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It is essential for surgeons to have their skill evaluated prior to entering the oper- ating room. Most evaluation methods currently in use are subjective, relying on human judgment to assess trainees. Recently, sensors have been used to track the positions of instruments and the forces applied to them by surgeons, opening up the possibility of automated skill analysis. This thesis presents a newly developed recording system, and novel methods used to automatically analyze surgical skill within the context of laparoscopic procedures. The evaluation methods are tested using an empirical study involving a number of participants with a wide range of surgical skill.

<p>An essential tool in the truck development process is the ability to quantify and grade vehicle dynamic behavior. Today this is performed either through subjective or objective tests. Subjective tests have the disadvantage that numerous factors influence test drivers’ opinions while objective measures have the advantage of repeatability. However, objective methods of today are often only able to provide a rough grading of vehicles. The main objective with this thesis is to develop more sensitive objective methods for ride comfort evaluation.</p><p>An effective test procedure to measure driver perception sensitivity to small differences in vehicle ride is suggested and utilized. The driver sensitivity is tested on dynamic behavior that is typically graded in vehicle development. Cab motions from a truck are first measured and then recreated in a simulator where a test driver is seated. The perception threshold for small changes in typical vehicle motion is established in this way for each test person.</p><p>The perception sensitivity tests indicate that humans are quite sensitive to transients in vehicle motion. One problem with many common vehicle ride measures is that the impact of transient behavior is small due to the averaging used to condense the measurement data into scalar measures. A new evaluation method for ride comfort, with influences from the well known handling diagram, is suggested. This method has four main advantages: it is fairly simple to interpret, it shows the absolute vibration level, it considers transient events separately and it shows changes in vehicle character with increasing excitation. Promising results from both measurements and simulations are derived.</p><p>New technology has made it possible to vary vehicle suspension parameters during vehicle ride. In order to prescribe different damping for different vehicle modes, modal motion estimates are needed. A system identification approach is suggested. It yields improved estimates of vehicle modal motion compared to previous work.</p>

An essential tool in the truck development process is the ability to quantify and grade vehicle dynamic behavior. Today this is performed either through subjective or objective tests. Subjective tests have the disadvantage that numerous factors influence test drivers’ opinions while objective measures have the advantage of repeatability. However, objective methods of today are often only able to provide a rough grading of vehicles. The main objective with this thesis is to develop more sensitive objective methods for ride comfort evaluation. An effective test procedure to measure driver perception sensitivity to small differences in vehicle ride is suggested and utilized. The driver sensitivity is tested on dynamic behavior that is typically graded in vehicle development. Cab motions from a truck are first measured and then recreated in a simulator where a test driver is seated. The perception threshold for small changes in typical vehicle motion is established in this way for each test person. The perception sensitivity tests indicate that humans are quite sensitive to transients in vehicle motion. One problem with many common vehicle ride measures is that the impact of transient behavior is small due to the averaging used to condense the measurement data into scalar measures. A new evaluation method for ride comfort, with influences from the well known handling diagram, is suggested. This method has four main advantages: it is fairly simple to interpret, it shows the absolute vibration level, it considers transient events separately and it shows changes in vehicle character with increasing excitation. Promising results from both measurements and simulations are derived. New technology has made it possible to vary vehicle suspension parameters during vehicle ride. In order to prescribe different damping for different vehicle modes, modal motion estimates are needed. A system identification approach is suggested. It yields improved estimates of vehicle modal motion compared to previous work. / QC 20101221

brace on the child's motor development and it briefly informs about the possibilities of the objective evaluation of child' significant influence of the diagnosis DDH and inseparable orthopaedic brace on the child's - ltaneusly intensive physiotherapy using Vojta's reflex

