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1. A Deep Learning-Based Real-time Seizure Detection System

   https://doi.org/10.1109/SPMB50085.2020.9353623  

   Shawki, N. ; Elseify, T. ; Cap, T. ; Shah, V. ; Obeid, I. ; Picone, J. ( December 2020 , Proceedings of the IEEE Signal Processing in Medicine and Biology Symposium (SPMB))

   Obeid, Iyad Selesnick (Ed.)

   Electroencephalography (EEG) is a popular clinical monitoring tool used for diagnosing brain-related disorders such as epilepsy [1]. As monitoring EEGs in a critical-care setting is an expensive and tedious task, there is a great interest in developing real-time EEG monitoring tools to improve patient care quality and efficiency [2]. However, clinicians require automatic seizure detection tools that provide decisions with at least 75% sensitivity and less than 1 false alarm (FA) per 24 hours [3]. Some commercial tools recently claim to reach such performance levels, including the Olympic Brainz Monitor [4] and Persyst 14 [5]. In this abstract, we describemore »our efforts to transform a high-performance offline seizure detection system [3] into a low latency real-time or online seizure detection system. An overview of the system is shown in Figure 1. The main difference between an online versus offline system is that an online system should always be causal and has minimum latency which is often defined by domain experts. The offline system, shown in Figure 2, uses two phases of deep learning models with postprocessing [3]. The channel-based long short term memory (LSTM) model (Phase 1 or P1) processes linear frequency cepstral coefficients (LFCC) [6] features from each EEG channel separately. We use the hypotheses generated by the P1 model and create additional features that carry information about the detected events and their confidence. The P2 model uses these additional features and the LFCC features to learn the temporal and spatial aspects of the EEG signals using a hybrid convolutional neural network (CNN) and LSTM model. Finally, Phase 3 aggregates the results from both P1 and P2 before applying a final postprocessing step. The online system implements Phase 1 by taking advantage of the Linux piping mechanism, multithreading techniques, and multi-core processors. To convert Phase 1 into an online system, we divide the system into five major modules: signal preprocessor, feature extractor, event decoder, postprocessor, and visualizer. The system reads 0.1-second frames from each EEG channel and sends them to the feature extractor and the visualizer. The feature extractor generates LFCC features in real time from the streaming EEG signal. Next, the system computes seizure and background probabilities using a channel-based LSTM model and applies a postprocessor to aggregate the detected events across channels. The system then displays the EEG signal and the decisions simultaneously using a visualization module. The online system uses C++, Python, TensorFlow, and PyQtGraph in its implementation. The online system accepts streamed EEG data sampled at 250 Hz as input. The system begins processing the EEG signal by applying a TCP montage [8]. Depending on the type of the montage, the EEG signal can have either 22 or 20 channels. To enable the online operation, we send 0.1-second (25 samples) length frames from each channel of the streamed EEG signal to the feature extractor and the visualizer. Feature extraction is performed sequentially on each channel. The signal preprocessor writes the sample frames into two streams to facilitate these modules. In the first stream, the feature extractor receives the signals using stdin. In parallel, as a second stream, the visualizer shares a user-defined file with the signal preprocessor. This user-defined file holds raw signal information as a buffer for the visualizer. The signal preprocessor writes into the file while the visualizer reads from it. Reading and writing into the same file poses a challenge. The visualizer can start reading while the signal preprocessor is writing into it. To resolve this issue, we utilize a file locking mechanism in the signal preprocessor and visualizer. Each of the processes temporarily locks the file, performs its operation, releases the lock, and tries to obtain the lock after a waiting period. The file locking mechanism ensures that only one process can access the file by prohibiting other processes from reading or writing while one process is modifying the file [9]. The feature extractor uses circular buffers to save 0.3 seconds or 75 samples from each channel for extracting 0.2-second or 50-sample long center-aligned windows. The module generates 8 absolute LFCC features where the zeroth cepstral coefficient is replaced by a temporal domain energy term. For extracting the rest of the features, three pipelines are used. The differential energy feature is calculated in a 0.9-second absolute feature window with a frame size of 0.1 seconds. The difference between the maximum and minimum temporal energy terms is calculated in this range. Then, the first derivative or the delta features are calculated using another 0.9-second window. Finally, the second derivative or delta-delta features are calculated using a 0.3-second window [6]. The differential energy for the delta-delta features is not included. In total, we extract 26 features from the raw sample windows which add 1.1 seconds of delay to the system. We used the Temple University Hospital Seizure Database (TUSZ) v1.2.1 for developing the online system [10]. The statistics for this dataset are shown in Table 1. A channel-based LSTM model was trained using the features derived from the train set using the online feature extractor module. A window-based normalization technique was applied to those features. In the offline model, we scale features by normalizing using the maximum absolute value of a channel [11] before applying a sliding window approach. Since the online system has access to a limited amount of data, we normalize based on the observed window. The model uses the feature vectors with a frame size of 1 second and a window size of 7 seconds. We evaluated the model using the offline P1 postprocessor to determine the efficacy of the delayed features and the window-based normalization technique. As shown by the results of experiments 1 and 4 in Table 2, these changes give us a comparable performance to the offline model. The online event decoder module utilizes this trained model for computing probabilities for the seizure and background classes. These posteriors are then postprocessed to remove spurious detections. The