• Quantification of the pressures generated during insertion of an epidural needle in labouring women of varying body mass indices

      Wee, M. Y. K.; Isaacs, R.; Vaughan, Neil; Dubey, V. N.; Parker, B.; University of Chester; Bournemouth University; Poole Hospital NHS Trust; West Hertfordshire NHS Trust; Southampton University Hospital (Heighten Science Publications, 2017-12-01)
      Objective: The primary aim of this study was to measure pressure generated on a Tuohy needle during the epidural procedure in labouring women of varying body mass indices (BMI) with a view of utilising the data for the future development of a high fi delity epidural simulator. High-fi delity epidural simulators have a role in improving training and safety but current simulators lack a realistic experience and can be improved. Methods: This study was approved by the National Research Ethics Service Committee South Central, Portsmouth (REC reference 11/SC/0196). After informed consent epidural needle insertion pressure was measured using a Portex 16-gauge Tuohy needle, loss-of-resistance syringe, a three-way tap, pressure transducer and a custom-designed wireless transmitter. This was performed in four groups of labouring women, stratified according to BMI kg/m2: 18-24.9; 25-34.9; 35-44.9 and >=45. One-way ANOVA was used to compare difference in needle insertion pressure between the BMI groups. A paired t-test was performed between BMI group 18-24.9 and the three other BMI groups. Ultrasound images of the lumbar spine were undertaken prior to the epidural procedure and lumbar magnetic resonance imaging (MRI) was performed within 72h post-delivery. These images will be used in the development of a high fi delity epidural simulator. Results: The mean epidural needle insertion pressure of labouring women with BMI 18-24.9 was 461mmHg; BMI 25-34.9 was 430mmHg; BMI 35-44.9 was 415mmHg and BMI >=45 was 376mmHg, (p=0.52). Conclusion: Although statistically insignifi cant, the study did show a decreasing trend of epidural insertion pressure with increasing body mass indices.
    • Real-time Geometry-Aware Augmented Reality in Minimally Invasive Surgery

      Chen, Long; Tang, Wen; John, Nigel W.; Bournemouth University; University of Chester (IET, 2017-10-27)
      The potential of Augmented Reality (AR) technology to assist minimally invasive surgeries (MIS) lies in its computational performance and accuracy in dealing with challenging MIS scenes. Even with the latest hardware and software technologies, achieving both real-time and accurate augmented information overlay in MIS is still a formidable task. In this paper, we present a novel real-time AR framework for MIS that achieves interactive geometric aware augmented reality in endoscopic surgery with stereo views. Our framework tracks the movement of the endoscopic camera and simultaneously reconstructs a dense geometric mesh of the MIS scene. The movement of the camera is predicted by minimising the re-projection error to achieve a fast tracking performance, while the 3D mesh is incrementally built by a dense zero mean normalised cross correlation stereo matching method to improve the accuracy of the surface reconstruction. Our proposed system does not require any prior template or pre-operative scan and can infer the geometric information intra-operatively in real-time. With the geometric information available, our proposed AR framework is able to interactively add annotations, localisation of tumours and vessels, and measurement labelling with greater precision and accuracy compared with the state of the art approaches.
    • Real-Time Guidance and Anatomical Information by Image Projection onto Patients

      Edwards, Marc R.; Pop, Serban R.; John, Nigel W.; Ritsos, Panagiotis D.; Avis, Nick J.; University of Chester (Eurographics Association, 2016-09)
      The Image Projection onto Patients (IPoP) system is work in progress intended to assist medical practitioners perform procedures such as biopsies, or provide a novel anatomical education tool, by projecting anatomy and other relevant information from the operating room directly onto a patient’s skin. This approach is not currently used widely in hospitals but has the benefit of providing effective procedure guidance without the practitioner having to look away from the patient. Developmental work towards the alpha-phase of IPoP is presented including tracking methods for tools such as biopsy needles, patient tracking, image registration and problems encountered with the multi-mirror effect.
    • Recent Developments and Future Challenges in Medical Mixed Reality

