A web-based system for visualizing upper limb motor performance of Parkinson’s disease patients

Objective To design, develop and set up a web-based system for enabling graphical visualization of upper limb motor performance (ULMP) of Parkinson’s disease (PD) patients to clinicians. Background Sixty-five patients diagnosed with advanced PD have used a test battery, implemented in a touch-screen handheld computer, in their home environment settings over the course of a 3-year clinical study. The test items consisted of objective measures of ULMP through a set of upper limb motor tests (finger to tapping and spiral drawings). For the tapping tests, patients were asked to perform alternate tapping of two buttons as fast and accurate as possible, first using the right hand and then the left hand. The test duration was 20 seconds. For the spiral drawing test, patients traced a pre-drawn Archimedes spiral using the dominant hand, and the test was repeated 3 times per test occasion. In total, the study database consisted of symptom assessments during 10079 test occasions. Methods Visualization of ULMP The web-based system is used by two neurologists for assessing the performance of PD patients during motor tests collected over the course of the said study. The system employs animations, scatter plots and time series graphs to visualize the ULMP of patients to the neurologists. The performance during spiral tests is depicted by animating the three spiral drawings, allowing the neurologists to observe real-time accelerations or hesitations and sharp changes during the actual drawing process. The tapping performance is visualized by displaying different types of graphs. Information presented included distribution of taps over the two buttons, horizontal tap distance vs. time, vertical tap distance vs. time, and tapping reaction time over the test length. Assessments Different scales are utilized by the neurologists to assess the observed impairments. For the spiral drawing performance, the neurologists rated firstly the ‘impairment’ using a 0 (no impairment) – 10 (extremely severe) scale, secondly three kinematic properties: ‘drawing speed’, ‘irregularity’ and ‘hesitation’ using a 0 (normal) – 4 (extremely severe) scale, and thirdly the probable ‘cause’ for the said impairment using 3 choices including Tremor, Bradykinesia/Rigidity and Dyskinesia. For the tapping performance, a 0 (normal) – 4 (extremely severe) scale is used for first rating four tapping properties: ‘tapping speed’, ‘accuracy’, ‘fatigue’, ‘arrhythmia’, and then the ‘global tapping severity’ (GTS). To achieve a common basis for assessment, initially one neurologist (DN) performed preliminary ratings by browsing through the database to collect and rate at least 20 samples of each GTS level and at least 33 samples of each ‘cause’ category. These preliminary ratings were then observed by the two neurologists (DN and PG) to be used as templates for rating of tests afterwards. In another track, the system randomly selected one test occasion per patient and visualized its items, that is tapping and spiral drawings, to the two neurologists. Statistical methods Inter-rater agreements were assessed using weighted Kappa coefficient. The internal consistency of properties of tapping and spiral drawing tests were assessed using Cronbach’s α test. One-way ANOVA test followed by Tukey multiple comparisons test was used to test if mean scores of properties of tapping and spiral drawing tests were different among GTS and ‘cause’ categories, respectively. Results When rating tapping graphs, inter-rater agreements (Kappa) were as follows: GTS (0.61), ‘tapping speed’ (0.89), ‘accuracy’ (0.66), ‘fatigue’ (0.57) and ‘arrhythmia’ (0.33). The poor inter-rater agreement when assessing “arrhythmia” may be as a result of observation of different things in the graphs, among the two raters. When rating animated spirals, both raters had very good agreement when assessing severity of spiral drawings, that is, ‘impairment’ (0.85) and irregularity (0.72). However, there were poor agreements between the two raters when assessing ‘cause’ (0.38) and time-information properties like ‘drawing speed’ (0.25) and ‘hesitation’ (0.21). Tapping properties, that is ‘tapping speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’ had satisfactory internal consistency with a Cronbach’s α coefficient of 0.77. In general, the trends of mean scores of tapping properties worsened with increasing levels of GTS. The mean scores of the four properties were significantly different to each other, only at different levels. In contrast from tapping properties, kinematic properties of spirals, that is ‘drawing speed’, ‘irregularity’ and ‘hesitation’ had a questionable consistency among them with a coefficient of 0.66. Bradykinetic spirals were associated with more impaired speed (mean = 83.7 % worse, P < 0.001) and hesitation (mean = 77.8% worse, P < 0.001), compared to dyskinetic spirals. Both these ‘cause’ categories had similar mean scores of ‘impairment’ and ‘irregularity’. Conclusions In contrast from current approaches used in clinical setting for the assessment of PD symptoms, this system enables clinicians to animate easily and realistically the ULMP of patients who at the same time are at their homes. Dynamic access of visualized motor tests may also be useful when observing and evaluating therapy-related complications such as under- and over-medications. In future, we foresee to utilize these manual ratings for developing and validating computer methods for automating the process of assessing ULMP of PD patients.