[pt] As técnicas de estimação de movimento utilizadas nos padrões de compressão de vídeo proporcionam a utilização mais eficiente dos recursos de transmissão e armazenamento, através da redução do número de bits necessários para representar um sinal de vídeo e da conservação da qualidade do conteúdo que está sendo processado. O objetivo dessa dissertação de Mestrado é propor um novo algoritmo capaz de reduzir a grande complexidade computacional envolvida nestas técnicas, mantendo a qualidade do sinal reconstruído. Dessa maneira, apresenta-se um algoritmo AUMHS (Adaptive Unsymmetrical-cross Multi-Hexagon-grid Search) o qual traz como principais modificações ao algoritmo UMHS (Unsymmetrical-cross Multi-Hexagon-grid Search) a implementação de uma medida de movimento que classifica as cenas de uma seqüência de vídeo de acordo com o movimento detectado para posterior adequação dos parâmetros de estimação de movimento e de outros parâmetros do codificador. Como resultado apresenta-se um ganho expressivo na velocidade de processamento, e conseqüente redução do custo computacional, conservando-se a qualidade obtida pelos principais algoritmos da literatura. O algoritmo foi implementado no codificador do padrão H.264/AVC onde realizou-se análises comparativas de desempenho com os algoritmos UMHS e FSA através da medição de parâmetros como PSNR (Peak Signal to Noise Ratio), tempo de processamento do codificador, tempo de processamento do módulo de estimação de movimento, taxa de bits utilizada e avaliação subjetiva informal. / [en] The motion estimation techniques used by the video compression standards provide an efficient utilization of the transmission and storage resources, through the reduction of the number of bits required to represent a video signal and the conservation of the content quality that is being processed. The objective of this work is to propose a new algorithm capable of reducing the great computational complexity involved in the motion estimation techniques, keeping the quality of the reconstructed signal. In this way, we present an algorithm called AUMHS (Adaptive Unsymmetrical-cross Multi-Hexagon-grid Search) which brings as main modifications relative to the UMHS (Unsymmetrical-cross Multi-Hexagon-grid Search) the implementation of a movement measure that can classify the scenes of a video sequence according to the motion detected for posterior adequacy of the motion estimation and others coder parameters. As result we present an expressive gain in the processing speed, and consequent computational cost reduction, conserving the same quality of the main algorithms published in the literature. The algorithm was implemented in the H.264/AVC coder in order to proceed with comparative analysis of perfomance together with the UMHS and FSA algorithms, measuring parameters as PSNR (Peak Signal you the Noise Ratio), coding processing time, motion estimation time, bit rate, and informal subjective evaluation.

Doctor of Philosophy / Radiographic film/screen (F/S) images have a narrow latitude or dynamic range. The film’s ability to record and view all the anatomy within the x-ray field is limited by this narrow dynamic range. The advent of digital radiographic means of storing and displaying radiographic images has improved the ability to record and visualise all of the anatomy. The problem still exists in digital radiography (DR) when radiographic examinations of certain anatomical regions are undertaken. In this work, the value of anatomically shaped radiographic contrast-enhancement masks (RCMs) in improving image contrast and reducing the dynamic range of images in DR was examined. Radiographic contrast-enhancement masks are digital masks that alter the radiographic contrast in DR images. The shape of these masks can be altered by the user. Anatomically shaped RCMs have been modelled on tissue compensation filters (TCFs) commonly used in F/S radiographic examinations. The prime purpose of a TCF is to reduce the dynamic range of photons reaching the image receptor and hence improve radiographic contrast in the resultant image. RCMs affect the dynamic range of the image rather than the energy source of the image, that of the x-ray photons. The research consisted of three distinct phases. The first phase was to examine physical TCFs and their effects on F/S radiographic images. Physical TCFs are used in radiographic F/S examinations to attenuate the x-ray beam to compensate for varying patient tissue thicknesses and/or densities. The effect of the TCF is to reduce resultant radiographic optical density variations in the image, allowing the viewer to observe a range of densities within the image which would otherwise not be visualised. Physical TCFs are commonly aluminium- or lead-based materials that attenuate the x-ray beam. A TCF has varying physical thickness to differentially attenuate the iii beam and is shaped for specific anatomical situations. During this project, various commonly used physical TCFs were examined. Measurements of size and thickness were made. Characteristics of linear attenuation coefficients and half-value thicknesses were delineated for various TCF materials and at various energies. The second phase of the research was to model the physical TCFs in a digital environment and apply the RCMs to DR images. The digital RCMs were created with similar characteristics to mimic the shapes to the physical TCFs. The RCM