El paciente debe seguir una terapia con insulina administrada por vía subcutánea, que debe estar adaptada a sus necesidades metabólicas y a sus hábitos de vida. Esta terapia intenta imitar el perfil insulínico de un páncreas sano. La tecnología actual permite abordar el desarrollo del denominado “páncreas endocrino artificial” (PEA), que aportaría precisión, eficacia y seguridad en la aplicación de las terapias con insulina y permitiría una mayor independencia de los pacientes frente a su enfermedad, que en la actualidad están sujetos a una constante toma de decisiones. El PEA consta de un sensor continuo de glucosa, una bomba de infusión de insulina y un algoritmo de control, que calcula la insulina a infusionar utilizando los niveles de glucosa del paciente como información principal. Este trabajo presenta una modificación en el método de control en lazo cerrado propuesto en un proyecto previo. El controlador del que se parte está compuesto por un controlador basal booleano y un controlador borroso postprandial basado en reglas borrosas heredadas del controlador basal. El controlador postprandial administra el 50% del bolo manual (calculado a partir de la cantidad de carbohidratos que el paciente va a consumir) en el instante del aviso de la ingesta y reparte el resto en instantes posteriores. El objetivo es conseguir una regulación óptima del nivel de glucosa en el periodo postprandial. Con el objetivo de reducir las hiperglucemias que se producen en el periodo postprandial se realiza un transporte de insulina, que es un adelanto de la insulina basal del periodo postprandial que se suministrará junto con un porcentaje variable del bolo manual. Este porcentaje estará relacionado con el estado metabólico del paciente previo a la ingesta. Además se modificará la base de conocimiento para adecuar el comportamiento del controlador al periodo postprandial. Este proyecto está enfocado en la mejora del controlador borroso postprandial previo, modificando dos aspectos: la inferencia del controlador postprandial y añadiendo una toma de decisiones automática sobre el % del bolo manual y el transporte. Se ha propuesto un controlador borroso con una nueva inferencia, que no hereda las características del controlado basal, y ha sido adaptado al periodo postprandial. Se ha añadido una inferencia borrosa que modifica la cantidad de insulina a administrar en el momento del aviso de ingesta y la cantidad de insulina basal a transportar del periodo postprandial al bolo manual. La validación del algoritmo se ha realizado mediante experimentos en simulación utilizando una población de diez pacientes sintéticos pertenecientes al Simulador de Padua/Virginia, evaluando los resultados con estadísticos para después compararlos con los obtenidos con el método de control anterior. Tras la evaluación de los resultados se puede concluir que el nuevo controlador postprandial, acompañado de la toma de decisiones automática, realiza un mejor control glucémico en el periodo postprandial, disminuyendo los niveles de las hiperglucemias. ABSTRACT. Diabetes mellitus is a disease characterized by the insufficient or null production of insulin from the pancreas or by a reduced sensitivity to this hormone, which helps glucose get to the tissues and the nervous system to provide energy. Diabetes has more prevalence in developed countries due to multiple factors, including obesity, sedentary lifestyle and endocrine dysfunctions related to the pancreas. Type 1 Diabetes is a chronic, incurable disease in which beta cells in the pancreas that produce insulin are destroyed, and exogenous insulin delivery is required to control blood glucose levels. The patient must follow a therapy with insulin administered by the subcutaneous route that should be adjusted to the metabolic needs and lifestyle of the patient. This therapy tries to imitate the insulin profile of a non-pathological pancreas. Current technology can adress the development of the so-called “endocrine artificial pancreas” (EAP) that would provide accuracy, efficacy and safety in the application of insulin therapies and will allow patients a higher level of independence from their disease. Patients are currently tied to constant decision making. The EAP consists of a continuous glucose sensor, an insulin infusion pump and a control algorithm that computes the insulin amount that has to be infused using the glucose as the main source of information. This work shows modifications to the control method in closed loop proposed in a previous project. The reference controller is composed by a boolean basal controller and a postprandial rule-based fuzzy controller which inherits the rules from the basal controller. The postprandial controller administrates 50% of the bolus (calculated from the amount of carbohydrates that the patient is going to ingest) in the moment of the intake warning, and distributes the remaining in later instants. The goal is to achieve an optimum regulation of the glucose level in the postprandial period. In order to reduce hyperglycemia in the postprandial period an insulin transport is carried out. It consists on a feedforward of the basal insulin from the postprandial period, which will be administered with a variable percentage of the manual bolus. This percentage would be linked with the metabolic state of the patient in moments previous to the intake. Furthermore, the knowledge base is going to be modified in order to fit the controller performance to the postprandial period. This project is focused on the improvement of the previous controller, modifying two aspects: the postprandial controller inference, and the automatic decision making on the percentage of the manual bolus and the transport. A fuzzy controller with a new inference has been proposed and has been adapted to the postprandial period. A fuzzy inference has been added, which modifies both the amount of manual bolus to administrate at the intake warning and the amount of basal insulin to transport to the prandial bolus. The algorithm assessment has been done through simulation experiments using a synthetic population of 10 patients in the UVA/PADOVA simulator, evaluating the results with statistical parameters for further comparison with those obtained with the previous control method. After comparing results it can be concluded that the new postprandial controller, combined with the automatic decision making, carries out a better glycemic control in the postprandial period, decreasing levels of hyperglycemia.

