Reliability of the Knee Examination in Osteoarthritis: Effect of Standardization

Objective. To assess the reliability of physical examination of the osteoarthritic (OA) knee by rheumatologists, and to evaluate the benefits of standardization. Methods. Forty-two physical signs and techniques were evaluated using a 6 X 6 Latin square design. Patients with mild to severe knee OA, based on physical and radiographic signs, were examined in random order prior to and following standardization of techniques. For those signs with dichotomous scales, agreement among the rheumatologists was calculated as the prevalence-adjusted bias-adjusted kappa (PABAK), while for the signs with continuous and ordinal scales, a reliability coefficient (R-c) was calculated using analysis of variance. A PABAK of >0.60 and an Re of >0.80 were considered to indicate adequate reliability. Results. Adequate poststandardization reliability was achieved for 30 of 42 physical signs/techniques (71%). The most highly reliable signs identified by physical examination of the OA knee included alignment by goniometer (R-c = 0.99), bony swelling (R-c = 0.97), general passive crepitus (R-c = 0.96), gait by inspection (PABAK = 0.78), effusion bulge sign (R-c = 0.97), quadriceps atrophy (R. = 0.97), medial tibiofemoral tenderness (R-c = 0.94), lateral tibiofemoral tenderness (R-c = 0.85), patellofemoral tenderness by grind test (R-c = 0.94), and flexion contracture (R-c = 0.95). The standardization process resulted in substantial improvements in reliability for evaluation of a number of physical signs, although for some signs, minimal or no effect of standardization was noted. After standardization, warmth (PABAK = 0.14), medial instability at 30degrees flexion (PABAK = 0.02), and lateral instability at 30degrees flexion (PABAK = 0.34) were the only 3 signs that were highly unreliable. Conclusion. With the exception of physical examinations for instability, a comprehensive knee examination can be performed with adequate reliability. Standardization further improves the reliability for some physical signs and techniques. The application of these findings to future OA studies will contribute to improved outcome assessments in OA.

Tuning pattern classifier parameters using a genetic algorithm with an application in mobile robotics

Support vector machines (SVMs) have recently emerged as a powerful technique for solving problems in pattern classification and regression. Best performance is obtained from the SVM its parameters have their values optimally set. In practice, good parameter settings are usually obtained by a lengthy process of trial and error. This paper describes the use of genetic algorithm to evolve these parameter settings for an application in mobile robotics.

Monitoring dendritic cells in clinical practice using a new whole blood single-platform TruCOUNT assay

Dendritic cells (DC) from distinct DC subsets are essential contributors to normal human immune responses. Despite this, reliable assays that enable DC to be counted precisely have been slow to evolve. We have now developed a new single-platform flow cytometric assay based on TruCOUN(TM) beads and the whole blood Lyse/No-Wash protocol that allows precise counting of the CD14(-) blood DC subsets: CD11c(+)CD16(-) DC, CD11c(+)CD16(+) DC, CD123(hi) DC, CD1c(+) DC and BDCA-3(+) DC. This assay requires 50 mul of whole blood; does not rely on a hematology blood analyser for the absolute DC counts; allows DC counting in EDTA samples 24 It after collection; and is suitable for cord blood and peripheral blood. The data is highly reproducible with intra-assay and inter-assay coefficients of variation less than 3% and 11%, respectively. This assay does not produce the DC-T lymphocyte conjugates that result in DC counting abnormalities in conventional gradient-density separation procedures. Using the TruCOUNT assay, we established that absolute blood DC counts reduce with age in healthy individuals. In preliminary studies, we found a significantly lower absolute blood CD11c(+)CD16(+) DC count in stage III/IV versus stage I/II breast carcinoma patients and a lower absolute blood CD123(hi) DC count in multiple myeloma patients, compared to age-matched controls. These data indicate that scientific progress in DC counting technology will lead to the global standardization of DC counting and allow clinically meaningful data to be obtained. (C) 2003 Elsevier B.V. All rights reserved.

Ultrasound organometry: the importance of body height adjusted normal ranges in assessing liver and spleen parameters among Chinese subjects with Schistosoma japonicum infection

Hepatosplenic measurements among 550 Chinese subjects, aged 3-59 years from Yueyang city-a nonendemic area for schistosomiasis in Hunan province, China-were performed to define normal ranges of ultrasound organometry for assessing hepatosplenic, morbidity in Schistosoma japonicum infection. Measurements included the size of the liver (left lobe and right lobe), the main portal vein stem, the peripheral periportal vein branches, and spleen length and thickness. The results document the significant relationship between body height and organometric parameters. The reference values stratified by body height improve the accuracy of assessment. Thus, height-based normal ranges established in this study can be applied in hospital routine and in field studies of patients infected with S. japonicum in Hunan province and in other endemic areas of China. (C) 2004 Elsevier B.V. All rights reserved.

