A multimedia package for patient understanding and rehabilitation of non-contact anterior cruciate ligament injuries

Non-contact anterior cruciate ligament (ACL) injury is one of the most common ligament injuries in the body. Many patients’ receive graft surgery to repair the damage, but have to undertake an extensive period of rehabilitation. However, non-compliance and lack of understanding of the injury, healing process and rehabilitation means patient’s return to activities before effective structural integrity of the graft has been reached. When clinicians educate the patient, to encourage compliance with treatment and rehabilitation, the only tools that are currently widely in use are static plastic models, line diagrams and pamphlets. As modern technology grows in use in anatomical education, we have developed a unique educational and training package for patient’s to use in gaining a better understanding of their injury and treatment plan. We have combined cadaveric dissections of the knee (and captured with high resolution digital images) with reconstructed 3D modules from the Visible Human dataset, computer generated animations, and images to produce a multimedia package, which can be used to educate the patient in their knee anatomy, the injury, the healing process and their rehabilitation, and how this links into key stages of improving graft integrity. It is hoped that this will improve patient compliance with their rehabilitation programme, and better long-term prognosis in returning to normal or near-normal activities. Feedback from healthcare professionals about this package has been positive and encouraging for its long-term use

Development and preliminary evaluation of a novel low cost VR-based upper limb stroke rehabilitation platform using Wii technology.

Abstract Purpose: This paper proposes a novel system (using the Nintendo Wii remote) that offers customised, non-immersive, virtual reality-based, upper-limb stroke rehabilitation and reports on promising preliminary findings with stroke survivors. Method: The system novelty lies in the high accuracy of the full kinematic tracking of the upper limb movement in real-time, offering strong personal connection between the stroke survivor and a virtual character when executing therapist prescribed adjustable exercises/games. It allows the therapist to monitor patient performance and to individually calibrate the system in terms of range of movement, speed and duration. Results: The system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed, with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. Conclusions: Given the preliminary findings, it would be beneficial to extend the case study in terms of duration and participants and to conduct an acceptability and feasibility study with community dwelling survivors. Implications for Rehabilitation Low-cost, off-the-shelf game sensors, such as the Nintendo Wii remote, are acceptable by stroke survivors as an add-on to upper limb stroke rehabilitation but have to be bespoked to provide high-fidelity and real-time kinematic tracking of the arm movement. Providing therapists with real-time and remote monitoring of the quality of the movement and not just the amount of practice, is imperative and most critical for getting a better understanding of each patient and administering the right amount and type of exercise. The ability to translate therapeutic arm movement into individually calibrated exercises and games, allows accommodation of the wide range of movement difficulties seen after stroke and the ability to adjust these activities (in terms of speed, range of movement and duration) will aid motivation and adherence - key issues in rehabilitation. With increasing pressures on resources and the move to more community-based rehabilitation, the proposed system has the potential for promoting the intensity of practice necessary for recovery in both community and acute settings.The National Health Service (NHS) London Regional Innovation Fund

Immersive analytics for oncology patient cohorts

This thesis proposes a novel interactive immersive analytics tool and methods to interrogate the cancer patient cohort in an immersive virtual environment, namely Virtual Reality to Observe Oncology data Models (VROOM). The overall objective is to develop an immersive analytics platform, which includes a data analytics pipeline from raw gene expression data to immersive visualisation on virtual and augmented reality platforms utilising a game engine. Unity3D has been used to implement the visualisation. Work in this thesis could provide oncologists and clinicians with an interactive visualisation and visual analytics platform that helps them to drive their analysis in treatment efficacy and achieve the goal of evidence-based personalised medicine. The thesis integrates the latest discovery and development in cancer patients’ prognoses, immersive technologies, machine learning, decision support system and interactive visualisation to form an immersive analytics platform of complex genomic data. For this thesis, the experimental paradigm that will be followed is in understanding transcriptomics in cancer samples. This thesis specifically investigates gene expression data to determine the biological similarity revealed by the patient's tumour samples' transcriptomic profiles revealing the active genes in different patients. In summary, the thesis contributes to i) a novel immersive analytics platform for patient cohort data interrogation in similarity space where the similarity space is based on the patient's biological and genomic similarity; ii) an effective immersive environment optimisation design based on the usability study of exocentric and egocentric visualisation, audio and sound design optimisation; iii) an integration of trusted and familiar 2D biomedical visual analytics methods into the immersive environment; iv) novel use of the game theory as the decision-making system engine to help the analytics process, and application of the optimal transport theory in missing data imputation to ensure the preservation of data distribution; and v) case studies to showcase the real-world application of the visualisation and its effectiveness