A web based decision support system for status assessment in advanced parkinson

The purpose of this work is to develop a web based decision support system, based onfuzzy logic, to assess the motor state of Parkinson patients on their performance in onscreenmotor tests in a test battery on a hand computer. A set of well defined rules, basedon an expert’s knowledge, were made to diagnose the current state of the patient. At theend of a period, an overall score is calculated which represents the overall state of thepatient during the period. Acceptability of the rules is based on the absolute differencebetween patient’s own assessment of his condition and the diagnosed state. Anyinconsistency can be tracked by highlighted as an alert in the system. Graphicalpresentation of data aims at enhanced analysis of patient’s state and performancemonitoring by the clinic staff. In general, the system is beneficial for the clinic staff,patients, project managers and researchers.

ANALYSIS & STUDY OF AI TECHNIQUES FORAUTOMATIC CONDITION MONITORING OFRAILWAY TRACK INFRASTRUCTURE : Artificial Intelligence Techniques

Since the last decade the problem of surface inspection has been receiving great attention from the scientific community, the quality control and the maintenance of products are key points in several industrial applications.The railway associations spent much money to check the railway infrastructure. The railway infrastructure is a particular field in which the periodical surface inspection can help the operator to prevent critical situations. The maintenance and monitoring of this infrastructure is an important aspect for railway association.That is why the surface inspection of railway also makes importance to the railroad authority to investigate track components, identify problems and finding out the way that how to solve these problems. In railway industry, usually the problems find in railway sleepers, overhead, fastener, rail head, switching and crossing and in ballast section as well. In this thesis work, I have reviewed some research papers based on AI techniques together with NDT techniques which are able to collect data from the test object without making any damage. The research works which I have reviewed and demonstrated that by adopting the AI based system, it is almost possible to solve all the problems and this system is very much reliable and efficient for diagnose problems of this transportation domain. I have reviewed solutions provided by different companies based on AI techniques, their products and reviewed some white papers provided by some of those companies. AI based techniques likemachine vision, stereo vision, laser based techniques and neural network are used in most cases to solve the problems which are performed by the railway engineers.The problems in railway handled by the AI based techniques performed by NDT approach which is a very broad, interdisciplinary field that plays a critical role in assuring that structural components and systems perform their function in a reliable and cost effective fashion. The NDT approach ensures the uniformity, quality and serviceability of materials without causing any damage of that materials is being tested. This testing methods use some way to test product like, Visual and Optical testing, Radiography, Magnetic particle testing, Ultrasonic testing, Penetrate testing, electro mechanic testing and acoustic emission testing etc. The inspection procedure has done periodically because of better maintenance. This inspection procedure done by the railway engineers manually with the aid of AI based techniques.The main idea of thesis work is to demonstrate how the problems can be reduced of thistransportation area based on the works done by different researchers and companies. And I have also provided some ideas and comments according to those works and trying to provide some proposal to use better inspection method where it is needed.The scope of this thesis work is automatic interpretation of data from NDT, with the goal of detecting flaws accurately and efficiently. AI techniques such as neural networks, machine vision, knowledge-based systems and fuzzy logic were applied to a wide spectrum of problems in this area. Another scope is to provide an insight into possible research methods concerning railway sleeper, fastener, ballast and overhead inspection by automatic interpretation of data.In this thesis work, I have discussed about problems which are arise in railway sleepers,fastener, and overhead and ballasted track. For this reason I have reviewed some research papers related with these areas and demonstrated how their systems works and the results of those systems. After all the demonstrations were taking place of the advantages of using AI techniques in contrast with those manual systems exist previously.This work aims to summarize the findings of a large number of research papers deploying artificial intelligence (AI) techniques for the automatic interpretation of data from nondestructive testing (NDT). Problems in rail transport domain are mainly discussed in this work. The overall work of this paper goes to the inspection of railway sleepers, fastener, ballast and overhead.

Separation and Execution of graphical engine on a cross platform IDE to enhance performance

“Biosim” is a simulation software which works to simulate the harvesting system.This system is able to design a model for any logistic problem with the combination of several objects so that the artificial system can show the performance of an individual model. The system will also describe the efficiency, possibility to be chosen for real life application of that particular model. So, when any one wish to setup a logistic model like- harvesting system, in real life he/she may be noticed about the suitable prostitution for his plants and factories as well as he/she may get information about the least number of objects, total time to complete the task, total investment required for his model, total amount of noise produced for his establishment in advance. It will produce an advance over view for his model. But “Biosim” is quite slow .As it is an object based system, it takes long time to make its decision. Here the main task is to modify the system so that it can work faster than the previous. So, the main objective of this thesis is to reduce the load of “Biosim” by making some modification of the original system as well as to increase its efficiency. So that the whole system will be faster than the previous one and performs more efficiently when it will be applied in real life. Theconcept is to separate the execution part of ”Biosim” form its graphical engine and run this separated portion in a third generation language platform. C++ is chosenhere as this external platform. After completing the proposed system, results with different models have been observed. The results show that, for any type of plants of fields, for any number of trucks, the proposed system is faster than the original system. The proposed system takes at least 15% less time “Biosim”. The efficiency increase with the complexity of than the original the model. More complex the model, more efficient the proposed system is than original “Biosim”.Depending on the complexity of a model, the proposed system can be 56.53 % faster than the original “Biosim”.