      Chen, Long; Day, Thomas; Tang, Wen; John, Nigel W.; Bournemouth University and University of Chester (2017-10)
      Mixed Reality (MR) is of increasing interest within technology driven modern medicine but is not yet used in everyday practice. This situation is changing rapidly, however, and this paper explores the emergence of MR technology and the importance of its utility within medical applications. A classification of medical MR has been obtained by applying an unbiased text mining method to a database of 1,403 relevant research papers published over the last two decades. The classification results reveal a taxonomy for the development of medical MR research during this period as well as suggesting future trends. We then use the classification to analyse the technology and applications developed in the last five years. Our objective is to aid researchers to focus on the areas where technology advancements in medical MR are most needed, as well as providing medical practitioners with a useful source of reference.
    • Sketching Designs Using the Five Design-Sheet Methodology

      Roberts, Jonathan C.; Headleand, Christopher J.; Ritsos, Panagiotis D.; University of Bangor, University of Bangor, University of Chester (IEEE, 2016-01)
      Sketching designs has been shown to be a useful way of planning and considering alternative solutions. The use of lo-fidelity prototyping, especially paper-based sketching, can save time, money and converge to better solutions more quickly. However, this design process is often viewed to be too informal. Consequently users do not know how to manage their thoughts and ideas (to first think divergently, to then finally converge on a suitable solution). We present the Five Design Sheet (FdS) methodology. The methodology enables users to create information visualization interfaces through lo-fidelity methods. Users sketch and plan their ideas, helping them express different possibilities, think through these ideas to consider their potential effectiveness as solutions to the task (sheet 1); they create three principle designs (sheets 2,3 and 4); before converging on a final realization design that can then be implemented (sheet 5). In this article, we present (i) a review of the use of sketching as a planning method for visualization and the benefits of sketching, (ii) a detailed description of the Five Design Sheet (FdS) methodology, and (iii) an evaluation of the FdS using the System Usability Scale, along with a case-study of its use in industry and experience of its use in teaching.
    • SLAM-based dense surface reconstruction in monocular Minimally Invasive Surgery and its application to Augmented Reality

      Chen, Long; Tang, Wen; John, Nigel W.; Wan, Tao R.; Zhang, Jian J.; Bournemouth University; University of Chester; University of Bradford (Elsevier, 2018-02-08)
      Background and Objective While Minimally Invasive Surgery (MIS) offers considerable benefits to patients, it also imposes big challenges on a surgeon's performance due to well-known issues and restrictions associated with the field of view (FOV), hand-eye misalignment and disorientation, as well as the lack of stereoscopic depth perception in monocular endoscopy. Augmented Reality (AR) technology can help to overcome these limitations by augmenting the real scene with annotations, labels, tumour measurements or even a 3D reconstruction of anatomy structures at the target surgical locations. However, previous research attempts of using AR technology in monocular MIS surgical scenes have been mainly focused on the information overlay without addressing correct spatial calibrations, which could lead to incorrect localization of annotations and labels, and inaccurate depth cues and tumour measurements. In this paper, we present a novel intra-operative dense surface reconstruction framework that is capable of providing geometry information from only monocular MIS videos for geometry-aware AR applications such as site measurements and depth cues. We address a number of compelling issues in augmenting a scene for a monocular MIS environment, such as drifting and inaccurate planar mapping. Methods A state-of-the-art Simultaneous Localization And Mapping (SLAM) algorithm used in robotics has been extended to deal with monocular MIS surgical scenes for reliable endoscopic camera tracking and salient point mapping. A robust global 3D surface reconstruction framework has been developed for building a dense surface using only unorganized sparse point clouds extracted from the SLAM. The 3D surface reconstruction framework employs the Moving Least Squares (MLS) smoothing algorithm and the Poisson surface reconstruction framework for real time processing of the point clouds data set. Finally, the 3D geometric information of the surgical scene allows better understanding and accurate placement AR augmentations based on a robust 3D calibration. Results We demonstrate the clinical relevance of our proposed system through two examples: a) measurement of the surface; b) depth cues in monocular endoscopy. The performance and accuracy evaluations of the proposed framework consist of two steps. First, we have created a computer-generated endoscopy simulation video to quantify the accuracy of the camera tracking by comparing the results of the video camera tracking with the recorded ground-truth camera trajectories. The accuracy of the surface reconstruction is assessed by evaluating the Root Mean Square Distance (RMSD) of surface vertices of the reconstructed mesh with that of the ground truth 3D models. An error of 1.24mm for the camera trajectories has been obtained and the RMSD for surface reconstruction is 2.54mm, which compare favourably with previous approaches. Second, in vivo laparoscopic videos are used to examine the quality of accurate AR based annotation and measurement, and the creation of depth cues. These results show the potential promise of our geometry-aware AR technology to be used in MIS surgical scenes. Conclusions The results show that the new framework is robust and accurate in dealing with challenging situations such as the rapid endoscopy camera movements in monocular MIS scenes. Both camera tracking and surface reconstruction based on a sparse point cloud are eff active and operated in real-time. This demonstrates the potential of our algorithm for accurate AR localization and depth augmentation with geometric cues and correct surface measurements in MIS with monocular endoscopes.
    • Stigmergic Interoperability for Autonomic Systems: Managing Complex Interactions in Multi-Manager Scenarios