Dynamical density delay maps: simple, new method for visualising the behaviour of complex systems

Background. Physiologic signals, such as cardiac interbeat intervals, exhibit complex fluctuations. However, capturing important dynamical properties, including nonstationarities may not be feasible from conventional time series graphical representations. Methods. We introduce a simple-to-implement visualisation method, termed dynamical density delay mapping (``D3-Map'' technique) that provides an animated representation of a system's dynamics. The method is based on a generalization of conventional two-dimensional (2D) Poincar� plots, which are scatter plots where each data point, x(n), in a time series is plotted against the adjacent one, x(n+1). First, we divide the original time series, x(n) (n=1,..., N), into a sequence of segments (windows). Next, for each segment, a three-dimensional (3D) Poincar� surface plot of x(n), x(n+1), hx(n),x(n+1) is generated, in which the third dimension, h, represents the relative frequency of occurrence of each (x(n),x(n+1)) point. This 3D Poincar\'e surface is then chromatised by mapping the relative frequency h values onto a colour scheme. We also generate a colourised 2D contour plot from each time series segment using the same colourmap scheme as for the 3D Poincar\'e surface. Finally, the original time series graph, the colourised 3D Poincar\'e surface plot, and its projection as a colourised 2D contour map for each segment, are animated to create the full ``D3-Map.'' Results. We first exemplify the D3-Map method using the cardiac interbeat interval time series from a healthy subject during sleeping hours. The animations uncover complex dynamical changes, such as transitions between states, and the relative amount of time the system spends in each state. We also illustrate the utility of the method in detecting hidden temporal patterns in the heart rate dynamics of a patient with atrial fibrillation. The videos, as well as the source code, are made publicly available. Conclusions. Animations based on density delay maps provide a new way of visualising dynamical properties of complex systems not apparent in time series graphs or standard Poincar\'e plot representations. Trainees in a variety of fields may find the animations useful as illustrations of fundamental but challenging concepts, such as nonstationarity and multistability. For investigators, the method may facilitate data exploration

Measuring the effectiveness of computer-based scientific visualisations for conceptual development in Australian chemistry classrooms

Visual modes of representation have always been very important in science and science education. Interactive computer-based animations and simulations offer new visual resources for chemistry education. Many studies have shown that students enjoy learning with visualisations but few have explored how learning outcomes compare when teaching with or without visualisations. This study employs a quasi-experimental crossover research design and quantitative methods to measure the educational effectiveness - defined as level of conceptual development on the part of students - of using computer-based scientific visualisations versus teaching without visualisations in teaching chemistry. In addition to finding that teaching with visualisations offered outcomes that were not significantly different from teaching without visualisations, the study also explored differences in outcomes for male and female students, students with different learning styles (visual, aural, kinesthetic) and students of differing levels of academic ability

A review of different approaches to access and people circulation within health-care facilities and the application of modelling, simulation and visualisation

Evidence suggests that improving access and people circulation in hospitals can: improve staff performance and productivity; enhance patients’ safety, privacy and rate of recovery; minimise the risk of cross-infection; reduce the delay time of external service delivery; create a more welcoming environment for visitors; and reduce the evacuation time in emergency situations. Consequently the need to design hospital layouts that benefit from the most effective system cannot be over-emphasised. This paper focuses on identifying different systems of access and people circulation in health-care facilities in general and hospitals in particular. The research on access and people circulation reported in this paper comprises three main phases. The first phase involves a literature review of existing health-care environments to identify different types of access and people circulation requirements. The second phase focuses on categorising the adopted approaches and systems in order to compare and contrast the advantages and disadvantages of each. The final phase provides a critique of current modelling and simulation tools being applied during the planning and design phases to improve access and people circulation. The paper concludes with recommendations which will be used to shape future research in the area

