Wojciech Glinkowski

Method of pectus excavatum measurement based on structured light technique

We present an automatic method for assessment of pectus excavatum severity based on an optical 3-D markerless shape measurement. A four-directional measurement system based on a structured light projection method is built to capture the shape of the body surface of the patients. The system setup is described and typical measurement parameters are given. The automated data analysis path is explained. Their main steps are: normalization of trunk model orientation, cutting the model into slices, analysis of each slice shape, selecting the proper slice for the assessment of pectus excavatum of the patient, and calculating its shape parameter. We develop a new shape parameter (I(3ds)) that shows high correlation with the computed tomography (CT) Haller index widely used for assessment of pectus excavatum. Clinical results and the evaluation of developed indexes are presented.

Automatic recognition of surface landmarks of anatomical structures of back and posture

Faulty postures, scoliosis and sagittal plane deformities should be detected as early as possible to apply preventive and treatment measures against major clinical consequences. To support documentation of the severity of deformity and diminish x-ray exposures, several solutions utilizing analysis of back surface topography data were introduced. A novel approach to automatic recognition and localization of anatomical landmarks of the human back is presented that may provide more repeatable results and speed up the whole procedure. The algorithm was designed as a two-step process involving a statistical model built upon expert knowledge and analysis of three-dimensional back surface shape data. Voronoi diagram is used to connect mean geometric relations, which provide a first approximation of the positions, with surface curvature distribution, which further guides the recognition process and gives final locations of landmarks. Positions obtained using the developed algorithms are validated with respect to accuracy of manual landmark indication by experts. Preliminary validation proved that the landmarks were localized correctly, with accuracy depending mostly on the characteristics of a given structure. It was concluded that recognition should mainly take into account the shape of the back surface, putting as little emphasis on the statistical approximation as possible.

3D Diagnostic System for Anatomical Structures Detection Based on a Parameterized Method of Body Surface Analysis

Features of trunk and postural deformations are clinically observed to detect related musculoskeletal disorders, namely scoliosis, kyphosis or other thoracic deformities. High variability and controversial reliability of results of postural screening require new solutions to be employed. Standardized criteria for correct body posture are needed for further studies. The aim of this work was to present the current status of development of the 3D diagnostic system for anatomical structures detection. The designed system is based on a parameterized method of body surface analysis for automated measurement of the three-dimensional shape of patient’s trunk. This system uses structured light to measure patient’s body in 3D space by projection of a set of raster images on its surface. A unique feature of the presented system is the ability to operate on remote sites and carry out measurement interpretation by telemedicine utilizing a data warehouse. The system comprises of three independent modules which deal with measurement, data archiving and its analysis. Communication between modules is performed over the TCP/IP protocol, incorporating two different channels for each client, dedicated to two kinds of data - text channel, for transmission of XML documents used for delivering commands and information and binary channel for the transfer of large binary data, such as clouds of points or photographs. Presented modules altogether allow to measure the full shape of subject’s 3D surface along with measurement data storage and analysis for support of screening and diagnosis.

Effects of preoperative physiotherapy in hip osteoarthritis patients awaiting total hip replacement.

Introduction The World Health Organization (WHO) claimed osteoarthritis as a civilization-related disease. The effectiveness of preoperative physiotherapy among patients suffering hip osteoarthritis (OA) at the end of their conservative treatment is rarely described in the literature. The aim of this study was to assess the quality of life and musculoskeletal health status of patients who received preoperative physiotherapy before total hip replacement (THR) surgery within a year prior to admission for a scheduled THR and those who did not. Material and methods Forty-five patients, admitted to the Department of Orthopaedics and Traumatology of Locomotor System for elective total hip replacement surgery, were recruited for this study. The assessment consisted of a detailed interview using various questionnaires: the Harris Hip Score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 36-Item Short Form Health Survey (SF-36), and the Hip disability and Osteoarthritis Outcome Score (HOOS), as well as physical examination. Patients were assigned to groups based on their attendance of preoperative physiotherapy within a year prior to surgery. Results Among patients who received preoperative physiotherapy a significant improvement was found for pain, daily functioning, vitality, psychological health, social life, and (active and passive) internal rotation (p < 0.05). Conclusions Patients are not routinely referred to physiotherapy within a year before total hip replacement surgery. This study confirmed that pre-operative physiotherapy may have a positive influence on selected musculoskeletal system status indicators and quality of life in hip osteoarthritis patients awaiting surgery.

Telemedicine as a special case of machine translation

Machine translation is evolving quite rapidly in terms of quality. Nowadays, we have several machine translation systems available in the web, which provide reasonable translations. However, these systems are not perfect, and their quality may decrease in some specific domains. This paper examines the effects of different training methods when it comes to Polish-English Statistical Machine Translation system used for the medical data. Numerous elements of the EMEA parallel text corpora and not related OPUS Open Subtitles project were used as the ground for creation of phrase tables and different language models including the development, tuning and testing of these translation systems. The BLEU, NIST, METEOR, and TER metrics have been used in order to evaluate the results of various systems. Our experiments deal with the systems that include POS tagging, factored phrase models, hierarchical models, syntactic taggers, and other alignment methods. We also executed a deep analysis of Polish data as preparatory work before automatized data processing such as true casing or punctuation normalization phase. Normalized metrics was used to compare results. Scores lower than 15% mean that Machine Translation engine is unable to provide satisfying quality, scores greater than 30% mean that translations should be understandable without problems and scores over 50 reflect adequate translations. The average results of Polish to English translations scores for BLEU, NIST, METEOR, and TER were relatively high and ranged from 7058 to 8272. The lowest score was 6438. The average results ranges for English to Polish translations were little lower (6758-7897). The real-life implementations of presented high quality Machine Translation Systems are anticipated in general medical practice and telemedicine.