online postprocessor receives and saves 8 seconds of class posteriors in a buffer for further processing. It applies multiple heuristic filters (e.g., probability threshold) to make an overall decision by combining events across the channels. These filters evaluate the average confidence, the duration of a seizure, and the channels where the seizures were observed. The postprocessor delivers the label and confidence to the visualizer. The visualizer starts to display the signal as soon as it gets access to the signal file, as shown in Figure 1 using the “Signal File” and “Visualizer” blocks. Once the visualizer receives the label and confidence for the latest epoch from the postprocessor, it overlays the decision and color codes that epoch. The visualizer uses red for seizure with the label SEIZ and green for the background class with the label BCKG. Once the streaming finishes, the system saves three files: a signal file in which the sample frames are saved in the order they were streamed, a time segmented event (TSE) file with the overall decisions and confidences, and a hypotheses (HYP) file that saves the label and confidence for each epoch. The user can plot the signal and decisions using the signal and HYP files with only the visualizer by enabling appropriate options. For comparing the performance of different stages of development, we used the test set of TUSZ v1.2.1 database. It contains 1015 EEG records of varying duration. The any-overlap performance [12] of the overall system shown in Figure 2 is 40.29% sensitivity with 5.77 FAs per 24 hours. For comparison, the previous state-of-the-art model developed on this database performed at 30.71% sensitivity with 6.77 FAs per 24 hours [3]. The individual performances of the deep learning phases are as follows: Phase 1’s (P1) performance is 39.46% sensitivity and 11.62 FAs per 24 hours, and Phase 2 detects seizures with 41.16% sensitivity and 11.69 FAs per 24 hours. We trained an LSTM model with the delayed features and the window-based normalization technique for developing the online system. Using the offline decoder and postprocessor, the model performed at 36.23% sensitivity with 9.52 FAs per 24 hours. The trained model was then evaluated with the online modules. The current performance of the overall online system is 45.80% sensitivity with 28.14 FAs per 24 hours. Table 2 summarizes the performances of these systems. The performance of the online system deviates from the offline P1 model because the online postprocessor fails to combine the events as the seizure probability fluctuates during an event. The modules in the online system add a total of 11.1 seconds of delay for processing each second of the data, as shown in Figure 3. In practice, we also count the time for loading the model and starting the visualizer block. When we consider these facts, the system consumes 15 seconds to display the first hypothesis. The system detects seizure onsets with an average latency of 15 seconds. Implementing an automatic seizure detection model in real time is not trivial. We used a variety of techniques such as the file locking mechanism, multithreading, circular buffers, real-time event decoding, and signal-decision plotting to realize the system. A video demonstrating the system is available at: https://www.isip.piconepress.com/projects/nsf_pfi_tt/resources/videos/realtime_eeg_analysis/v2.5.1/video_2.5.1.mp4. The final conference submission will include a more detailed analysis of the online performance of each module. ACKNOWLEDGMENTS Research reported in this publication was most recently supported by the National Science Foundation Partnership for Innovation award number IIP-1827565 and the Pennsylvania Commonwealth Universal Research Enhancement Program (PA CURE). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the official views of any of these organizations. REFERENCES [1] A. Craik, Y. He, and J. L. Contreras-Vidal, “Deep learning for electroencephalogram (EEG) classification tasks: a review,” J. Neural Eng., vol. 16, no. 3, p. 031001, 2019. https://doi.org/10.1088/1741-2552/ab0ab5. [2] A. C. Bridi, T. Q. Louro, and R. C. L. Da Silva, “Clinical Alarms in intensive care: implications of alarm fatigue for the safety of patients,” Rev. Lat. Am. Enfermagem, vol. 22, no. 6, p. 1034, 2014. https://doi.org/10.1590/0104-1169.3488.2513. [3] M. Golmohammadi, V. Shah, I. Obeid, and J. Picone, “Deep Learning Approaches for Automatic Seizure Detection from Scalp Electroencephalograms,” in Signal Processing in Medicine and Biology: Emerging Trends in Research and Applications, 1st ed., I. Obeid, I. Selesnick, and J. Picone, Eds. New York, New York, USA: Springer, 2020, pp. 233–274. https://doi.org/10.1007/978-3-030-36844-9_8. [4] “CFM Olympic Brainz Monitor.” [Online]. Available: https://newborncare.natus.com/products-services/newborn-care-products/newborn-brain-injury/cfm-olympic-brainz-monitor. [Accessed: 17-Jul-2020]. [5] M. L. Scheuer, S. B. Wilson, A. Antony, G. Ghearing, A. Urban, and A. I. Bagic, “Seizure Detection: Interreader Agreement and Detection Algorithm Assessments Using a Large Dataset,” J. Clin. Neurophysiol., 2020. https://doi.org/10.1097/WNP.0000000000000709. [6] A. Harati, M. Golmohammadi, S. Lopez, I. Obeid, and J. Picone, “Improved EEG Event Classification Using Differential Energy,” in Proceedings of the IEEE Signal Processing in Medicine and Biology Symposium, 2015, pp. 1–4. https://doi.org/10.1109/SPMB.2015.7405421. [7] V. Shah, C. Campbell, I. Obeid, and J. Picone, “Improved Spatio-Temporal Modeling in Automated Seizure Detection using Channel-Dependent Posteriors,” Neurocomputing, 2021. [8] W. Tatum, A. Husain, S. Benbadis, and P. Kaplan, Handbook of EEG Interpretation. New York City, New York, USA: Demos Medical Publishing, 2007. [9] D. P. Bovet and C. Marco, Understanding the Linux Kernel, 3rd ed. O’Reilly Media, Inc., 2005. https://www.oreilly.com/library/view/understanding-the-linux/0596005652/. [10] V. Shah et al., “The Temple University Hospital Seizure Detection Corpus,” Front. Neuroinform., vol. 12, pp. 1–6, 2018. https://doi.org/10.3389/fninf.2018.00083. [11] F. Pedregosa et al., “Scikit-learn: Machine Learning in Python,” J. Mach. Learn. Res., vol. 12, pp. 2825–2830, 2011. https://dl.acm.org/doi/10.5555/1953048.2078195. [12] J. Gotman, D. Flanagan, J. Zhang, and B. Rosenblatt, “Automatic seizure detection in the newborn: Methods and initial evaluation,” Electroencephalogr. Clin. Neurophysiol., vol. 103, no. 3, pp. 356–362, 1997. https://doi.org/10.1016/S0013-4694(97)00003-9.« less
2. Issues in the Reproducibility of Deep Learning Results