Visualisation of multi-dimensional medical images with application to brain electrical impedance tomography

Medical imaging plays an important role in modem medicine. With the increasing complexity and information presented by medical images, visualisation is vital for medical research and clinical applications to interpret the information presented in these images. The aim of this research is to investigate improvements to medical image visualisation, particularly for multi-dimensional medical image datasets. A recently developed medical imaging technique known as Electrical Impedance Tomography (EIT) is presented as a demonstration. To fulfil the aim, three main efforts are included in this work. First, a novel scheme for the processmg of brain EIT data with SPM (Statistical Parametric Mapping) to detect ROI (Regions of Interest) in the data is proposed based on a theoretical analysis. To evaluate the feasibility of this scheme, two types of experiments are carried out: one is implemented with simulated EIT data, and the other is performed with human brain EIT data under visual stimulation. The experimental results demonstrate that: SPM is able to localise the expected ROI in EIT data correctly; and it is reasonable to use the balloon hemodynamic change model to simulate the impedance change during brain function activity. Secondly, to deal with the absence of human morphology information in EIT visualisation, an innovative landmark-based registration scheme is developed to register brain EIT image with a standard anatomical brain atlas. Finally, a new task typology model is derived for task exploration in medical image visualisation, and a task-based system development methodology is proposed for the visualisation of multi-dimensional medical images. As a case study, a prototype visualisation system, named EIT5DVis, has been developed, following this methodology. to visualise five-dimensional brain EIT data. The EIT5DVis system is able to accept visualisation tasks through a graphical user interface; apply appropriate methods to analyse tasks, which include the ROI detection approach and registration scheme mentioned in the preceding paragraphs; and produce various visualisations

A recommended workflow methodology in the creation of an educational and training application incorporating a digital reconstruction of the cerebral ventricular system and cerebrospinal fluid circulation to aid anatomical understanding

BACKGROUND: The use of computer-aided learning in education can be advantageous, especially when interactive three-dimensional (3D) models are used to aid learning of complex 3D structures. The anatomy of the ventricular system of the brain is difficult to fully understand as it is seldom seen in 3D, as is the flow of cerebrospinal fluid (CSF). This article outlines a workflow for the creation of an interactive training tool for the cerebral ventricular system, an educationally challenging area of anatomy. This outline is based on the use of widely available computer software packages. METHODS: Using MR images of the cerebral ventricular system and several widely available commercial and free software packages, the techniques of 3D modelling, texturing, sculpting, image editing and animations were combined to create a workflow in the creation of an interactive educational and training tool. This was focussed on cerebral ventricular system anatomy, and the flow of cerebrospinal fluid. RESULTS: We have successfully created a robust methodology by using key software packages in the creation of an interactive education and training tool. This has resulted in an application being developed which details the anatomy of the ventricular system, and flow of cerebrospinal fluid using an anatomically accurate 3D model. In addition to this, our established workflow pattern presented here also shows how tutorials, animations and self-assessment tools can also be embedded into the training application. CONCLUSIONS: Through our creation of an established workflow in the generation of educational and training material for demonstrating cerebral ventricular anatomy and flow of cerebrospinal fluid, it has enormous potential to be adopted into student training in this field. With the digital age advancing rapidly, this has the potential to be used as an innovative tool alongside other methodologies for the training of future healthcare practitioners and scientists. This workflow could be used in the creation of other tools, which could be developed for use not only on desktop and laptop computers but also smartphones, tablets and fully immersive stereoscopic environments. It also could form the basis on which to build surgical simulations enhanced with haptic interaction