Analyzing time attributes in temporal event sequences

Event data is present in a variety of domains such as electronic health records, daily living activities and web clickstream records. Current visualization methods to explore event data focus on discovering sequential patterns but present limitations when studying time attributes in event sequences. Time attributes are especially important when studying waiting times or lengths of visit in patient flow analysis. We propose a visual analytics methodology that allows the identification of trends and outliers in respect of duration and time of occurrence in event sequences. The proposed method presents event data using a single Sequential and Time Patterns overview. User-driven alignment by multiple events, sorting by sequence similarity and a novel visual encoding of events allows the comparison of time trends across and within sequences. The proposed visualization allows the derivation of findings that otherwise could not be obtained using traditional visualizations. The proposed methodology has been applied to a real-world dataset provided by Sheffield Teaching Hospitals NHS Foundation Trust, for which four classes of conclusions were derived

The Role of Computational Fluid Dynamics in the Management of Unruptured Intracranial Aneurysms: A Clinicians' View

Objective. The importance of hemodynamics in the etiopathogenesis of intracranial aneurysms (IAs) is widely accepted. Computational fluid dynamics (CFD) is being used increasingly for hemodynamic predictions. However, alogn with the continuing development and validation of these tools, it is imperative to collect the opinion of the clinicians. Methods. A workshop on CFD was conducted during the European Society of Minimally Invasive Neurological Therapy (ESMINT) Teaching Course, Lisbon, Portugal. 36 delegates, mostly clinicians, performed supervised CFD analysis for an IA, using the @neuFuse software developed within the European project @neurIST. Feedback on the workshop was collected and analyzed. The performance was assessed on a scale of 1 to 4 and, compared with experts' performance. Results. Current dilemmas in the management of unruptured IAs remained the most important motivating factor to attend the workshop and majority of participants showed interest in participating in a multicentric trial. The participants achieved an average score of 2.52 (range 0–4) which was 63% (range 0–100%) of an expert user. Conclusions. Although participants showed a manifest interest in CFD, there was a clear lack of awareness concerning the role of hemodynamics in the etiopathogenesis of IAs and the use of CFD in this context. More efforts therefore are required to enhance understanding of the clinicians in the subject

Modeling intracranial aneurysm stability and growth: An integrative mechanobiological framework for clinical cases

We present a novel patient-specific fluid-solid-growth framework to model the mechanobiological state of clinically detected intracranial aneurysms (IAs) and their evolution. The artery and IA sac are modeled as thick-walled, non-linear elastic fiber-reinforced composites. We represent the undulation distribution of collagen fibers: the adventitia of the healthy artery is modeled as a protective sheath whereas the aneurysm sac is modeled to bear load within physiological range of pressures. Initially, we assume the detected IA is stable and then consider two flow-related mechanisms to drive enlargement: (1) low wall shear stress; (2) dysfunctional endothelium which is associated with regions of high oscillatory flow. Localized collagen degradation and remodelling gives rise to formation of secondary blebs on the aneurysm dome. Restabilization of blebs is achieved by remodelling of the homeostatic collagen fiber stretch distribution. This integrative mechanobiological modelling workflow provides a step towards a personalized risk-assessment and treatment of clinically detected IAs

Gradeer : an open-source modular hybrid grader

Automated assessment has been shown to greatly simplify the process of assessing students' programs. However, manual assessment still offers benefits to both students and tutors. We introduce Gradeer, a hybrid assessment tool, which allows tutors to leverage the advantages of both automated and manual assessment. The tool features a modular design, allowing new grading functionality to be added. Gradeer directly assists manual grading, by automatically loading code inspectors, running students' programs, and allowing grading to be stopped and resumed in place at a later time. We used Gradeer to assess an end of year assignment for an introductory Java programming course, and found that its hybrid approach offers several benefits

How do coil configuration and packing density influence intra-aneurysmal hemodynamics?

Endovascular coiling is a well-established therapy for treating intracranial aneurysms. Nonetheless, postoperative hemodynamic changes induced by this therapy remain not fully understood. The purpose of this work is to assess the influence of coil configuration and packing density on intra-aneurysmal hemodynamicsThis work was partially supported within the CENIT program, as part of CDTEAM and cvREMOD projects funded by the Spanish CDTI and partly within the framework of the @neurIST Project (IST-2005-027703), which is cofinanced by the European Commission within the IST Program of the Sixth Framework Progra

Sequen-C: A multilevel overview of temporal event sequences

Building a visual overview of temporal event sequences with an optimal level-of-detail (i.e. simplified but informative) is an ongoing challenge - expecting the user to zoom into every important aspect of the overview can lead to missing insights. We propose a technique to build a multilevel overview of event sequences, whose granularity can be transformed across sequence clusters (vertical level-of-detail) or longitudinally (horizontal level-of-detail), using hierarchical aggregation and a novel cluster data representation Align-Score-Simplify. By default, the overview shows an optimal number of sequence clusters obtained through the average silhouette width metric – then users are able to explore alternative optimal sequence clusterings. The vertical level-of-detail of the overview changes along with the number of clusters, whilst the horizontal level-of-detail refers to the level of summarization applied to each cluster representation. The proposed technique has been implemented into a visualization system called Sequence Cluster Explorer (Sequen-C) that allows multilevel and detail-on-demand exploration through three coordinated views, and the inspection of data attributes at cluster, unique sequence, and individual sequence level. We present two case studies using real-world datasets in the healthcare domain: CUREd and MIMIC-III; which demonstrate how the technique can aid users to obtain a summary of common and deviating pathways, and explore data attributes for selected patterns

A Computational Framework to Explore the Role of Pulsatile Haemodynamics on Cerebral Aneurysm Development for Patient-Specific Arterial Geometries

A patient-specific cerebral aneurysm case was identified from clinical imaging data, and then segmented to create a geometrical representation of the aneurysm and surrounding vasculature. Using ANSYS ICEM CFD, the geometry was manipulated to remove the aneurysm and replace it with a short (initially cylindrical) section, which reconnected to the upstream and downstream arterial sections so that the surface gradients were continuous. This section is modelled using a realistic constitutive model of the arterial wall and is the location where the computational model of the aneurysm evolves. The aneurysm evolution FEA model is combined with detailed 3D haemodynamic solutions using ANSYS CFX. A rigid-wall approach is adopted to solve the flow, to derive the haemodynamic stimuli that act on the endothelial cell layer of the tissue. Additionally, the geometry of the aneurysm is obtained at systolic and diastolic pressures (using a quasi-static approach) to obtain the cyclic stretch experienced by the cells within the arterial wall. This is the first patient-specific model of cerebral aneurysm evolution to explicitly link growth and remodelling of arterial tissue to the local mechanical environment. It will provide the basis for investigating the role and importance of various mechanical stimuli on the progression of the disease and will yield improved understanding of the aetiology of cerebral aneurysm formation. © 2010 International Federation for Medical and Biological Engineering