Recognition, Analysis, and Assessments of Human Skills using Wearable Sensors

One of the biggest social issues in mature societies such as Europe and Japan is the aging population and declining birth rate. These societies have a serious problem with the retirement of the expert workers, doctors, and engineers etc. Especially in the sectors that require long time to make experts in fields like medicine and industry; the retirement and injuries of the experts, is a serious problem. The technology to support the training and assessment of skilled workers (like doctors, manufacturing workers) is strongly required for the society. Although there are some solutions for this problem, most of them are video-based which violates the privacy of the subjects. Furthermore, they are not easy to deploy due to the need for large training data. This thesis provides a novel framework to recognize, analyze, and assess human skills with minimum customization cost. The presented framework tackles this problem in two different domains, industrial setup and medical operations of catheter-based cardiovascular interventions (CBCVI). In particular, the contributions of this thesis are four-fold. First, it proposes an easy-to-deploy framework for human activity recognition based on zero-shot learning approach, which is based on learning basic actions and objects. The model recognizes unseen activities by combinations of basic actions learned in a preliminary way and involved objects. Therefore, it is completely configurable by the user and can be used to detect completely new activities. Second, a novel gaze-estimation model for attention driven object detection task is presented. The key features of the model are: (i) usage of the deformable convolutional layers to better incorporate spatial dependencies of different shapes of objects and backgrounds, (ii) formulation of the gaze-estimation problem in two different way, as a classification as well as a regression problem. We combine both formulations using a joint loss that incorporates both the cross-entropy as well as the mean-squared error in order to train our model. This enhanced the accuracy of the model from 6.8 by using only the cross-entropy loss to 6.4 for the joint loss. The third contribution of this thesis targets the area of quantification of quality of i actions using wearable sensor. To address the variety of scenarios, we have targeted two possibilities: a) both expert and novice data is available , b) only expert data is available, a quite common case in safety critical scenarios. Both of the developed methods from these scenarios are deep learning based. In the first one, we use autoencoders with OneClass SVM, and in the second one we use the Siamese Networks. These methods allow us to encode the expert’s expertise and to learn the differences between novice and expert workers. This enables quantification of the performance of the novice in comparison to the expert worker. The fourth contribution, explicitly targets medical practitioners and provides a methodology for novel gaze-based temporal spatial analysis of CBCVI data. The developed methodology allows continuous registration and analysis of gaze data for analysis of the visual X-ray image processing (XRIP) strategies of expert operators in live-cases scenarios and may assist in transferring experts’ reading skills to novices

Ultrasound-Augmented Laparoscopy

Laparoscopic surgery is perhaps the most common minimally invasive procedure for many diseases in the abdomen. Since the laparoscopic camera provides only the surface view of the internal organs, in many procedures, surgeons use laparoscopic ultrasound (LUS) to visualize deep-seated surgical targets. Conventionally, the 2D LUS image is visualized in a display spatially separate from that displays the laparoscopic video. Therefore, reasoning about the geometry of hidden targets requires mentally solving the spatial alignment, and resolving the modality differences, which is cognitively very challenging. Moreover, the mental representation of hidden targets in space acquired through such cognitive medication may be error prone, and cause incorrect actions to be performed. To remedy this, advanced visualization strategies are required where the US information is visualized in the context of the laparoscopic video. To this end, efficient computational methods are required to accurately align the US image coordinate system with that centred in the camera, and to render the registered image information in the context of the camera such that surgeons perceive the geometry of hidden targets accurately. In this thesis, such a visualization pipeline is described. A novel method to register US images with a camera centric coordinate system is detailed with an experimental investigation into its accuracy bounds. An improved method to blend US information with the surface view is also presented with an experimental investigation into the accuracy of perception of the target locations in space

