Browsing by Author "Yang, Bing-Shiang"

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A digital assessment system for evaluating kinetic tremor in essential tremor and Parkinson's disease
(2018-03-09)
Lin, Po-Chieh
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Chen, Kai-Hsiang
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Yang, Bing-Shiang
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Chen, Yu-Jung
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機械工程學系
Background: Spiral drawing on papers is a common tremor evaluation tool for diagnosing patients with essential tremor (ET) or Parkinson's disease (PD). No standard drawing methods and parameters that use graphic tablets are yet available for objective evaluation. Methods: This study established a tremor assessment system for tremor severity by using graphic tablets. Twelve patients with ET and twelve patients with PD were tested to establish system algorithms, and six additional patients were tested with the developed system to evaluate its performance. The patients also performed spiral drawing with three guiding paradigms on a graphic tablet: traced along a given spiral (S1), performed freehand drawing (S2), and traced along a guiding point (S3). Three parameters were calculated to quantify tremor severity: the means of radial difference per radian(|dr/d theta|), the means of radial difference per second (|dr/dt|), and the area under curve (AUC) of the frequency spectrum of the velocity. Each patient's drawing was also evaluated using a visual rating scale (VRS) by experienced physicians. The interrater reliability was examined to identify the most consistent test paradigm. Results: The parameter |dr/d theta| and AUC correlated well with the VRS (R > 0.8) in S1, S2 and S3 tests. The S1 test presented the best interrater reliability (Weighted Kappa coefficient, k = 0.80) among three tests. The Weighted Kappa coefficients are 0.67 and 0.71 in S2 and S3 tests, respectively. Conclusions: We developed three different guiding paradigms for spiral drawing on a digital graphic tablet for clinical tests. Three parameters were calculated to represent the tremor severity in spiral drawing and used to quantify temporal and spatial characteristics of tremor, and provided good correlation with current clinical assessments. The test "traced along a given spiral" is recommended due to its good interrater reliability.
A STUDY OF FITTS' LAW ON GOAL-DIRECTED AIMING TASK WITH MOVING TARGETS
(2011-08-01)
Chiu, Tien-Ting
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Lin, Chun-Ling
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Young, Kuu-Young
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Lin, Chin-Teng
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Hsu, Shang-Hwa
Most research based on Fitts' law define a log-linear relationship between temporal and spatial accuracy in goal-directed aiming tasks using stationary targets. Whether this relationship holds or not when the targets have varying velocities, and how the behavioral strategies and physical activities may change accordingly are of interest. The aim of this study was to investigate the relationship between temporal and spatial accuracy in goal-directed aiming tasks with moving targets. Participants were asked to aim at two target widths using a joystick. Results demonstrated that in a goal-directed aiming task there was a negative effect on performance when target velocity was increased or target width was decreased. Participants moved faster and then made more systematic errors in a high-velocity target condition. Results may be applicable to the complex perceptual-motor behavior of people who perform tasks using computers.
Additional Vitamin and Mineral Support for Patients with Severe Burns: A Nationwide Experience from a Catastrophic Color-Dust Explosion Event in Taiwan
(2018-11-01)
Chen, Li-Ru
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Yang, Bing-Shiang
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Chang, Chih-Ning
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Yu, Chia-Meng
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Chen, Kuo-Hu
Major burn injuries, which encompass >= 20% of the total body surface area (TBSA), are the most severe form of trauma because of the stress response they provoke, which includes hypermetabolism, muscle wasting, and stress-induced diabetes. In 2015, a color-dust explosion disaster occurred in the Formosa Fun Coast of Taiwan and injured 499 people, who were transferred via a nationwide emergency delivery system. Some recommendations are currently available regarding vitamin and mineral support for wound healing and recovery in severe burns, but there is a lack of evidence to confirm the benefits. Thus, the current study aimed to investigate the effects of additional vitamin and mineral support for patients with severe burn injuries. Sixty-one hospitalized individuals with major burns (full thickness and >= 20% TBSA) were classified into the supplement (n = 30) and control (n = 31) groups, according to whether they received supplementation with additional vitamins, calcium, and magnesium. There were significant differences between the supplement and control groups in the incidence of wound infection (30.0% vs. 77.4%, p < 0.001), sepsis (13.3% vs. 41.9%, p = 0.021), and hospitalization days (51.80 vs. 76.81, p = 0.025). After adjustment, logistic regression analysis revealed that, compared to those in the control group, patients in the supplement group had a lower risk for wound infection (OR 0.11; 95% CI 0.03-0.43; p = 0.002) and sepsis (OR 0.09; 95% CI 0.01-0.61; p = 0.014). Supplementation of multiple vitamins, calcium, and magnesium reduced the risk of wound infection and sepsis, shortened the time of hospitalization, and can be considered for use in major burns.