characteristics can be adjusted by the viewer of the image to suit the anatomy being imaged. Anatomically shaped RCMs were designed to assist in overcoming a limitation when viewing digital radiographic images, that of the dynamic range of the image. Anatomically shaped RCMs differ from other means of controlling the dynamic range of a digital radiographic image. It has been shown that RCMs can reduce the range of optical densities within images with a large dynamic range, to facilitate visualisation of all anatomy within the image. Physical TCFs are used within a specific range of radiographic F/S examinations. Digital radiographic images from this range of examinations were collected from various clinical radiological centres. Anatomically shaped RCMs were applied to the images to improve radiographic contrast of the images. The third phase of the research was to ascertain the benefits of the use of RCMs. Various other methods are currently in use to reduce the dynamic range of digital radiographic images. It is generally accepted that these methods also introduce noise into the image and hence reduce image quality. Quantitative comparisons of noise within the image were undertaken. The anatomically shaped RCMs introduced less noise than current methods designed to reduce the dynamic range of digital radiographic images. It was shown that RCM methods do not affect image quality. Radiographers make subjective assessment of digital radiographic image quality as part of their professional practice. To assess the subjective quality of images enhanced with anatomically shaped RCMs, a survey of radiographers and other iv qualified people was undertaken to ascertain any improvement in RCM-modified images compared to the original images. Participants were provided with eight pairs of image to compare. Questions were asked in the survey as to which image had the better range of optical densities; in which image the anatomy was easiest to visualise; which image had the simplest contrast and density manipulation for optimal visualisation; and which image had the overall highest image quality. Responses from 123 participants were received and analysed. The statistical analysis showed a higher preference by radiographers for the digital radiographic images in which the RCMs had been applied. Comparisons were made between anatomical regions and between patient-related factors of size, age and whether pathology was present in the image or not. The conclusion was drawn that digital RCMs correctly applied to digital radiographic images decrease the dynamic range of the image, allowing the entire anatomy to be visualised in one image. Radiographic contrast in the image can be maximised whilst maintaining image quality. Using RCMs in some digital radiographic examinations, radiographers will be able to present optimised images to referring clinicians. It is envisaged that correctly applied RCMs in certain radiographic examinations will enhance radiographic image quality and possibly lead to improved diagnosis from these images.

Doctor of Philosophy / Radiographic film/screen (F/S) images have a narrow latitude or dynamic range. The film’s ability to record and view all the anatomy within the x-ray field is limited by this narrow dynamic range. The advent of digital radiographic means of storing and displaying radiographic images has improved the ability to record and visualise all of the anatomy. The problem still exists in digital radiography (DR) when radiographic examinations of certain anatomical regions are undertaken. In this work, the value of anatomically shaped radiographic contrast-enhancement masks (RCMs) in improving image contrast and reducing the dynamic range of images in DR was examined. Radiographic contrast-enhancement masks are digital masks that alter the radiographic contrast in DR images. The shape of these masks can be altered by the user. Anatomically shaped RCMs have been modelled on tissue compensation filters (TCFs) commonly used in F/S radiographic examinations. The prime purpose of a TCF is to reduce the dynamic range of photons reaching the image receptor and hence improve radiographic contrast in the resultant image. RCMs affect the dynamic range of the image rather than the energy source of the image, that of the x-ray photons. The research consisted of three distinct phases. The first phase was to examine physical TCFs and their effects on F/S radiographic images. Physical TCFs are used in radiographic F/S examinations to attenuate the x-ray beam to compensate for varying patient tissue thicknesses and/or densities. The effect of the TCF is to reduce resultant radiographic optical density variations in the image, allowing the viewer to observe a range of densities within the image which would otherwise not be visualised. Physical TCFs are commonly aluminium- or lead-based materials that attenuate the x-ray beam. A TCF has varying physical thickness to differentially attenuate the iii beam and is shaped for specific anatomical situations. During this project, various commonly used physical TCFs were examined. Measurements of size and thickness were made. Characteristics of linear attenuation coefficients and half-value thicknesses were delineated for various TCF