Recent Advances in Minimally Invasive Surgery

Minimally invasive surgery has become a common term in visceral as well as gynecologic surgery. It has almost evolved into its own surgical speciality over the past 20 years. Today, being firmly established in every subspeciality of visceral surgery, it is now no longer a distinct skillset, but a fixed part of the armamentarium of surgical options available. In every indication, the advantages of a minimally invasive approach include reduced intraoperative blood loss, less postoperative pain, and shorter rehabilitation times, as well as a marked reduction of overall and surgical postoperative morbidity. In the advent of modern oncologic treatment algorithms, these effects not only lower the immediate impact that an operation has on the patient, but also become important key steps in reducing the side-effects of surgery. Thus, they enable surgery to become a module in modern multi-disciplinary cancer treatment, which blends into multimodular treatment options at different times and prolongs and widens the possibilities available to cancer patients. In this quickly changing environment, the requirement to learn and refine not only open surgical but also different minimally invasive techniques on high levels deeply impact modern surgical training pathways. The use of modern elearning tools and new and praxis-based surgical training possibilities have been readily integrated into modern surgical education,which persists throughout the whole surgical career of modern gynecologic and visceral surgery specialists

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted

Separator fluid volume requirements in multi-infusion settings

INTRODUCTION. Intravenous (IV) therapy is a widely used method for the administration of medication in hospitals worldwide. ICU and surgical patients in particular often require multiple IV catheters due to incompatibility of certain drugs and the high complexity of medical therapy. This increases discomfort by painful invasive procedures, the risk of infections and costs of medication and disposable considerably. When different drugs are administered through the same lumen, it is common ICU practice to flush with a neutral fluid between the administration of two incompatible drugs in order to optimally use infusion lumens. An important constraint for delivering multiple incompatible drugs is the volume of separator fluid that is sufficient to safely separate them. OBJECTIVES. In this pilot study we investigated whether the choice of separator fluid, solvent, or administration rate affects the separator volume required in a typical ICU infusion setting. METHODS. A standard ICU IV line (2m, 2ml, 1mm internal diameter) was filled with methylene blue (40 mg/l) solution and flushed using an infusion pump with separator fluid. Independent variables were solvent for methylene blue (NaCl 0.9% vs. glucose 5%), separator fluid (NaCl 0.9% vs. glucose 5%), and administration rate (50, 100, or 200 ml/h). Samples were collected using a fraction collector until <2% of the original drug concentration remained and were analyzed using spectrophotometry. RESULTS. We did not find a significant effect of administration rate on separator fluid volume. However, NaCl/G5% (solvent/separator fluid) required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). Also, G5%/G5% required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). The significant decrease in required flushing volume might be due to differences in the viscosity of the solutions. However, mean differences were small and were most likely caused by human interactions with the fluid collection setup. The average required flushing volume is 3.7 ml. CONCLUSIONS. The choice of separator fluid, solvent or administration rate had no impact on the required flushing volume in the experiment. Future research should take IV line length, diameter, volume and also drug solution volumes into account in order to provide a full account of variables affecting the required separator fluid volume

Wearable and Nearable Biosensors and Systems for Healthcare

Biosensors and systems in the form of wearables and “nearables” (i.e., everyday sensorized objects with transmitting capabilities such as smartphones) are rapidly evolving for use in healthcare. Unlike conventional approaches, these technologies can enable seamless or on-demand physiological monitoring, anytime and anywhere. Such monitoring can help transform healthcare from the current reactive, one-size-fits-all, hospital-centered approach into a future proactive, personalized, decentralized structure. Wearable and nearable biosensors and systems have been made possible through integrated innovations in sensor design, electronics, data transmission, power management, and signal processing. Although much progress has been made in this field, many open challenges for the scientific community remain, especially for those applications requiring high accuracy. This book contains the 12 papers that constituted a recent Special Issue of Sensors sharing the same title. The aim of the initiative was to provide a collection of state-of-the-art investigations on wearables and nearables, in order to stimulate technological advances and the use of the technology to benefit healthcare. The topics covered by the book offer both depth and breadth pertaining to wearable and nearable technology. They include new biosensors and data transmission techniques, studies on accelerometers, signal processing, and cardiovascular monitoring, clinical applications, and validation of commercial devices

Instructional Message Design: Theory, Research, and Practice (Volume 2)