      Eze, Thaddeus; Anthony, Richard; University of Chester; University of Greenwich (IEEE, 2016-09)
      The success of autonomic computing has led to its popular use in many application domains, leading to scenarios where multiple autonomic managers (AMs) coexist, but without adequate support for interoperability. This is evident, for example, in the increasing number of large datacentres with multiple managers which are independently designed. The increase in scale and size coupled with heterogeneity of services and platforms means that more AMs could be integrated to manage the arising complexity. This has led to the need for interoperability between AMs. Interoperability deals with how to manage multi-manager scenarios, to govern complex coexistence of managers and to arbitrate when conflicts arise. This paper presents an architecture-based stigmergic interoperability solution. The solution presented in this paper is based on the Trustworthy Autonomic Architecture (TAArch) and uses stigmergy (the means of indirect communication via the operating environment) to achieve indirect coordination among coexisting agents. Usually, in stigmergy-based coordination, agents may be aware of the existence of other agents. In the approach presented here in, agents (autonomic managers) do not need to be aware of the existence of others. Their design assumes that they are operating in 'isolation' and they simply respond to changes in the environment. Experimental results with a datacentre multi-manager scenario are used to analyse the proposed approach.
    • Swarm Communication by Evolutionary Algorithms

      Vaughan, Neil; University of Chester (IEEE, 2018-05-27)
      This research has applied evolutionary algorithms to evolve swarm communication. Controllers were evolved for colonies of artificial simulated ants during a food foriaging task which communicate using pheromone. Neuroevolution enables both weights and the topology of the artificial neural networks to be optimized for food foriaging. The developed model results in evolution of ants which communicate using pheromone trails. The ants successfully collect and return food to the nest. The controller has evolved to adjust the strength of pheromone which provides a signal to guide the direction of other ants in the colony by hill climbing strategy. A single ANN controller for ant direction successfully evolved which exhibits many separate skills including food search, pheromone following, food collection and retrieval to the nest.
    • A Tablet-based Virtual Environment for Neurosurgery Training

