Visualization of spirography-based objective measures in Parkinson's disease

Objective: To investigate whether advanced visualizations of spirography-based objective measures are useful in differentiating drug-related motor dysfunctions between Off and dyskinesia in Parkinson’s disease (PD). Background: During the course of a 3 year longitudinal clinical study, in total 65 patients (43 males and 22 females with mean age of 65) with advanced PD and 10 healthy elderly (HE) subjects (5 males and 5 females with mean age of 61) were assessed. Both patients and HE subjects performed repeated and time-stamped assessments of their objective health indicators using a test battery implemented on a telemetry touch screen handheld computer, in their home environment settings. Among other tasks, the subjects were asked to trace a pre-drawn Archimedes spiral using the dominant hand and repeat the test three times per test occasion. Methods: A web-based framework was developed to enable a visual exploration of relevant spirography-based kinematic features by clinicians so they can in turn evaluate the motor states of the patients i.e. Off and dyskinesia. The system uses different visualization techniques such as time series plots, animation, and interaction and organizes them into different views to aid clinicians in measuring spatial and time-dependent irregularities that could be associated with the motor states. Along with the animation view, the system displays two time series plots for representing drawing speed (blue line) and displacement from ideal trajectory (orange line). The views are coordinated and linked i.e. user interactions in one of the views will be reflected in other views. For instance, when the user points in one of the pixels in the spiral view, the circle size of the underlying pixel increases and a vertical line appears in the time series views to depict the corresponding position. In addition, in order to enable clinicians to observe erratic movements more clearly and thus improve the detection of irregularities, the system displays a color-map which gives an idea of the longevity of the spirography task. Figure 2 shows single randomly selected spirals drawn by a: A) patient who experienced dyskinesias, B) HE subject, and C) patient in Off state. Results: According to a domain expert (DN), the spirals drawn in the Off and dyskinesia motor states are characterized by different spatial and time features. For instance, the spiral shown in Fig. 2A was drawn by a patient who showed symptoms of dyskinesia; the drawing speed was relatively high (cf. blue-colored time series plot and the short timestamp scale in the x axis) and the spatial displacement was high (cf. orange-colored time series plot) associated with smooth deviations as a result of uncontrollable movements. The patient also exhibited low amount of hesitation which could be reflected both in the animation of the spiral as well as time series plots. In contrast, the patient who was in the Off state exhibited different kinematic features, as shown in Fig. 2C. In the case of spirals drawn by a HE subject, there was a great precision during the drawing process as well as unchanging levels of time-dependent features over the test trial, as seen in Fig. 2B. Conclusions: Visualizing spirography-based objective measures enables identification of trends and patterns of drug-related motor dysfunctions at the patient’s individual level. Dynamic access of visualized motor tests may be useful during the evaluation of drug-related complications such as under- and over-medications, providing decision support to clinicians during evaluation of treatment effects as well as improve the quality of life of patients and their caregivers. In future, we plan to evaluate the proposed approach by assessing within- and between-clinician variability in ratings in order to determine its actual usefulness and then use these ratings as target outcomes in supervised machine learning, similarly as it was previously done in the study performed by Memedi et al. (2013).

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.

Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study

Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0). Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

Dynamically Adapting BDI Agent Architectures based on High-level User Specifications

Users are facing an increasing challenge of managing information and being available anytime anywhere, as the web exponentially grows. As a consequence, assisting them in their routine tasks has become a relevant issue to be addressed. In this paper, we introduce a software framework that supports the development of Personal Assistance Software (PAS). It relies on the idea of exposing a high level user model in order to increase user trust in the task delegation process as well as empowering them to manage it. The framework provides a synchronization mechanism that is responsible for dynamically adapting an underlying BDI agent-based running implementation in order to keep this high-level view of user customizations consistent with it.

