Development, implementation, and evaluation of a structured reporting web tool for abdominal aortic aneurysms

BACKGROUND The majority of radiological reports are lacking a standard structure. Even within a specialized area of radiology, each report has its individual structure with regards to details and order, often containing too much of non-relevant information the referring physician is not interested in. For gathering relevant clinical key parameters in an efficient way or to support long-term therapy monitoring, structured reporting might be advantageous. OBJECTIVE Despite of new technologies in medical information systems, medical reporting is still not dynamic. To improve the quality of communication in radiology reports, a new structured reporting system was developed for abdominal aortic aneurysms (AAA), intended to enhance professional communication by providing the pertinent clinical information in a predefined standard. METHODS Actual state analysis was performed within the departments of radiology and vascular surgery by developing a Technology Acceptance Model. The SWOT (strengths, weaknesses, opportunities, and threats) analysis focused on optimization of the radiology reporting of patients with AAA. Definition of clinical parameters was achieved by interviewing experienced clinicians in radiology and vascular surgery. For evaluation, a focus group (4 radiologists) looked at the reports of 16 patients. The usability and reliability of the method was validated in a real-world test environment in the field of radiology. RESULTS A Web-based application for radiological "structured reporting" (SR) was successfully standardized for AAA. Its organization comprises three main categories: characteristics of pathology and adjacent anatomy, measurements, and additional findings. Using different graphical widgets (eg, drop-down menus) in each category facilitate predefined data entries. Measurement parameters shown in a diagram can be defined for clinical monitoring and be adducted for quick adjudications. Figures for optional use to guide and standardize the reporting are embedded. Analysis of variance shows decreased average time required with SR to obtain a radiological report compared to free-text reporting (P=.0001). Questionnaire responses confirm a high acceptance rate by the user. CONCLUSIONS The new SR system may support efficient radiological reporting for initial diagnosis and follow-up for AAA. Perceived advantages of our SR platform are ease of use, which may lead to more accurate decision support. The new system is open to communicate not only with clinical partners but also with Radiology Information and Hospital Information Systems.

Development and Evaluation of a New Tablet Computer Application for the Therapy of Brain-Injured Patients with Aphasia

Introduction Language is the most important mean of communication and plays a central role in our everyday life. Brain damage (e.g. stroke) can lead to acquired disorders of lan- guage affecting the four linguistic modalities (i.e. reading, writing, speech production and comprehension) in different combinations and levels of severity. Every year, more than 5000 people (Aphasie Suisse) are affected by aphasia in Switzerland alone. Since aphasia is highly individual, the level of difficulty and the content of tasks have to be adapted continuously by the speech therapists. Computer-based assignments allow patients to train independently at home and thus increasing the frequency of ther- apy. Recent developments in tablet computers have opened new opportunities to use these devices for rehabilitation purposes. Especially older people, who have no prior experience with computers, can benefit from the new technologies. Methods The aim of this project was to develop an application that enables patients to train language related tasks autonomously and, on the other hand, allows speech therapists to assign exercises to the patients and to track their results online. Seven categories with various types of assignments were implemented. The application has two parts which are separated by a user management system into a patient interface and a therapist interface. Both interfaces were evaluated using the SUS (Subject Usability Scale). The patient interface was tested by 15 healthy controls and 5 patients. For the patients, we also collected tracking data for further analysis. The therapist interface was evaluated by 5 speech therapists. Results The SUS score are xpatients = 98 and xhealthy = 92.7 (median = 95, SD = 7, 95% CI [88.8, 96.6]) in case of the patient interface and xtherapists = 68 in case of the therapist interface. Conclusion Both, the patients and the healthy subjects, attested high SUS scores to the patient interface. These scores are considered as "best imaginable". The therapist interface got a lower SUS score compared to the patient interface, but is still considered as "good" and "usable". The user tracking system and the interviews revealed that there is room for improvements and inspired new ideas for future versions.