Custos Remote On-demand Healthcare Aided with Wireless Sensors and Mobile Phones
(2008)
Zao, John K.
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Fan, Shih-Chen
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Yang, Bing-Shiang
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Hsu, Shang-Hwa
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Cheng, Han-Chin
Telemonitoring and remote healthcare are two ICT techniques promise to deliver cost effective long-term healthcare services to the aging population worldwide. Anticipating an emerging market opportunity, NCTU Kannon project team is creating Custos, an open composeable platform for developing remote on-demand healthcare applications using smart phones and wireless sensor networks. Camps' is integrated readily with Internet web services and UPnP digital-home platform so that it can be used to detect abnormal health conditions through multisensor data fusion, adapt environment conditions to user needs, dispatch medical alerts and instigate remedial actions via SMS/RSS communication. Moreover, Custos is easy to program because it uses Sun SPOT and Squawk Java J2ME as its sensor/actuator hub. In this position paper, we present the design principles, system architecture and operation concepts of Custos as well as a pilot plan for clinical trials in the Geriatric Psychiatry Ward of Wei-Gong Memorial Hospital in Miaoli, Taiwan.
Development of method for quantifying essential tremor using a small optical device
(2016-06-15)
Chen, Kai-Hsiang
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Lin, Po-Chieh
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Chen, Yu-Jung
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Yang, Bing-Shiang
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Lin, Chin-Hsien
Background: Clinical assessment scales are the most common means used by physicians to assess tremor severity. Some scientific tools that may be able to replace these scales to objectively assess the severity, such as accelerometers, digital tablets, electromyography (EMG) measurement devices, and motion capture cameras, are currently available. However, most of the operational modes of these tools are relatively complex or are only able to capture part of the clinical information; furthermore, using these tools is sometimes time consuming. Currently, there is no tool available for automatically quantifying tremor severity in clinical environments. New method: We aimed to develop a rapid, objective, and quantitative system for measuring the severity of finger tremor using a small portable optical device (Leap Motion). Results: A single test took 15 s to conduct, and three algorithms were proposed to quantify the severity of finger tremor. The system was tested with four patients diagnosed with essential tremor. Comparison with existing method: The proposed algorithms were able to quantify different characteristics of tremor in clinical environments, and could be used as references for future clinical assessments. Conclusions: A portable, easy-to-use, small -sized, and noncontact device (Leap Motion) was used to clinically detect and record finger movement, and three algorithms were proposed to describe tremor amplitudes. (C) 2016 Elsevier B.V. All rights reserved.
Effect of Practice on Stepping Movements Onto Laterally Compliant Raised Structures: Age Differences in Healthy Males
(2010-02-01)
Yang, Bing-Shiang
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Ashton-Miller, James A.