materials and at various energies. The second phase of the research was to model the physical TCFs in a digital environment and apply the RCMs to DR images. The digital RCMs were created with similar characteristics to mimic the shapes to the physical TCFs. The RCM characteristics can be adjusted by the viewer of the image to suit the anatomy being imaged. Anatomically shaped RCMs were designed to assist in overcoming a limitation when viewing digital radiographic images, that of the dynamic range of the image. Anatomically shaped RCMs differ from other means of controlling the dynamic range of a digital radiographic image. It has been shown that RCMs can reduce the range of optical densities within images with a large dynamic range, to facilitate visualisation of all anatomy within the image. Physical TCFs are used within a specific range of radiographic F/S examinations. Digital radiographic images from this range of examinations were collected from various clinical radiological centres. Anatomically shaped RCMs were applied to the images to improve radiographic contrast of the images. The third phase of the research was to ascertain the benefits of the use of RCMs. Various other methods are currently in use to reduce the dynamic range of digital radiographic images. It is generally accepted that these methods also introduce noise into the image and hence reduce image quality. Quantitative comparisons of noise within the image were undertaken. The anatomically shaped RCMs introduced less noise than current methods designed to reduce the dynamic range of digital radiographic images. It was shown that RCM methods do not affect image quality. Radiographers make subjective assessment of digital radiographic image quality as part of their professional practice. To assess the subjective quality of images enhanced with anatomically shaped RCMs, a survey of radiographers and other iv qualified people was undertaken to ascertain any improvement in RCM-modified images compared to the original images. Participants were provided with eight pairs of image to compare. Questions were asked in the survey as to which image had the better range of optical densities; in which image the anatomy was easiest to visualise; which image had the simplest contrast and density manipulation for optimal visualisation; and which image had the overall highest image quality. Responses from 123 participants were received and analysed. The statistical analysis showed a higher preference by radiographers for the digital radiographic images in which the RCMs had been applied. Comparisons were made between anatomical regions and between patient-related factors of size, age and whether pathology was present in the image or not. The conclusion was drawn that digital RCMs correctly applied to digital radiographic images decrease the dynamic range of the image, allowing the entire anatomy to be visualised in one image. Radiographic contrast in the image can be maximised whilst maintaining image quality. Using RCMs in some digital radiographic examinations, radiographers will be able to present optimised images to referring clinicians. It is envisaged that correctly applied RCMs in certain radiographic examinations will enhance radiographic image quality and possibly lead to improved diagnosis from these images.

Grafomotorické dovednosti (GA) představují skupinu psychomotorických procesů, které se zapojují během kreslení a psaní. GA jsou nutnou prerekvizitou pro zvládání základních školních schopností, konkrétně psaní. Děti v první a druhé třídě mohou mít potíže s prováděním jednoduchých grafomotorických úkolů (GD) a později ve třetí a čtvrté třídě také se samotným psaním (HD). Narušení procesů spojených se psaním je obecně nazýváno jako vývojová dysgrafie (DD). Prevalence DD v České republice se pohybuje kolem 3–5 %. V současné době je DD hodnocena subjektivně týmem psychologů a speciálních pedagogů. V praxi stále chybí objektivní měřicí nástroj, který by umožňoval hodnocení GD a HD. Z tohoto důvodu se tato disertační práce zabývá identifikováním symptomů spojených s grafomotorickou neobratností u dětí školního věku a vývojem nových parametrů, které je budou kvantifikovat. Byl vytvořen komplexní GA protokol (36 úloh), který představuje prostředí, ve kterém se mohou projevit různé symptomy spojené s GD a HD. K těmto symptomům bylo přiřazeno 76 kvantifikujících parametrů. Dále byla navrhnuta nová škála grafomotorických obtíží (GDRS) založena na automatizovaném zpracování online píma. Nakonec byla prezentována a otestována nová sada parametrizačních technik založených na Tunable Q Factor Wavelet Transform (TQWT). Parametry TQWT dokážou kvantifikovat grafomotorickou obratnost nebo nedostatečný projev v jemné motorice. GDRS přestavuje nový, moderní a objektivní měřící nástroj, který doposud chyběl jak v České republice, tak v zahraničí. Použití škály by pomohlo modernizovat jak diagnostiku DD, tak reedukační/remediační proces. Další výzkum by tento nástroj mohl adaptovat i do jiných jazyků. Navíc, tato metodologie může být použita a optimalizována pro diagnostiku dalších nemocí a poruch, které ovlivňují grafomotorické dovednosti, například pro autismus, poruchu pozornosti s hyperaktivitou (ADHD) nebo dyspraxii (DCD).