      John, Nigel W.; Phillips, Nicholas I.; ap Cenydd, Llyr; Coope, David; Carleton-Bland, Nick; Kamaly-Asl, Ian; Grey, William P.; University of Chester, Leeds General Infirmary, Bangor University, University of Manchester, Cardiff University (MIT Press, 2015)
      The requirement for training surgical procedures without exposing the patient to additional risk is well accepted and is part of a national drive in the UK and internationally. Computer-based simulations are important in this context, including neurosurgical resident training. The objective of this study is to evaluate the effectiveness of a custom built virtual environment in assisting training of a ventriculostomy procedure. The training tool (called VCath) has been developed as an app for a tablet platform to provide easy access and availability to trainees. The study was conducted at the first boot camp organized for all year one trainees in neurosurgery in the UK. The attendees were randomly distributed between the VCath training group and the Control group. Efficacy of performing ventriculostomy for both groups was assessed at the beginning and end of the study using a simulated insertion task. Statistically significant changes in performance of selecting the burr hole entry point, the trajectory length and duration metrics for the VCath group, together with a good indicator of improved normalized jerk (representing the speed and smoothness of arm motion), all suggest that there has been a higher level cognitive benefit to using VCath. The app is successful as it is focused on the cognitive task of ventriculostomy, encouraging the trainee to rehearse the entry point and use anatomical landmarks to create a trajectory to the target. In straight-line trajectory procedures such as ventriculostomy, cognitive task based education is a useful adjunct to traditional methods and may reduce the learning curve and ultimately improve patient safety.
    • Thermophoresis effect on the free convective flow in a differentially heated square cavity

      Pop, Serban R.; Grosan, Teodor; University of Chester; Babes-Bolyai University of Cluj Napoca (Begell House, 2015)
      A numerical analysis is made for thermophoretic transport of small particles through the convective flow in a differentially heated square cavity. The governing gas-particle partial differential equations are solved numerically for some values of the considered parameters to investigate their influence on the flow, heat, and mass transfer patterns. It is found that the effect of thermophoresis can be quite significant in appropriate situations.
    • Throwing sheep in the bandroom: Visualising a social and economic network of musicians in Cheshire and North Wales

      Southall, Helen; University of Chester (2012-07-25)
      The aim of this session is to apply some of the visual and technological tools of 21st-Century online social networking, e.g. network visualisation using "friend wheels", to a densely interconnected network of jazz and dance band musicians active in the Chester (UK) area in the 1950s, as revealed by research on the "hidden history" of live music in the area. Over 30 interviews with musicians, dancers and promoters have been collected, plus more than 200 photographs from personal collections, and an M.U. diary/address book belonging to local bandleader Wilf Field. The recent dramatic growth of online social networks such as Facebook, LinkedIn and MySpace has led to a revival of interest in the economic importance of social networks; Fraser and Dutta’s "Throwing Sheep in the Boardroom" provides an interesting survey of the issues, and was an inspiration for this session. But working musicians have long known the importance of knowing (and impressing) the "right people" in order to get work. Have social networks changed fundamentally since the advent of Web 2.0, or were they always there, and just a little harder to visualise when held in a pocket diary, rather than displayed on a Facebook wall?
    • Total war and its effects on the live music industry in Cheshire and North Wales

      Southall, Helen; University of Chester (University of Chester, 2014-10-03)
      Given the profound effect which World War II had on the economy of the UK as a whole, it would be surprising if specific areas of that economy – such as live music in the provinces – were not affected as well. How did ‘total war’ affect the live music industry on a local level? Evidence I have collected for a study of musicians active in and around Chester during the period suggests that the large number of military bases in the area, combined with the effects of other wartime factors such as conscription, rationing and the need to maintain both military and civilian morale, did indeed affect the size and nature of the market for live dance music locally. For instance, the large US Air Force base at Burtonwood was a source of work for local musicians, as well as an opportunity to mix with American musicians and music fans. As well as presenting information obtained through interviews with musicians and their relatives, I will also look briefly at what happened to the musicians and the bands after the war, when economic and social conditions changed again, at the same time as advances occurred in music-related technology.
    • Towards Organisational Learning Enhancement: Assessing Software Engineering Practice