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機械工程學系
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Department of Mechanical Engineering
Objective: The aim of this study was to examine effects of practice and age on step-up movements onto raised structures. Background: Falls from laterally compliant structures, such as stepladders, often cause injuries in elderly persons. Although age differences in step-up movements onto raised structures with unexpected structural compliance have been reported, practice effects of such movement control have not been investigated. Method: Movement behavior of 20 healthy adults (10 young and 10 older males) was measured while they stepped up onto a raised structure with no compliance (i.e., rigid) (C(0)), a small amount of mediolateral compliance (C(1)), or greater mediolateral compliance (C(2)). The conditions C(0), C(1), and C(2) were presented in three sets of six fixed-order trials with step-up movements performed at a comfortable speed. Practice effects in step-up behavior were examined by comparing data within each trial block with the use of repeated-measures ANOVA. Results: Practice significantly reduced the stepping duration (Ts) needed to complete the step-up movement (p < .001). With practice, older males reduced their lateral oscillations 26% to 40% for C(1) and C(2), whereas the corresponding results for young males lay between 8% and 17%, respectively. The age difference in Ts decreased across six consecutive trials but remained significant, especially on the structure with greater compliance. Conclusion: With practice, both young and elderly men adapted their stepping behavior to the presence of lateral structural compliance, but it is noteworthy from a fall-injury prevention perspective that the elderly men required more trials to do so. Application: Designers and users of raised structures, such as stepladders, should be aware of the age difference of people using such structures and should minimize the structure compliance when designing them.
Human Recognition Based on Kinematics and Kinetics of Gait
(2011)
Lin, Yu-Chih
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Yang, Bing-Shiang
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Lin, Yu-Tzu
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Yang, Yi-Ting
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機械工程學系
Human recognition based on gait is a new biometric method that considers both spatial and temporal features which tracks the gait of a human being from a distance. The most widely used techniques for gait recognition at present can be divided into two categories: the model-free method and the model-based method. Both these methods process images of a moving body. Although some effort has been devoted to gait recognition, a high identification rate and low computational cost still need to be achieved. In this study, we investigated gait recognition in terms of biomechanics, which is often overlooked in the fields of computer science and electronics. We present a method for people recognition by using both the three-dimensional parameters for lower limb joints, i.e., kinematic and kinetic parameters. Dynamic data are acquired by tracking marker positions using a motion capture system with force plates. Although a marker-free and cable-free biometric system is more applicable for security purposes, acquiring data by marker tracking is one of the most precise methods currently available. The results obtained from marker tracking can clarify the relationship between the recognition rate and dynamic data of normal walking. In this study, 350 trials were conducted for 10 subjects. For each subject, 20 trials were conducted for training and the remaining 15 were for testing. A self-organizing map (SOM) neural network was employed for data classification. The importance of a specific variable in each dimension for each joint is discussed in detail to investigate the major factors that cause the differences in human gait according to a biomechanical approach. Experimental results showed that gait is a reliable feature for individual identification since a high recognition rate can be achieved by choosing appropriate joints or dynamic parameters in some dimensions of a gait. Kinematic variables in the frontal and transverse planes of the knee or hip joints are recommended due to their higher recognition rates. These findings can be applied to both biomedicine and computer science.
Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective
(2018-01-01)
Luh, Hui-Tzung
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Huang, Abel Po-Hao
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Yang, Shih-Hung
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Chen, Chien-Ming
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Cho, Der-Yang
Background/Purpose: Minimally invasive endoscope-assisted (MIE) evacuation of spontaneous intracerebral hemorrhage (ICH) is simple and effective, but the limited working space may hinder meticulous hemostasis and might lead to rebleeding. Management of intraoperative hemorrhage is therefore a critical issue of this study. This study presents experience in the treatment of patients with various types of ICH by MIE evacuation followed by direct local injection of FloSeal Hemostatic Matrix (Baxter Healthcare Corp, Fremont, CA, USA) for hemostasis. Methods: The retrospective nonrandomized clinical and radiology-based analysis enrolled 42 patients treated with MIE evacuation of ICH followed by direct local injection of FloSeal Hemostatic Matrix. Rebleeding, morbidity, and mortality were the primary endpoints. The percentage of hematoma evacuated was calculated from the pre-and postoperative brain computed tomography (CT) scans. Extended Glasgow Outcome Scale (GOSE) was evaluated at 6 months postoperatively. Results: Forty-two ICH patients were included in this study, among these, 23 patients were putaminal hemorrhage, 16 were thalamic ICH, and the other three were subcortical type. Surgery-related mortality was 2.4%. The average percentage of hematoma evacuated was 80.8%, and the rebleeding rate was 4.8%. The mean operative time was 102.7 minutes and the average blood loss was 84.9 mL. The mean postoperative GOSE score was 4.55 at 6-months' follow-up. Conclusion: This study shows that local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis during MIE evacuation of ICH. In our experience, this shortens the operation time, especially in cases with intraoperative bleeding. A large, prospective, randomized trial is needed to confirm the findings. Copyright (C) 2017, Formosan Medical Association. Published by Elsevier Taiwan LLC.