IT support for administrative planning of clinical practice.

The administration of clinical practice placements for nursing students is a highly complex and information driven task. This demonstration is intended to give insight into the web based system KliPP (a Swedish acronym for Clinical Practice Planning) and to discuss the possibilities for further development and use.

A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients

Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting. Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown. Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients. Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

Mobile systems for monitoring Parkinson's disease

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device. One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data-driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time. Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.

Kravsammanställning samt utvärdering avbildvisningsprogramför diagnostik inom telepatologi : En fallstudiemed SIV-metoden som tillvägagångssätt

De flesta har i sin närhet någon som drabbats av cancer och sjukdomsfallen har ökat genom åren. Den yrkesgrupp som ställer diagnos av denna sjukdom är patologer. Bristen på patologer är idagsläget stor och det finns därför ett behov av att finna effektiva lösningar för att möta denna brist och en ökande mängd patienter. För att digitalisera vävnadsproven som diagnostiseras, scannas dessa in med en glasscanner. Dessa digitala bildfiler kan sedan visas i ett bildvisningsprogram och delas digitalt mellan patologer på distans. Detta begrepp kallas för telepatologi. Studien utgår utifrån följande frågeställningar: Vilka krav är väsentliga och bör ingå i en utvärdering för bildvisningsprogram avsedda för diagnostik inom telepatologi? Vilket bildvisningsprogram är mest lämpat att implementeras i ett webbaserat system baserat på dessa väsentliga krav? Syftet med studien är att undersöka vilka krav som är väsentliga och bör ingå i en utvärdering av bildvisningsprogram avsedda för diagnostik inom telepatologi, samt att utföra en utvärdering av ett urval bildvisningsprogramvaror med hjälp av dessa krav. En fallstudie genomfördes med datainsamlingsmetoderna: intervjuer med två personer från studiens samarbetspartner CGM, Frågeformulär där Sveriges patologer var respondenter samt dokumentstudier för att samla in information gällande bildvisningsprogrammen. Studien tillämpar utvalda delar ur Anders G. Nilssons SIV-metod som tillvägagångsätt för att samla in krav samt för att göra ett urval av bildvisningsprogram som sedan utvärderas gentemot dessa krav. Resultaten av datainsamlingarna analyserades och ledde till ett kravdokument med väsentliga krav.Tre så kallade utslagsgivande faktorer bland dessa krav var att bildvisningsprogrammet måste vara webbaserat utan installation på klient, funktioner för in- och ut-zoomning samt panorering måste finnas. Utvärderingen av utvalda bildvisningsprogram visade slutligen att OpenSlide var mest lämpad att implementeras i ett webbaserat system.

Automatic and objective assessment of alternating tapping performance in Parkinson’s disease

This paper presents the development and evaluation of a method for enabling quantitative and automatic scoring of alternating tapping performance of patients with Parkinson’s disease (PD). Ten healthy elderly subjects and 95 patients in different clinical stages of PD have utilized a touch-pad handheld computer to perform alternate tapping tests in their home environments. First, a neurologist used a web-based system to visually assess impairments in four tapping dimensions (‘speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’) and a global tapping severity (GTS). Second, tapping signals were processed with time series analysis and statistical methods to derive 24 quantitative parameters. Third, principal component analysis was used to reduce the dimensions of these parameters and to obtain scores for the four dimensions. Finally, a logistic regression classifier was trained using a 10-fold stratified cross-validation to map the reduced parameters to the corresponding visually assessed GTS scores. Results showed that the computed scores correlated well to visually assessed scores and were significantly different across Unified Parkinson’s Disease Rating Scale scores of upper limb motor performance. In addition, they had good internal consistency, had good ability to discriminate between healthy elderly and patients in different disease stages, had good sensitivity to treatment interventions and could reflect the natural disease progression over time. In conclusion, the automatic method can be useful to objectively assess the tapping performance of PD patients and can be included in telemedicine tools for remote monitoring of tapping.

On processing GPS tracking data of spatiotemporal car movements : a case study

The advancement of GPS technology has made it possible to use GPS devices as orientation and navigation tools, but also as tools to track spatiotemporal information. GPS tracking data can be broadly applied in location-based services, such as spatial distribution of the economy, transportation routing and planning, traffic management and environmental control. Therefore, knowledge of how to process the data from a standard GPS device is crucial for further use. Previous studies have considered various issues of the data processing at the time. This paper, however, aims to outline a general procedure for processing GPS tracking data. The procedure is illustrated step-by-step by the processing of real-world GPS data of car movements in Borlänge in the centre of Sweden.