Evaluation of Video Transmission Energy Consumption and Quality

The widespread use of wireless enabled devices and the increasing capabilities of wireless technologies has promoted multimedia content access and sharing among users. However, the quality perceived by the users still depends on multiple factors such as video characteristics, device capabilities, and link quality. While video characteristics include the video time and spatial complexity as well as the coding complexity, one of the most important device characteristics is the battery lifetime. There is the need to assess how these aspects interact and how they impact the overall user satisfaction. This paper advances previous works by proposing and validating a flexible framework, named EViTEQ, to be applied in real testbeds to satisfy the requirements of performance assessment. EViTEQ is able to measure network interface energy consumption with high precision, while being completely technology independent and assessing the application level quality of experience. The results obtained in the testbed show the relevance of combined multi-criteria measurement approaches, leading to superior end-user satisfaction perception evaluation .

Assessing fun in serious games: Formative evaluation of games from two diabetes prevention interventions

Purpose. To determine the usability of two video games to prevent type 2 diabetes and obesity among youth through analysis of data collected during alpha-testing. ^ Subjects. Ten children aged 9 to 12 were selected for three 2-hour alpha testing sessions.^ Methods. "Escape from Diab" and "Nanoswarm" were designed to change dietary and physical inactivity behaviors, based on a theoretical framework of mediating variables obtained from social cognitive theory, self-determination theory, elaboration likelihood model, and behavioral inoculation theory. Thirteen mini-games developed by the software company were divided into 3 groups based on completion date. Children tested 4-5 mini-games in each of three sessions. Observed game play was followed by a scripted interview. Results from observation forms and interview transcripts were tabulated and coded to determine usability. Suggestions for game modifications were delivered to the software design firm, and a follow-up table reports rationale for inclusion or exclusion of such modifications.^ Results. Participants were 50% frequent video game players and 20% non game-players. Most (60%) were female. The mean grade (indicating likeability as a subset of usability) across all games given by children was significantly greater than a neutral grade of 80% (89%, p < 0.01), indicating a positive likeability score. The games on average also received positive ratings for fun, helpfulness of instructions and length compared to neutral values (midpoint on likert scales) (all p < 0.01). Observation notes indicated that participants paid attention to the instructions, did not appear to have much difficulty with the games, and were "not frustrated", "not bored", "very engaged", "not fidgety" and "very calm" (all p < 0.01). The primary issues noted in observations and interviews were unclear instructions and unclear purpose of some games. Player suggestions primarily involved ways to make on screen cues more visible or noticeable, instructions more clear, and games more elaborate or difficult.^ Conclusions. The present study highlights the importance of alpha testing video game components for usability prior to completion to enhance usability and likeability. Results indicate that creating clear instructions, making peripheral screen cues more eye-catching or noticeable, and vigorously stating the purpose of the game to improve understandability are important elements. However, future interventions will each present unique materials and user-interfaces and should therefore also be thoroughly alpha-tested. ^

AN EVALUATION OF THE CONSISTENCY OF IMRT PATIENT-SPECIFIC QA TECHNIQUES

To ensure the integrity of an intensity modulated radiation therapy (IMRT) treatment, each plan must be validated through a measurement-based quality assurance (QA) procedure, known as patient specific IMRT QA. Many methods of measurement and analysis have evolved for this QA. There is not a standard among clinical institutions, and many devices and action levels are used. Since the acceptance criteria determines if the dosimetric tools’ output passes the patient plan, it is important to see how these parameters influence the performance of the QA device. While analyzing the results of IMRT QA, it is important to understand the variability in the measurements. Due to the different form factors of the many QA methods, this reproducibility can be device dependent. These questions of patient-specific IMRT QA reproducibility and performance were investigated across five dosimeter systems: a helical diode array, radiographic film, ion chamber, diode array (AP field-by-field, AP composite, and rotational composite), and an in-house designed multiple ion chamber phantom. The reproducibility was gauged for each device by comparing the coefficients of variation (CV) across six patient plans. The performance of each device was determined by comparing each one’s ability to accurately label a plan as acceptable or unacceptable compared to a gold standard. All methods demonstrated a CV of less than 4%. Film proved to have the highest variability in QA measurement, likely due to the high level of user involvement in the readout and analysis. This is further shown by how the setup contributed more variation than the readout and analysis for all of the methods, except film. When evaluated for ability to correctly label acceptable and unacceptable plans, two distinct performance groups emerged with the helical diode array, AP composite diode array, film, and ion chamber in the better group; and the rotational composite and AP field-by-field diode array in the poorer group. Additionally, optimal threshold cutoffs were determined for each of the dosimetry systems. These findings, combined with practical considerations for factors such as labor and cost, can aid a clinic in its choice of an effective and safe patient-specific IMRT QA implementation.