Model Configuration And Data Management In The Short-Term Water Information Forecasting Tools

The Short-term Water Information and Forecasting Tools (SWIFT) is a suite of tools for flood and short-term streamflow forecasting, consisting of a collection of hydrologic model components and utilities. Catchments are modeled using conceptual subareas and a node-link structure for channel routing. The tools comprise modules for calibration, model state updating, output error correction, ensemble runs and data assimilation. Given the combinatorial nature of the modelling experiments and the sub-daily time steps typically used for simulations, the volume of model configurations and time series data is substantial and its management is not trivial. SWIFT is currently used mostly for research purposes but has also been used operationally, with intersecting but significantly different requirements. Early versions of SWIFT used mostly ad-hoc text files handled via Fortran code, with limited use of netCDF for time series data. The configuration and data handling modules have since been redesigned. The model configuration now follows a design where the data model is decoupled from the on-disk persistence mechanism. For research purposes the preferred on-disk format is JSON, to leverage numerous software libraries in a variety of languages, while retaining the legacy option of custom tab-separated text formats when it is a preferred access arrangement for the researcher. By decoupling data model and data persistence, it is much easier to interchangeably use for instance relational databases to provide stricter provenance and audit trail capabilities in an operational flood forecasting context. For the time series data, given the volume and required throughput, text based formats are usually inadequate. A schema derived from CF conventions has been designed to efficiently handle time series for SWIFT.

Volunteered Geographic Information For Water Management: A Prototype Architecture

Driven by Web 2.0 technology and the almost ubiquitous presence of mobile devices, Volunteered Geographic Information (VGI) is knowing an unprecedented growth. These notable technological advancements have opened fruitful perspectives also in the field of water management and protection, raising the demand for a reconsideration of policies which also takes into account the emerging trend of VGI. This research investigates the opportunity of leveraging such technology to involve citizens equipped with common mobile devices (e.g. tablets and smartphones) in a campaign of report of water-related phenomena. The work is carried out in collaboration with ADBPO - Autorità di bacino del fiume Po (Po river basin Authority), i.e. the entity responsible for the environmental planning and protection of the basin of river Po. This is the longest Italian river, spreading over eight among the twenty Italian Regions and characterized by complex environmental issues. To enrich ADBPO official database with user-generated contents, a FOSS (Free and Open Source Software) architecture was designed which allows not only user field-data collection, but also data Web publication through standard protocols. Open Data Kit suite allows users to collect georeferenced multimedia information using mobile devices equipped with location sensors (e.g. the GPS). Users can report a number of environmental emergencies, problems or simple points of interest related to the Po river basin, taking pictures of them and providing other contextual information. Field-registered data is sent to a server and stored into a PostgreSQL database with PostGIS spatial extension. GeoServer provides then data dissemination on the Web, while specific OpenLayers-based viewers were built to optimize data access on both desktop computers and mobile devices. Besides proving the suitability of FOSS in the frame of VGI, the system represents a successful prototype for the exploitation of user local, real-time information aimed at managing and protecting water resources.

Um modelo de EIS - enterprise information system - que identifica características para comportamentos proativos na recuperação de informações

Este documento constitui uma dissertação de mestrado, requisito parcial para a obtenção do grau de Mestre em Administração pela Universidade Federal do Rio Grande do Sul. O tema da pesquisa é o relacionamento existente entre as características técnicas de um projeto de sistema de informação e apoio à decisão e os comportamentos dos usuários no seu uso. O objetivo é desenvolver e apresentar um modelo conceitual de EIS (“Enterprise Information Systems”), a partir da literatura, das tendências tecnológicas e de estudos de caso, que identifique características para comportamentos proativos dos usuários na recuperação de informações. Adotou-se o conceito de comportamento proativo na recuperação de informações como a combinação das categorias exploração de dados e busca focada. Entre os principais resultados, pode-se destacar a definição de categorias relacionadas com as características dos sistemas - flexibilidade, integração e apresentação - e de categorias relacionadas com os comportamentos dos usuários na recuperação de informações - exploração de dados e busca focada, bem como a apresentação de um modelo conceitual para sistemas EIS. Pode-se destacar também a exploração de novas técnicas para análise qualitativa de dados, realizada com o objetivo de buscar uma maior preservação do contexto nos estudos de caso.

Proposta de uma sistemática de avaliação de investimentos utilizando o método ABC (activity-based costing)

As técnicas tradicionais de avaliação de rentabilidade apresentam características que resultam eficazes no que tange aos aspectos econômicos da análise de investimentos. No entanto, a validade das informações fornecidas por estes métodos depende dos dados incluídos na avaliação. Neste sentido, em função da complexidade e do inter-relacionamento existente nos processos produtivos de empresas, as alterações proporcionadas por um investimento podem ter impacto sobre áreas que não estão diretamente envolvidas com o projeto a ser implementado. Este fato dificulta a identificação e conseqüente inclusão da totalidade dos fatores que causam impacto na análise do projeto. Além disso, impactos relacionados a atividades indiretas não possuem uma metodologia que permita sua quantificação. Como forma de abordar o problema, este trabalho apresenta uma sistemática de avaliação de investimentos que, através de uma seqüência estruturada de passos e com a utilização das informações geradas por um sistema de custeio do tipo ABC (Activity-Based Costing), possibilita incluir na análise impactos indiretos gerados pelo projeto. A aplicação desta sistemática em um projeto de substituição de equipamento numa empresa do ramo industrial mostra que as informações geradas complementam aquelas obtidas quando da aplicação das técnicas tradicionais. Desta forma, foi possível avaliar o impacto econômico provocado por possíveis alterações nos setores não diretamente ligados ao projeto.