Message design is all around us, from the presentations we see in meetings and classes, to the instructions that come with our latest tech gadgets, to multi-million-dollar training simulations. In short, instructional message design is the real-world application of instructional and learning theories to design the tools and technologies used to communicate and effectively convey information. This field of study pulls from many applied sciences including cognitive psychology, industrial design, graphic design, instructional design, information technology, and human performance technology to name just a few. In this book we visit several foundational theories that guide our research, look at different real-world applications, and begin to discuss directions for future best practice. For instance, cognitive load and multimedia learning theories provide best practice, virtual reality and simulations are only a few of the multitude of applications. Special needs learners and designing for online, e-learning, and web conferencing are only some of many applied areas where effective message design can improve outcomes. Studying effective instructional message design tools and techniques has and will continue to be a critical aspect of the overall instructional design process. Hopefully, this book will serve as an introduction to these topics and inspire your curiosity to explore further!https://digitalcommons.odu.edu/distancelearning_books/1003/thumbnail.jp

Instructional Message Design: Theory, Research, and Practice (Volume 2)

Message design is all around us, from the presentations we see in meetings and classes, to the instructions that come with our latest tech gadgets, to multi-million-dollar training simulations. In short, instructional message design is the real-world application of instructional and learning theories to design the tools and technologies used to communicate and effectively convey information. This field of study pulls from many applied sciences including cognitive psychology, industrial design, graphic design, instructional design, information technology, and human performance technology to name just a few. In this book we will visit several foundational theories that guide our research, look at different real-world applications, and begin to discuss directions for future best practice. For instance, cognitive load and multimedia learning theories provide best practice, virtual reality and simulations are only a few of the multitude of applications. Special needs learners and designing for online, e-learning, and web conferencing are only some of many applied areas where effective message design can improve outcomes. Studying effective instructional message design tools and techniques has and will continue to be a critical aspect of the overall instructional design process. Hopefully, this book will serve as an introduction to these topics and inspire your curiosity to explore further

ESICM LIVES 2017 : 30th ESICM Annual Congress. September 23-27, 2017.

INTRODUCTION. Unplanned readmission to intensive care is highly undesirable in that it contributes to increased variance in care, disruption, difficulty in resource allocation and may increase length of stay and mortality particularly if subject to delays. Unlike the ICU admission from the ward, readmission prediction has received relatively little attention, perhaps in part because at the point of ICU discharge, full physiological information is systematically available to the clinician and so it is expected that readmission should be largely due to unpredictable factors. However it may be that there are multidimensional trends that are difficult for the clinician to perceive that may nevertheless be predictive of readmission. OBJECTIVES. We investigated whether machine learning (ML) techniques could be used to improve on the simple published SWIFT score [1] for the prediction of unplanned readmission to ICU within 48 hours. METHODS. We extracted systolic BP, pulse pressure, heart and respiration rate, temperature, SpO2, bilirubin, creatinine, INR, lactate, white cell count, platelet count, pH, FiO2, and total Glasgow Coma Score from ICU stays of over 2000 adult patients from our hospital electronic patient record system. We trained our own custom multidimensional / time-sensitive algorithmic ML system to predict failed discharges defined as either readmission or unexpected death within 48 hours of discharge. We used 10-fold cross validation to assess performance. We also assessed the effect of augmenting our system by transfer learning (TL) with 44,000 additional cases from the MIMIC III database. RESULTS. The SWIFT score performed relatively poorly with an AUROC of around 0.6 which our ML system trained on local data was also able to match. However when augmented with an additional dataset by TL, the AUROC for the ML system improved statistically and clinically significantly to over 0.7. CONCLUSIONS. Machine learning is able to improve on predictors based on simple multiple logistic regression. Thus there is likely to be information in the trends and in combinations of variables. A disadvantage with this technique is that ML approaches require large amounts of data for training. However, ML approaches can be improved by TL. Basing prediction models on locally derived data augmented by TL is a potentially novel approach to generating tools that customised to the institution yet can exploit the potential power of ML algorithms. REFERENCES [1] Gajic O, Malinchoc M, Comfere TB, et al. The Stability and Workload Index for Transfer score predicts unplanned intensive care unit patient readmission: initial development and validation. Crit Care Med. 2008;36(3):676–82. Grant Acknowledgement This work was internally funded