Code and readme of a MATLAB-based graphical user interface program for computing functionals of the geopotential

We present a novel graphical user interface program GrafLab (GRAvity Field LABoratory) for spherical harmonic synthesis (SHS) created in MATLAB®. This program allows to comfortably compute 38 various functionals of the geopotential up to ultra-high degrees and orders of spherical harmonic expansion. For the most difficult part of the SHS, namely the evaluation of the fully normalized associated Legendre functions (fnALFs), we used three different approaches according to required maximum degree: (i) the standard forward column method (up to maximum degree 1800, in some cases up to degree 2190); (ii) the modified forward column method combined with Horner's scheme (up to maximum degree 2700); (iii) the extended-range arithmetic (up to an arbitrary maximum degree). For the maximum degree 2190, the SHS with fnALFs evaluated using the extended-range arithmetic approach takes only approximately 2-3 times longer than its standard arithmetic counterpart, i.e. the standard forward column method. In the GrafLab, the functionals of the geopotential can be evaluated on a regular grid or point-wise, while the input coordinates can either be read from a data file or entered manually. For the computation on a regular grid we decided to apply the lumped coefficients approach due to significant time-efficiency of this method. Furthermore, if a full variance-covariance matrix of spherical harmonic coefficients is available, it is possible to compute the commission errors of the functionals. When computing on a regular grid, the output functionals or their commission errors may be depicted on a map using automatically selected cartographic projection.

Design and evaluation of acceleration strategies for speeding up the development of dialog applications

In this paper, we describe a complete development platform that features different innovative acceleration strategies, not included in any other current platform, that simplify and speed up the definition of the different elements required to design a spoken dialog service. The proposed accelerations are mainly based on using the information from the backend database schema and contents, as well as cumulative information produced throughout the different steps in the design. Thanks to these accelerations, the interaction between the designer and the platform is improved, and in most cases the design is reduced to simple confirmations of the “proposals” that the platform dynamically provides at each step. In addition, the platform provides several other accelerations such as configurable templates that can be used to define the different tasks in the service or the dialogs to obtain or show information to the user, automatic proposals for the best way to request slot contents from the user (i.e. using mixed-initiative forms or directed forms), an assistant that offers the set of more probable actions required to complete the definition of the different tasks in the application, or another assistant for solving specific modality details such as confirmations of user answers or how to present them the lists of retrieved results after querying the backend database. Additionally, the platform also allows the creation of speech grammars and prompts, database access functions, and the possibility of using mixed initiative and over-answering dialogs. In the paper we also describe in detail each assistant in the platform, emphasizing the different kind of methodologies followed to facilitate the design process at each one. Finally, we describe the results obtained in both a subjective and an objective evaluation with different designers that confirm the viability, usefulness, and functionality of the proposed accelerations. Thanks to the accelerations, the design time is reduced in more than 56% and the number of keystrokes by 84%.

IDT-3D: Identification and tracking in controlled environments using a 3D unified user interface

Identification and tracking of objects in specific environments such as harbors or security areas is a matter of great importance nowadays. With this purpose, numerous systems based on different technologies have been developed, resulting in a great amount of gathered data displayed through a variety of interfaces. Such amount of information has to be evaluated by human operators in order to take the correct decisions, sometimes under highly critical situations demanding both speed and accuracy. In order to face this problem we describe IDT-3D, a platform for identification and tracking of vessels in a harbour environment able to represent fused information in real time using a Virtual Reality application. The effectiveness of using IDT-3D as an integrated surveillance system is currently under evaluation. Preliminary results point to a significant decrease in the times of reaction and decision making of operators facing up a critical situation. Although the current application focus of IDT-3D is quite specific, the results of this research could be extended to the identification and tracking of targets in other controlled environments of interest as coastlines, borders or even urban areas.