      Fannoun, Sufian; Kerins, John; University of Chester (Emerald Publishing Limited, 2018-12-17)
      • Purpose – Issues surrounding knowledge management, knowledge transfer and learning within organisations challenge continuity and resilience in the face of changing environments. While initiatives are principally applied within large organisations, there is scope to assess how the processes are handled within small and medium enterprises (SMEs) and to consider how they might be enhanced. This paper presents an evaluation of practice within an evolving software development unit to determine what has been learned and how the knowledge acquired has been utilised to further organisational development. These results provide the basis for the design and implementation of a proposed support tool to enhance professional practice. • Design/methodology/approach – A small software development unit, which has successfully delivered bespoke systems since its establishment a number of years ago, was selected for analysis. The unit operates as a team whose actions and behaviours were identified and validated by the following means: in-depth interviews were carried out with each member of the team to elicit an understanding of individual and collective development. Interview data were recorded and transcribed and subjected to qualitative analysis to identify key themes underpinning knowledge acquisition and utilisation. Samples of project documentation were scrutinised to corroborate interview data. After analysing the data, a focus-group meeting was held to validate the results and to generate further insights into learning within the team. • Findings - Qualitative analysis of the data revealed key changes in thinking and practice within the team as well as insight into the development of individual and collective contextual knowledge, tacit understanding and learning. This analysis informed the proposal of a bespoke, lightweight, web-based system to support knowledge capture and organisational learning (OL). This approach has the potential to promote resilience and to enhance practice in similar small or start-up enterprises. • Research limitations/implications – Purposeful sampling was used in selecting a small software development team. This enabled in-depth interviewing of all members of the team. This offered a rich environment from which to derive awareness and understanding of individual and collective knowledge acquisition and learning. Focusing on a single small enterprise limits the extent to which the findings can be generalised. However, the research provides evidence of effective practice and learning and has identified themes for the development of a support tool. This approach can be extended to similar domains to advance research into learning and development. • Practical implications – Results of the work undertaken so far have generated promising foundations for the proposed support tool. This offers software developers a system within which they can reflect upon, and record, key learning events affecting technical, managerial and professional practice. • Originality/value – Small enterprises have limited resources to support OL. The qualitative research undertaken so far has yielded valuable insight into the successful development of a single software development team. The construction of a support tool to enhance knowledge acquisition and learning has the capacity to consolidate valuable, and potentially scarce, expertise. It also has the potential to facilitate further research to determine how the prototype might be extended or revised to improve its contribution to the team’s development.
    • Traversing social networks in the virtual dance hall: visualizing history in VR

      Southall, Helen; Beever, Lee; Butcher, Peter; University of Chester (IEEE Conference Publications, 2017-09-20)
      Digital recreations of historical sites and events are important tools both for academic researchers and for public interpretation. Current 3D visualization and VR technologies enable these recreations to be increasingly immersive and engaging. This poster describes a case study based on a mid-twentieth century Chester dance hall, examining the possibilities and limitations of 3D VR for recreating a public music venue which no longer physically exists, and also for visualizing and analyzing the professional network of musicians who played there, and at many other local venues.
    • The Use of Stereoscopy in a Neurosurgery Training Virtual Environment