Two Different Approaches of Feature Extraction for Classifying the EEG Signals

The focus of this chapter is to study feature extraction and pattern classification methods from two medical areas, Stabilometry and Electroencephalography (EEG). Stabilometry is the branch of medicine responsible for examining balance in human beings. Balance and dizziness disorders are probably two of the most common illnesses that physicians have to deal with. In Stabilometry, the key nuggets of information in a time series signal are concentrated within definite time periods are known as events. In this chapter, two feature extraction schemes have been developed to identify and characterise the events in Stabilometry and EEG signals. Based on these extracted features, an Adaptive Fuzzy Inference Neural network has been applied for classification of Stabilometry and EEG signals.

Global flow analysis as a practical compilation tool

This paper addresses the issue of the practicality of global flow analysis in logic program compilation, in terms of speed of the analysis, precisión, and usefulness of the information obtained. To this end, design and implementation aspects are discussed for two practical abstract interpretation-based flow analysis systems: MA , the MCC And-parallel Analyzer and Annotator; and Ms, an experimental mode inference system developed for SB-Prolog. The paper also provides performance data obtained (rom these implementations and, as an example of an application, a study of the usefulness of the mode information obtained in reducing run-time checks in independent and-parallelism.Based on the results obtained, it is concluded that the overhead of global flow analysis is not prohibitive, while the results of analysis can be quite precise and useful.

On the practicality of global flow analysis of logic programs

This paper addresses the issue of the practicality of global flow analysis in logic program compilation, in terms of both speed and precision of analysis. It discusses design and implementation aspects of two practical abstract interpretation-based flow analysis systems: MA3, the MOO Andparallel Analyzer and Annotator; and Ms, an experimental mode inference system developed for SB-Prolog. The paper also provides performance data obtained from these implementations. Based on these results, it is concluded that the overhead of global flow analysis is not prohibitive, while the results of analysis can be quite precise and useful.

Reconocimiento de gestos basado en acelerómetros

En los últimos años, ha crecido de forma significativa el interés por la utilización de dispositivos capaces de reconocer gestos humanos. En este trabajo, se pretenden reconocer gestos manuales colocando sensores en la mano de una persona. El reconocimiento de gestos manuales puede ser implementado para diversos usos y bajo diversas plataformas: juegos (Wii), control de brazos robóticos, etc. Como primer paso, se realizará un estudio de las actuales técnicas de reconocimiento de gestos que utilizan acelerómetros como sensor de medida. En un segundo paso, se estudiará como los acelerómetros pueden utilizarse para intentar reconocer los gestos que puedan realizar una persona (mover el brazo hacia un lado, girar la mano, dibujar un cuadrado, etc.) y los problemas que de su utilización puedan derivarse. Se ha utilizado una IMU (Inertial Measurement Unit) como sensor de medida. Está compuesta por tres acelerómetros y tres giróscopos (MTi-300 de Xsens). Con las medidas que proporcionan estos sensores se realiza el cálculo de la posición y orientación de la mano, representando esta última en función de los ángulos de Euler. Un aspecto importante a destacar será el efecto de la gravedad en las medidas de las aceleraciones. A través de diversos cálculos y mediante la ayuda de los giróscopos se podrá corregir dicho efecto. Por último, se desarrollará un sistema que identifique la posición y orientación de la mano como gestos reconocidos utilizando lógica difusa. Tanto para la adquisición de las muestras, como para los cálculos de posicionamiento, se ha desarrollado un código con el programa Matlab. También, con este mismo software, se ha implementado un sistema de lógica difusa con la que se realizará el reconocimiento de los gestos, utilizando la herramienta FIS Editor. Las pruebas realizadas han consistido en la ejecución de nueve gestos por diferentes personas teniendo una tasa de reconocimiento comprendida entre el 90 % y 100 % dependiendo del gesto a identificar. ABSTRACT In recent years, it has grown significantly interest in the use of devices capable of recognizing human gestures. In this work, we aim to recognize hand gestures placing sensors on the hand of a person. The recognition of hand gestures can be implemented for different applications on different platforms: games (Wii), control of robotic arms ... As a first step, a study of current gesture recognition techniques that use accelerometers and sensor measurement is performed. In a second step, we study how accelerometers can be used to try to recognize the gestures that can make a person (moving the arm to the side, rotate the hand, draw a square, etc...) And the problems of its use can be derived. We used an IMU (Inertial Measurement Unit) as a measuring sensor. It comprises three accelerometers and three gyroscopes (Xsens MTI-300). The measures provided by these sensors to calculate the position and orientation of the hand are made, with the latter depending on the Euler angles. An important aspect to note is the effect of gravity on the measurements of the accelerations. Through various calculations and with the help of the gyroscopes can correct this effect. Finally, a system that identifies the position and orientation of the hand as recognized gestures developed using fuzzy logic. Both the acquisition of samples to calculate position, a code was developed with Matlab program. Also, with the same software, has implemented a fuzzy logic system to be held with the recognition of gestures using the FIS Editor. Tests have involved the execution of nine gestures by different people having a recognition rate between 90% and 100% depending on the gesture to identify.