[EN] Wheelchair users represent around 1% of the population. This group is characterised through the number of hours spent each day in a seated position. This can lead to health problems linked mainly to the development of pressure ulcers. In addition, the position in the wheelchair is critical in order to be able to perform different activities comfortably. The aim of the cushions, integrated in the whole seating system, is to contribute to the prevention, positioning and comfort of the person in a wheelchair. Incorporating the user adequately into the assessment, prescription and development of new cushions is a key aspect, clearly identified in the bibliography, which requires the use of innovation models to produce this incorporation systematically. This research paper adopts the cause-effect model, successfully used in other fields such as the car or shoe making industries, but to date not used in the field of tissue management cushions. The use of this model has allowed for the identification of different links between the consequences of the interaction person-cushion (developed perception of the user) with the cushion and person characteristics, as well as with the physiological and biomechanical response resulting from this interaction. This was a necessary step to obtain design and selection criteria for the cushions. The physiological and biomechanical variables which have been analysed are pressure and microclimate. To study the consequences of this interaction we have considered the user perception obtained by means of a questionnaire. Thirty-six wheelchair users have participated in this study which includes the assessment of twenty-five cushions. The main criteria for the inclusion of users in the study has been the risk level of risk of developing pressure ulcers. The inclusion of cushions was based on the market representation and consideration of the different typologies. From the point of view of the user's opinion this research paper has allowed for the identification of the quality perception factors (F1. Stability, F2.Heat-pain, F3. Fitting, F4. Collapse, F5. Size-aesthetics and F6. Weight-cold) and for the calculation of their weight on the global factors of goodness and evolution of the cushions. In addition, the comparison of the pressure values obtained directly from the wheelchair users and those measured using the dummy highlights a clear divergence between both behaviour. We have also defined design criteria and limit values, admissible and recommendable, for a group of variables, as well as the relation of the subjective variables with these quality factors. The results of this research support the importance of a comprenhensive approach to the cushions, including the design, development and prescription processes whereby the users may become more of a protagonist than they have been so far. / [ES] Las personas en silla de ruedas representan alrededor del 1% de la población. Este colectivo se caracteriza por pasar muchas horas al día sentado. Esto puede comportar problemas de salud vinculados principalmente al desarrollo de úlceras por presión. Por otra parte, el posicionamiento en la silla de ruedas es crítico para poder realizar actividades diversas de forma confortable. El objetivo de los cojines, integrados dentro del sistema de sedestación, es contribuir a la prevención, el posicionamiento y el confort de la persona en la silla de ruedas. Incorporar el usuario de forma adecuada en la evaluación, prescripción y desarrollo de nuevos cojines es un aspecto clave, identificado claramente en la bibliografía, que requiere el uso de modelos de innovación que faciliten esta incorporación de forma sistemática. En este trabajo de investigación se ha adoptado el modelo de evaluación causa-efecto, empleado con éxito en ámbitos como la automoción o el calzado, pero que hasta el momento no se había utilizado en el campo de los cojines antiescaras. El uso de este modelo ha permitido la identificación de diversos encadenamientos entre las consecuencias de la interacción cojín-persona (percepción desarrollada en el usuario) con las características del cojín y la persona, así como con la respuesta fisiológica y biomecánica resultante de esta interacción. Éste era el paso previo para poder obtener criterios de diseño y selección de cojines. Las variables fisiológicas y biomecánicas analizadas han sido la presión y el microclima. Para estudiar las consecuencias de la interacción hemos considerado la percepción del usuario obtenida mediante cuestionarios. Treinta y seis personas en silla de