Sistema de informação de custos : o método de custeio ABC (Activity-Based Costing) como ferramenta de gestão de instituições de ensino : estudo de caso

Com a globalização do mercado e o alto nível de competitividade no setor educacional, as organizações, para manterem-se, devem ser ágeis e competentes. Neste contexto, a gestão eficiente dos recursos e a obtenção de informações precisas que apóiem a tomada de decisão dependerão, em grande parte, de um sistema de informações de custos. Este sistema deverá ter como base um método de custeio que forneça informações, a fim de atender as distintas necessidades dos gestores dos diversos níveis hierárquico e das diversas áreas de atuação. O trabalho consiste no estudo de uma metodologia de custeio aplicável a uma Instituição de Ensino Superior – IES privada, a qual atenda as três perspectivas que são fornecer informações para embasar a composição dos preços, para apoiar o processo decisório e para o planejamento e controle de gastos. Para tanto, partiu-se da pesquisa bibliográfica no levantamento do estado da arte relacionada ao tema. Com o estudo de caso buscou-se a identificação das necessidades de informações de custos, demandadas pelos gestores da IES, por meio de pesquisa qualitativa. A partir dessa identificação, as necessidades foram cruzadas com os métodos de custeio existentes, o que permitiu a identificação do método mais adequado a IES. Nesta etapa foi possível o cruzamento entre a teoria e a prática, onde foram comparados o método proposto em relação ao atual método adotado pela IES o que possibilitou a identificação das deficiências do modelo atual e suas causas. A partir disto, propõe-se uma sistemática mais adequada para apoiar a tomada de decisão, com o intuito de melhoria do desempenho da instituição. Os resultados obtidos demonstram o cumprimento do objetivo onde, considerando as necessidades de informações de custos dos gestores, o método de custeio por atividades é o mais adequado para o suporte a gestão da IES.

Combining collaborative and content-based filtering to recommend research papers

The number of research papers available today is growing at a staggering rate, generating a huge amount of information that people cannot keep up with. According to a tendency indicated by the United States’ National Science Foundation, more than 10 million new papers will be published in the next 20 years. Because most of these papers will be available on the Web, this research focus on exploring issues on recommending research papers to users, in order to directly lead users to papers of their interest. Recommender systems are used to recommend items to users among a huge stream of available items, according to users’ interests. This research focuses on the two most prevalent techniques to date, namely Content-Based Filtering and Collaborative Filtering. The first explores the text of the paper itself, recommending items similar in content to the ones the user has rated in the past. The second explores the citation web existing among papers. As these two techniques have complementary advantages, we explored hybrid approaches to recommending research papers. We created standalone and hybrid versions of algorithms and evaluated them through both offline experiments on a database of 102,295 papers, and an online experiment with 110 users. Our results show that the two techniques can be successfully combined to recommend papers. The coverage is also increased at the level of 100% in the hybrid algorithms. In addition, we found that different algorithms are more suitable for recommending different kinds of papers. Finally, we verified that users’ research experience influences the way users perceive recommendations. In parallel, we found that there are no significant differences in recommending papers for users from different countries. However, our results showed that users’ interacting with a research paper Recommender Systems are much happier when the interface is presented in the user’s native language, regardless the language that the papers are written. Therefore, an interface should be tailored to the user’s mother language.

Combating shoulder-surfing: a hidden button gesture based scheme

This project describes an authentication technique that is shoulder-surfing resistant. Shoulder surfing is an attack in which an attacker can get access to private information by observing the user’s interaction with a terminal, or by using recording tools to record the user interaction and study the obtained data, with the objective of obtaining unauthorized access to a target user’s personal information. The technique described here relies on gestural analysis coupled with a secondary channel of authentication that uses button pressing. The thesis presents and evaluates multiple alternative algorithms for gesture analysis, and furthermore assesses the effectiveness of the technique.