Constructs and evaluation strategies for intelligent speculative parallelism - armageddon revisited

This report addresses speculative parallelism (the assignment of spare processing resources to tasks which are not known to be strictly required for the successful completion of a computation) at the user and application level. At this level, the execution of a program is seen as a (dynamic) tree —a graph, in general. A solution for a problem is a traversal of this graph from the initial state to a node known to be the answer. Speculative parallelism then represents the assignment of resources to múltiple branches of this graph even if they are not positively known to be on the path to a solution. In highly non-deterministic programs the branching factor can be very high and a naive assignment will very soon use up all the resources. This report presents work assignment strategies other than the usual depth-first and breadth-first. Instead, best-first strategies are used. Since their definition is application-dependent, the application language contains primitives that allow the user (or application programmer) to a) indícate when intelligent OR-parallelism should be used; b) provide the functions that define "best," and c) indícate when to use them. An abstract architecture enables those primitives to perform the search in a "speculative" way, using several processors, synchronizing them, killing the siblings of the path leading to the answer, etc. The user is freed from worrying about these interactions. Several search strategies are proposed and their implementation issues are addressed. "Armageddon," a global pruning method, is introduced, together with both a software and a hardware implementation for it. The concepts exposed are applicable to áreas of Artificial Intelligence such as extensive expert systems, planning, game playing, and in general to large search problems. The proposed strategies, although showing promise, have not been evaluated by simulation or experimentation.

Assessing user bias in affect detection within context-based spoken dialog systems

This paper presents an empirical evidence of user bias within a laboratory-oriented evaluation of a Spoken Dialog System. Specifically, we addressed user bias in their satisfaction judgements. We question the reliability of this data for modeling user emotion, focusing on contentment and frustration in a spoken dialog system. This bias is detected through machine learning experiments that were conducted on two datasets, users and annotators, which were then compared in order to assess the reliability of these datasets. The target used was the satisfaction rating and the predictors were conversational/dialog features. Our results indicated that standard classifiers were significantly more successful in discriminating frustration and contentment and the intensities of these emotions (reflected by user satisfaction ratings) from annotator data than from user data. Indirectly, the results showed that conversational features are reliable predictors of the two abovementioned emotions.

Evaluation and implementation of a hybrid cross-platform application combining mobile web-technologies and native device functions

Este Proyecto de Fin de Carrera presenta un prototipo de aplicación móvil híbrida multi-plataforma para Android y iOS. Las aplicaciones móviles híbridas son una combinación de aplicaciones web móviles y aplicaciones móviles nativas. Se desarrollan parcialmente con tecnologías web y pueden acceder a la capa nativa y sensores del teléfono. Para el usuario se presentan como aplicaciones nativas, ya que se pueden descargar de las tiendas de aplicaciones y son instaladas en el dispositivo. El prototipo consiste en la migración del módulo de noticias financieras de las aplicaciones actuales para móviles de una compañía bancaria reimplementándolo como aplicación híbrida utilizando uno de los entornos de desarrollo disponibles en el mercado para este propósito. El desarrollo de aplicaciones híbridas puede ahorrar tiempo y dinero cuando se pretende alcanzar más de una plataforma móvil. El objetivo es la evaluación de las ventajas e inconvenientes que ofrece el desarrollo de aplicaciones híbridas en términos de reducción de costes, tiempo de desarrollo y resultado final de la aplicación. El proyecto consta de varias fases. Durante la primera fase se realiza un estudio sobre las aplicaciones híbridas que podemos encontrar hoy en día en el mercado utilizando los ejemplos de linkedIn, Facebook y Financial times. Se hace hincapié en las tecnologías utilizadas, uso de la red móvil y problemas encontrados. Posteriormente se realiza una comparación de distintos entornos de desarrollo multi-plataforma para aplicaciones híbridas en términos de la estrategia utilizada, plataformas soportadas, lenguajes de programación, acceso a capacidades nativas de los dispositivos y licencias de uso. Esta primera fase da como resultado la elección del entorno de desarrollo más adecuado a las exigencias del proyecto, que es PhoneGap, y continua con un análisis más detallado de dicho entorno en cuanto a su arquitectura, características y componentes. La siguiente fase comienza con un estudio de las aplicaciones actuales de la compañía para extraer el código fuente necesario y adaptarlo a la arquitectura que tendrá la aplicación. Para la realización del prototipo se hace uso de la característica que ofrece PhoneGap para acceder a la capa nativa del dispositivo, esto es, el uso de plugins. Se diseña y desarrolla un plugin que permite acceder a la capa nativa para cada plataforma. Una vez desarrollado el prototipo para la plataforma Android, se migra y adapta para la plataforma iOS. Por último se hace una evaluación de los prototipos en cuanto a su facilidad y tiempo de desarrollo, rendimiento, funcionalidad y apariencia de la interfaz de usuario. ABSTRACT. This bachelor's thesis presents a prototype of a hybrid cross-platform mobile application for Android and iOS. Hybrid mobile applications are a combination of mobile web and mobile native applications. They are built partially with web technologies and they can also access native features and sensors of the device. For a user, they look like native applications as they are downloaded from the application stores and installed on the device. This prototype consists of the migration of the financial news module of current mobile applications from a financial bank reimplementing them as a hybrid application using one of the frameworks available in the market for that purpose. Development of applications on a hybrid way can help reducing costs and effort when targeting more than one platform. The target of the project is the evaluation of the advantages and disadvantages that hybrid development can offer in terms of reducing costs and efforts and the final result of the application. The project starts with an analysis of successfully released hybrid applications using the examples of linkedIn, Facebook and Financial Times, emphasizing the different used technologies, the transmitted network data and the encountered problems during the development. This analysis is followed by a comparison of most popular hybrid crossplatform development frameworks in terms of the different approaches, supported platforms, programming languages, access to native features and license. This first stage has the outcome of finding the development framework that best fits to the requirements of the project, that is PhoneGap, and continues with a deeper analysis of its architecture, features and components. Next stage analyzes current company's applications to extract the needed source code and adapt it to the architecture of the prototype. For the realization of the application, the feature that PhoneGap offers to access the native layer of the device is used. This feature is called plugin. A custom plugin is designed and developed to access the native layer of each targeted platform. Once the prototype is finished for Android, it is migrated and adapted to the iOS platform. As a final conclusion the prototypes are evaluated in terms of ease and time of development, performance, functionality and look and feel.