ruedas han participado en este estudio que ha incluido la valoración de veinticinco cojines. El principal criterio para la inclusión de usuarios en el estudio ha sido el nivel de riesgo de desarrollar úlceras por presión. La inclusión de los cojines se ha basado en la representatividad del mercado y la inclusión de tipologías diferentes. Desde el punto de vista de la opinión de los usuarios este trabajo de investigación ha permitido identificar los factores de calidad percibida (F1. Estabilidad, F2. Calor-dolor, F3. Encajonamiento, F4. Colapso, F5. Tamaño-estética y F6. Peso-frío) y calcular el peso de ellos sobre los factores globales de bondad y evolución de los cojines. Por otra parte, la comparación de los valores de presión obtenidos con las personas en silla de ruedas y los medidos con el maniquí constata una clara divergencia en el comportamiento. También se han definido criterios de diseño y valores límite, admisibles y recomendables, para un conjunto de variables, así como su relación con los factores de calidad y las variables subjetivas agrupadas en estos factores. Los resultados de este trabajo apoyan la importancia de una aproximación global a los cojines, que incluya los procesos de diseño, desarrollo y prescripción, donde los usuarios sean mucho más protagonistas de lo que han sido hasta ahora. / [CA] Les persones en cadira de rodes representen al voltant de l'1% de la població. Aquest col·lectiu es caracteritza per passar moltes hores al dia damunt la cadira, cosa que pot comportar problemes de salut vinculats principalment al desenvolupament d'úlceres per pressió. Per altra banda, el posicionament en la cadira de rodes és crític per poder realitzar activitats diverses i que aquestes puguen fer-se de forma confortable. L'objectiu dels coixins, integrats dins del sistema de sedestació, és contribuir a la prevenció, el posicionament i el confort de la persona en la cadira de rodes. Incorporar l'usuari de forma adequada en l'avaluació, prescripció i desenvolupament de nous coixins és un aspecte clau, identificat clarament a la bibliografia, que requereix l'ús de models d'innovació que faciliten aquesta incorporació de forma sistemàtica. En aquest treball d'investigació s'ha adoptat el model d'avaluació causa-efecte, emprat amb èxit en àmbits com l'automoció o el calcer, però que fins al moment no s'havia utilitzat en el camp dels coixins antiescares. L'ús d'aquest model ha permès la identificació de diversos encadenaments entre les conseqüències de la interacció coixí-persona (percepció desenvolupada en l'usuari) amb les característiques del coixí i la persona, així com amb la resposta fisiològica i biomecànica resultant d'aquesta interacció. Aquest era el pas previ per poder obtenir cri teris de disseny i selecció de coixins. Les variables fisiològiques i biomecàniques analitzades han estat la pressió i el microclima. Per a estudiar les conseqüències de la interacció hem considerat la percepció de l'usuari obtinguda mitjançant l'ús de qüestionaris. Trenta-sis persones en cadira de rodes han participat en aquest estudi que ha inclòs la valoració de vint-i-cinc coixins. El principal criteri per a la inclusió d'usuaris en l'estudi ha estat el nivell de risc de desenvolupar úlceres per pressió. Per a la inclusió dels coixins s'ha buscat la representativitat del mercat i la inclusió de tipologies diferents. Des del punt de vista de l'opinió dels usuaris aquest treball d'investigació ha permès identificar els factors de qualitat percebuda (F1. Estabilitat, F2. Calor-dolor, F3. Encaixament, F4. Col·lapse, F5. Grandària-estètica i F6. Pes-fred) i calcular el pes d'ells sobre els factors globals de bondat i evolució dels coixins. Per altra banda, la comparació dels valors de pressió obtinguts amb les persones en cadira de rodes i els mesurats amb el maniquí constata una clara divergència en el comportament. També s'han definit criteris de disseny i valors límit, admissibles i recomanables, per a un conjunt de variables i la seua relació amb els factors de qualitat i les variables subjectives. Els resultats d'aquest treball suporten la importància d'una aproximació global als coixins, que incloga els processos de disseny, desenvolupament i prescripció, on els usuaris siguen molt més protagonistes del que ho han estat fins ara. / Barbera Guillem, R. (2016). Identificació de criteris de disseny i selecció de coixins antiescares, a partir d'aspectes funcionals dels coixins i les característiques particulars i preferències dels usuaris [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/61463 / TESIS