Enhancing the Assessment of (Polish) Translation in PROMIS Using Statistical, Semantic, and Neural Network Metrics

Differences in culture and language create the need for translators to convert text from one language into another. In order to preserve meaning, context must be analyzed in detail in translation. This study aims to develop accurate evaluation metrics for translations within the PROMIS (Patient-Reported Outcomes Measurement Information System) process, particularly in the reconciliation step, by providing reviews by experts as additional information following backward translation. The result is a semi-automatic semantic evaluation metric for Polish based on the concept of the human-aided translation evaluation metric (HMEANT). We assessed the proposed metrics using a statistics-based support vector machine classifier and applied deep neural networks to replicate the operation of the human brain. We compared the results of the proposed metrics with human judgment and well-known machine translation metrics, such as BLEU (Bilingual Evaluation Understudy), NIST, TER (Translation Error Rate), and METEOR (Metric for Evaluation of Translation with Explicit Ordering). We found that a few of the proposed metrics were highly correlated with human judgment and provided additional semantic information independent of human experience. This showed that the proposed metrics can help assess translations in PROMIS.

Supporting of Postural Deformities Diagnosis Using 3D Scanning

Traditionally posture deformity assessment for screening purposes is performed by visual examination of patient’s body by an expert. During further follow-up of the diagnosed deformity full spine, X-Ray 2D images are acquired. 3D medical imaging (Computer Tomography and MRI) is used when the spinal surgery is considered. Visual examination is subjective and is strongly dependent on expert knowledge. X-Ray and tomographic imaging exposure can be contraindicated in some cases (i.e. pregnancy). During last two decades, the dynamic development of methods and systems for 3D scanning and algorithms for measurement data analysis is observed. 3D scanning is successfully applied in modern industrial production lines, documentation of cultural heritage and human body analysis. Recently, algorithms for data analysis allow for 100% inspection of complex geometry and have increasing support for control of the technological process parameters on the base of calculated deviation between measurement and assumed 3D model. In this paper, we present an alternative approach for back posture analysis based on structured light 3D scanning. We present three different systems: mobile solution for prescreening of back shape, full body 3D scanner for monitoring of posture deformities and 4D scanner for dynamic analysis. Such a three-stage system fit into the idea of evidence-based medicine. Each of presented devices produces 3D geometry data representing the surface of patient’s body. Each of them has also accompanying software that has been developed for processing of geometry data into a final form that is easily interpreted by medical experts (angles, asymmetries, 3D models, changes in time of analyzed measures, etc.).

Posture and low back pain during pregnancy — 3D study

OBJECTIVES Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. MATERIAL AND METHODS The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4-39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. RESULTS The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. CONCLUSIONS The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases.

Manual versus automatic indices assessment based on a marker-less, three dimensional, structural light surface topography postural evaluation. Preliminary study

Methods A 3D Orthoscreen system, designed for postural deformity telediagnostics, using the structural light method, was used for school screening [2,3]. Clouds of dots were acquired for every subject. POTSI, DAPI, kyphosis and lordosis were measured, after marker-less landmarking of anatomical back structures, manually and automatically, for the same subjects. 50 subjects were assessed, 22 male adolescent subjects (average age 15.18 years from 14 to 17) and 28 females (average age 14.55 from 14 to 16) were examined. Their clouds of dots were acquired and saved. Clouds were retrieved and analyzed utilizing 3D Orthoscreen system. An operator (trained professional) retrieved 3D data and analyzed by pointing landmarks manually or automatically. After landmarking, procedure Indices and angular measurements were calculated by the system. MedCalc statistical software (Version 12.1.4.0) was used to calculate Inter-rater correlation for measurements.

Telemedicine and eHealth in Poland from 1995 to 2015

The aim of this study is to present a review based on the literature and proceedings from selected telemedicine conferences. The review was developed using the PRISMA framework. The Embase and PubMed (updated until July 13, 2015) literature databases were searched for telemedicine-related terms and Poland. The literature search identified 129 eligible articles in the databases and 85 in conference proceedings until July 2015. Articles measured as a number of contributions per year presented a similar rising, fluctuating and almost parallel pattern. Fifty-nine percent of the reviewed papers were published in impacted journals. Almost half of all publications presented original papers. The published articles concerned mostly cardiology (16%), family medicine (15%) and pathology (11%). Conference proceedings papers concerned orthopedics (29%, significantly more frequent; p < 0.001) and cardiology (14%). Scientific activity of researchers and practitioners in Poland in the field of telemedicine is not high, but it is increasing over time. There is a tendency to present the research rather in high-quality journals instead of conferences before publication. The occurrence of individual medical specialty telemedicine in Poland may reflect country-specific needs.