Design, implementation and evaluation of an unconstrained and contactless biometric system based on hand geometry and stress detection

Esta tesis propone un sistema biométrico de geometría de mano orientado a entornos sin contacto junto con un sistema de detección de estrés capaz de decir qué grado de estrés tiene una determinada persona en base a señales fisiológicas Con respecto al sistema biométrico, esta tesis contribuye con el diseño y la implementación de un sistema biométrico de geometría de mano, donde la adquisición se realiza sin ningún tipo de contacto, y el patrón del usuario se crea considerando únicamente datos del propio individuo. Además, esta tesis propone un algoritmo de segmentación multiescala para solucionar los problemas que conlleva la adquisición de manos en entornos reales. Por otro lado, respecto a la extracción de características y su posterior comparación esta tesis tiene una contribución específica, proponiendo esquemas adecuados para llevar a cabo tales tareas con un coste computacional bajo pero con una alta precisión en el reconocimiento de personas. Por último, este sistema es evaluado acorde a la norma estándar ISO/IEC 19795 considerando seis bases de datos públicas. En relación al método de detección de estrés, esta tesis propone un sistema basado en dos señales fisiológicas, concretamente la tasa cardiaca y la conductancia de la piel, así como la creación de un innovador patrón de estrés que recoge el comportamiento de ambas señales bajo las situaciones de estrés y no-estrés. Además, este sistema está basado en lógica difusa para decidir el grado de estrés de un individuo. En general, este sistema es capaz de detectar estrés de forma precisa y en tiempo real, proporcionando una solución adecuada para sistemas biométricos actuales, donde la aplicación del sistema de detección de estrés es directa para evitar situaciónes donde los individuos sean forzados a proporcionar sus datos biométricos. Finalmente, esta tesis incluye un estudio de aceptabilidad del usuario, donde se evalúa cuál es la aceptación del usuario con respecto a la técnica biométrica propuesta por un total de 250 usuarios. Además se incluye un prototipo implementado en un dispositivo móvil y su evaluación. ABSTRACT: This thesis proposes a hand biometric system oriented to unconstrained and contactless scenarios together with a stress detection method able to elucidate to what extent an individual is under stress based on physiological signals. Concerning the biometric system, this thesis contributes with the design and implementation of a hand-based biometric system, where the acquisition is carried out without contact and the template is created only requiring information from a single individual. In addition, this thesis proposes an algorithm based on multiscale aggregation in order to tackle with the problem of segmentation in real unconstrained environments. Furthermore, feature extraction and matching are also a specific contributions of this thesis, providing adequate schemes to carry out both actions with low computational cost but with certain recognition accuracy. Finally, this system is evaluated according to international standard ISO/IEC 19795 considering six public databases. In relation to the stress detection method, this thesis proposes a system based on two physiological signals, namely heart rate and galvanic skin response, with the creation of an innovative stress detection template which gathers the behaviour of both physiological signals under both stressing and non-stressing situations. Besides, this system is based on fuzzy logic to elucidate the level of stress of an individual. As an overview, this system is able to detect stress accurately and in real-time, providing an adequate solution for current biometric systems, where the application of a stress detection system is direct to avoid situations where individuals are forced to provide the biometric data. Finally, this thesis includes a user acceptability evaluation, where the acceptance of the proposed biometric technique is assessed by a total of 250 individuals. In addition, this thesis includes a mobile implementation prototype and its evaluation.