      John, Nigel W.; Phillips, Nicholas I.; ap Cenydd, Llyr; Pop, Serban R.; Coope, David; Kamaly-Asl, Ian; de Souza, Christopher; Watt, Simon J.; University of Chester, Leeds General Infirmary, Bangor University, University of Manchester, Salford Royal NHS Foundation Trust, Cardiff University (MIT Press, 2017-03-15)
      We have previously investigated the effectiveness of a custom built virtual environment in assisting training of a ventriculostomy procedure, which is a commonly performed procedure by a neurosurgeon and a core task for trainee surgeons. The training tool (called VCath) was initially developed as a low fidelity app for a tablet platform to provide easy access and availability to trainees. Subsequently we have developed a high fidelity version of VCath that uses a stereoscopic display to immerse the trainee in the virtual environment. This paper reports on two studies that have been carried out to compare the low and high fidelity versions of VCath, particularly to assess the value of stereoscopy. Study 1 was conducted at the second annual boot camp organized for all year one trainees in neurosurgery in the UK. Study 2 was performed on lay people, with no surgical experience. Our hypothesis was that using stereoscopy in the training task would be beneficial. Results from Study 1 demonstrated that performance improved for both the control group and the group trained with the tablet version of VCath. The group trained on the high fidelity version of VCath with a stereoscopic display showed no performance improvement. The indication is that our hypothesis is false. In Study 2, six different conditions were investigated that covered the use of training with VCath on a tablet, a mono display at two different sizes, a stereo display at two different sizes, and a control group who received no training. Results from this study with lay people show that stereoscopy can make a significant improvement to the accuracy of needle placement. The possible reasons for these results and the apparent contradiction between the two studies are discussed.
    • Using and Validating Airborne Ultrasound as a Tactile Interface within Medical Training Simulators

      Hung, Gary M. Y.; John, Nigel W.; Hancock, Chris; Hoshi, Takayuki; University of Chester (Springer International Publishing, 2014-10)
      We have developed a system called UltraSendo that creates a force field in space using an array of ultrasonic transducers cooperatively emitting ultrasonic waves to a focal point. UltraSendo is the first application of this technology in the context of medical training simulators. A face validation study was carried out at a Catheter Laboratory in a major regional hospital.
    • Using Virtual Reality to Experience Different Powered Wheelchair Configurations

      Day, Thomas; Headleand, Christopher; Pop, Serban; John, Nigel; Dobson, William; University of Chester, University of Lincoln (2017-09)
      This paper presents recent additions to our Wheelchair-VR application, in particular the use of different drive configurations. We have previously shown that Wheelchair-VR can be used to improve driving skills. Here we consider the utility of the application in allowing users who are in the process of purchasing or upgrading a wheelchair to experience different configurations and options in a cost-effective virtual environment. A preliminary study is presented, which suggests that this approach can be effective.
    • Visualization beyond the Desktop--the Next Big Thing

      Roberts, Jonathan C.; Ritsos, Panagiotis D.; Badam, Sriram Karthik; Brodbeck, Dominique; Kennedy, Jessie; Elmqvist, Niklas; University of Chester (IEEE, 2014-11)
      Visualization researchers need to develop and adapt to today’s new devices and tomorrow’s technology. Today, people interact with visual depictions through a mouse. Tomorrow, they’ll be touching, swiping, grasping, feeling, hearing, smelling, and even tasting data.
    • VRIA - A Framework for Immersive Analytics on the Web

      Butcher, Peter; John, Nigel; Ritsos, Panagiotis; University of Chester and Bangor University (ACM, 2019-05)
      We report on the design, implementation and evaluation of <VRIA>, a framework for building immersive analytics (IA) solutions inWeb-based Virtual Reality (VR), built upon WebVR, A-Frame, React and D3. The recent emergence of affordable VR interfaces have reignited the interest of researchers and developers in exploring new, immersive ways to visualize data. In particular, the use of open-standards web-based technologies for implementing VR in a browser facilitates the ubiquitous and platform-independent adoption of IA systems. Moreover, such technologies work in synergy with established visualization libraries, through the HTML document object model (DOM). We discuss high-level features of <VRIA> and present a preliminary user experience evaluation of one of our use-cases.
    • Wheelchair-MR: A Mixed Reality Wheelchair Training Environment

      Day, Thomas; University of Chester (2017-09-20)
      In previous work we have demonstrated that Virtual Reality can be used to help train driving skills for users of a powered wheelchair. However, cybersickness was a particular problem. This work-in-progress paper presents a Mixed Reality alternative to our wheelchair training software, which overcomes this problem. The design and implementation of this application is discussed. Early results shows some promise and overcomes the cybersickness issue. More work is needed before a larger scale study can be undertaken.