Outcome measurement in Australian rehabilitation environments

Objective: To determine the frequency and pattern of methods of outcome assessment used in Australian physical rehabilitation environments. Design: Postal survey. Methods: A questionnaire on service type, staffing, numbers of adults treated and outcome measures used for 7 conditions related to injury and road trauma as well as stroke and neuromuscular disorders was sent to 973 services providing adult physical rehabilitation treatment. Results: Questionnaires were completed by 440 service providers for a response rate of 45%, similar to that reported in a recent European survey reported in this journal. A small number of measures were reported as in use by most respondents, while a large number of measures were used by a few respondents. Measures of physical changes were used more frequently than those of generic well-being or quality of life. Ease of use and reporting to other professionals were cited as the most important reasons in selection of outcome measures. Conclusion: This Australian-wide survey detected considerable heterogeneity in outcome measurement procedures used in rehabilitation environments. While the goal of measurement may vary between providers and differ between conditions, the results highlight opportunities for harmonization, benchmarking and measurement of health-related quality of life.

Experiments in outdoor operation of RatSLAM

This paper shows initial results in deploying the biologically inspired Simultaneous Localisation and Mapping system, RatSLAM, in an outdoor environment. RatSLAM has been widely tested in indoor environments on the task of producing topologically coherent maps based on a fusion of odometric and visual information. This paper details the changes required to deploy RatSLAM on a small tractor equipped with odometry and an omnidirectional camera. The principal changes relate to the vision system, with others required for RatSLAM to use omnidirectional visual data. The initial results from mapping around a 500 m loop are promising, with many improvements still to be made.

Multi-robot control in highly dynamic, competitive environments

The control and coordination of multiple mobile robots is a challenging task; particularly in environments with multiple, rapidly moving obstacles and agents. This paper describes a robust approach to multi-robot control, where robustness is gained from competency at every layer of robot control. The layers are: (i) a central coordination system (MAPS), (ii) an action system (AES), (iii) a navigation module, and (iv) a low level dynamic motion control system. The multi-robot coordination system assigns each robot a role and a sub-goal. Each robot’s action execution system then assumes the assigned role and attempts to achieve the specified sub-goal. The robot’s navigation system directs the robot to specific goal locations while ensuring that the robot avoids any obstacles. The motion system maps the heading and speed information from the navigation system to force-constrained motion. This multi-robot system has been extensively tested and applied in the robot soccer domain using both centralized and distributed coordination.

A modified particle filter for simultaneous robot localization and landmark tracking in an indoor environment

This paper presents the implementation of a modified particle filter for vision-based simultaneous localization and mapping of an autonomous robot in a structured indoor environment. Through this method, artificial landmarks such as multi-coloured cylinders can be tracked with a camera mounted on the robot, and the position of the robot can be estimated at the same time. Experimental results in simulation and in real environments show that this approach has advantages over the extended Kalman filter with ambiguous data association and various levels of odometric noise.

UQ RoboRoos: Achieving power and agility in a small size robot

The UQ RoboRoos have been developed to participate in the RoboCup robot soccer small size league over several years. RoboCup 2001 saw a focus on the mechanical design of the RoboRoos, with the introduction of an omni-directional drive system and a high power kicker. The change in mechanical design had implications for the rest of the system particularly navigation and multi-robot planning. In addition, the overhead vision system was upgraded to improve reliability and robustness.

Classifying an opponent's behaviour in robot soccer

This paper illustrates the prediction of opponent behaviour in a competitive, highly dynamic, multi-agent and partially observableenvironment, namely RoboCup small size league robot soccer. The performance is illustrated in the context of the highly successful robot soccer team, the RoboRoos. The project is broken into three tasks; classification of behaviours, modelling and prediction of behaviours and integration of the predictions into the existing planning system. A probabilistic approach is taken to dealing with the uncertainty in the observations and with representing the uncertainty in the prediction of the behaviours. Results are shown for a classification system using a Naïve Bayesian Network that determines the opponent’s current behaviour. These results are compared to an expert designed fuzzy behaviour classification system. The paper illustrates how the modelling system will use the information from behaviour classification to produce probability distributions that model the manner with which the opponents perform their behaviours. These probability distributions are show to match well with the existing multi-agent planning system (MAPS) that forms the core of the RoboRoos system.

Achieving cooperation in a distributed multi-robot team

DMAPS (Distributed Multi-Agent Planning System) is a planning system developed for distributed multi-robot teams based on MAPS(Multi-Agent Planning System). MAPS assumes that each agent has the same global view of the environment in order to determine the most suitable actions. This assumption fails when perception is local to the agents: each agent has only a partial and unique view of the environment. DMAPS addresses this problem by creating a probabilistic global view on each agent by fusing the perceptual information from each robot. The experimental results on consuming tasks show that while the probabilistic global view is not identical on each robot, the shared view is still effective in increasing performance of the team.