I feel you: the design and evaluation of a domotic affect-sensitive spoken conversational agent

We describe the work on infusion of emotion into a limited-task autonomous spoken conversational agent situated in the domestic environment, using a need-inspired task-independent emotion model (NEMO). In order to demonstrate the generation of affect through the use of the model, we describe the work of integrating it with a natural-language mixed-initiative HiFi-control spoken conversational agent (SCA). NEMO and the host system communicate externally, removing the need for the Dialog Manager to be modified, as is done in most existing dialog systems, in order to be adaptive. The first part of the paper concerns the integration between NEMO and the host agent. The second part summarizes the work on automatic affect prediction, namely, frustration and contentment, from dialog features, a non-conventional source, in the attempt of moving towards a more user-centric approach. The final part reports the evaluation results obtained from a user study, in which both versions of the agent (non-adaptive and emotionally-adaptive) were compared. The results provide substantial evidences with respect to the benefits of adding emotion in a spoken conversational agent, especially in mitigating users' frustrations and, ultimately, improving their satisfaction.

Evaluation of a transplantation algorithm for expressive speech synthesis

When designing human-machine interfaces it is important to consider not only the bare bones functionality but also the ease of use and accessibility it provides. When talking about voice-based inter- faces, it has been proven that imbuing expressiveness into the synthetic voices increases signi?cantly its perceived naturalness, which in the end is very helpful when building user friendly interfaces. This paper proposes an adaptation based expressiveness transplantation system capable of copying the emotions of a source speaker into any desired target speaker with just a few minutes of read speech and without requiring the record- ing of additional expressive data. This system was evaluated through a perceptual test for 3 speakers showing up to an average of 52% emotion recognition rates relative to the natural voice recognition rates, while at the same time keeping good scores in similarity and naturality.

FocusDET, a new toolbox for SISCOM analysis. Evaluation of the registration accuracy using monte carlo simulation

Subtraction of Ictal SPECT Co-registered to MRI (SISCOM) is an imaging technique used to localize the epileptogenic focus in patients with intractable partial epilepsy. The aim of this study was to determine the accuracy of registration algorithms involved in SISCOM analysis using FocusDET, a new user-friendly application. To this end, Monte Carlo simulation was employed to generate realistic SPECT studies. Simulated sinograms were reconstructed by using the Filtered BackProjection (FBP) algorithm and an Ordered Subsets Expectation Maximization (OSEM) reconstruction method that included compensation for all degradations. Registration errors in SPECT-SPECT and SPECT-MRI registration were evaluated by comparing the theoretical and actual transforms. Patient studies with well-localized epilepsy were also included in the registration assessment. Global registration errors including SPECT-SPECT and SPECT-MRI registration errors were less than 1.2 mm on average, exceeding the voxel size (3.32 mm) of SPECT studies in no case. Although images reconstructed using OSEM led to lower registration errors than images reconstructed with FBP, differences after using OSEM or FBP in reconstruction were less than 0.2 mm on average. This indicates that correction for degradations does not play a major role in the SISCOM process, thereby facilitating the application of the methodology in centers where OSEM is not implemented with correction of all degradations. These findings together with those obtained by clinicians from patients via MRI, interictal and ictal SPECT and video-EEG, show that FocusDET is a robust application for performing SISCOM analysis in clinical practice.