People Recognition by Kinematics and Kinetics of Gait
(2009)
Lin, Yu-Chih
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Yang, Bing-Shiang
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Yang, Yi-Ting
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機械工程學系
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腦科學研究中心
Human recognition by gaits is a new biometric method which considers both spatial and temporal features by tracking the gait at a distance. Most researches use image processing methods to analyze the moving object, while some use the model-based methods. Although some efforts have been devoted to the gait recognition, a high identification rate and a low computational cost still need to be achieved. This paper tends to investigate the gait recognition from the biomechanical point of view, which is lacking in the computer science and electronics communities. We present the method of people recognition by using both three-dimensional parameters of lower limb joints, namely, kinematic parameters (including joint angles and angular velocities) and kinetic parameters (joint forces). Dynamic data are acquired by tracking the maker positions using a motion capture system. 350 trials for 10 subjects are conducted, in which we use 20 trials for each one of these for training and the remaining 15 for testing. Additional 35 trials for another one subject not in the training set are conducted for testing the adventitious people. SOM neuron networks are employed for data classification. The importance of specific joints and variables is discussed in detail to investigate the major factors that cause the differences in human gait through a biomechanical approach. Experimental results show that gait is a reliable feature for individual identification since a high recognition rate can be achieved by choosing the proper joints or dynamic parameters of a gait. It also suggests that some joints and dynamic parameters dominate the differences in the walking style of people, which can be applied to both the biomedical and the computer vision fields.
The difference in visuomotor feedback velocity control during spiral drawing between Parkinson's disease and essential tremor
(2018-06-01)
Chen, Kai-Hsiang
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Lin, Po-Chieh
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Yang, Bing-Shiang
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Chen, Yu-Jung
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機械工程學系
In a spiral task, the accuracy of the spiral trajectory, which is affected by tracing or tracking ability, differs between patients with Parkinson's disease (PD) and essential tremor (ET). However, not many studies have analyzed velocity differences between the groups during this task. This study aimed to examine differences between the groups related to this characteristic using a tablet. Fourteen PD, 12 ET, and 12 control group participants performed two tasks: tracing a given spiral (T1) and following a guiding point (T2). A digitized tablet was used to record movements and trajectory. Effects of direct visual feedback on intergroup and intragroup velocity were measured. Although PD patients had a significantly lower T1 velocity than the control group (p < 0.05), they could match the velocity of the guiding point (3.0 cm/s) in T2. There was no significant difference in the average T1 velocity between ET and the control groups (p = 0.26); however, the T2 velocity of ET patients was significantly higher than the control group (p < 0.05). They were also unable to adjust the velocity to match the guiding point, indicating that ET patients have a poorer ability to follow dynamic guidance. When both groups of patients have similar action tremor severity, their ability to follow dynamic guidance was still significantly different. Our study combined visual feedback with spiral drawing and demonstrated differences in the following-velocity distribution in PD and ET. This method may be used to distinguish the tremor presentation of both diseases, and thus, provide accurate diagnosis.
User experience of lower-limb orthosis
(2018-01-01)
Yang, Bing-Shiang
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Chen, Yen-Wan
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Tong, Ji-Rou
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機械工程學系
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分子醫學與生物工程研究所
If an assistive device is not acceptable to the user, it will not achieve efficacy and would be resource-wasting. This study employed in-depth interviews to understand what users' individual activities of daily living, problems of using orthoses, and considerations for selecting orthoses are. We conducted qualitative interviews with 35 lower-limb orthosis users, and semi-structured interviews were applied in this study. We analyzed the interview data from transcripts, through coding and concepts, to theories based on grounded theory. The results showed that problems of using orthoses are mostly related to activities of daily living of the user and user's expectation. Therefore, in order to enhance its efficacy and use intention, the design and prescribing process of orthoses need to address the problems in the light of activities of daily living and user education.