   https://doi.org/10.1109/SPMB47826.2019.9037840  

   Jean-Paul, S. ; Elseify, T. ; Obeid, I. ; Picone, J. ( December 2019 , IEEE Signal Processing in Medicine and Biology Symposium (SPMB))

   Obeid, I. ; Selesnik, I. ; Picone, J. (Ed.)

   The Neuronix high-performance computing cluster allows us to conduct extensive machine learning experiments on big data [1]. This heterogeneous cluster uses innovative scheduling technology, Slurm [2], that manages a network of CPUs and graphics processing units (GPUs). The GPU farm consists of a variety of processors ranging from low-end consumer grade devices such as the Nvidia GTX 970 to higher-end devices such as the GeForce RTX 2080. These GPUs are essential to our research since they allow extremely compute-intensive deep learning tasks to be executed on massive data resources such as the TUH EEG Corpus [2]. We use TensorFlow [3]more »as the core machine learning library for our deep learning systems, and routinely employ multiple GPUs to accelerate the training process. Reproducible results are essential to machine learning research. Reproducibility in this context means the ability to replicate an existing experiment – performance metrics such as error rates should be identical and floating-point calculations should match closely. Three examples of ways we typically expect an experiment to be replicable are: (1) The same job run on the same processor should produce the same results each time it is run. (2) A job run on a CPU and GPU should produce identical results. (3) A job should produce comparable results if the data is presented in a different order. System optimization requires an ability to directly compare error rates for algorithms evaluated under comparable operating conditions. However, it is a difficult task to exactly reproduce the results for large, complex deep learning systems that often require more than a trillion calculations per experiment [5]. This is a fairly well-known issue and one we will explore in this poster. Researchers must be able to replicate results on a specific data set to establish the integrity of an implementation. They can then use that implementation as a baseline for comparison purposes. A lack of reproducibility makes it very difficult to debug algorithms and validate changes to the system. Equally important, since many results in deep learning research are dependent on the order in which the system is exposed to the data, the specific processors used, and even the order in which those processors are accessed, it becomes a challenging problem to compare two algorithms since each system must be individually optimized for a specific data set or processor. This is extremely time-consuming for algorithm research in which a single run often taxes a computing environment to its limits. Well-known techniques such as cross-validation [5,6] can be used to mitigate these effects, but this is also computationally expensive. These issues are further compounded by the fact that most deep learning algorithms are susceptible to the way computational noise propagates through the system. GPUs are particularly notorious for this because, in a clustered environment, it becomes more difficult to control which processors are used at various points in time. Another equally frustrating issue is that upgrades to the deep learning package, such as the transition from TensorFlow v1.9 to v1.13, can also result in large fluctuations in error rates when re-running the same experiment. Since TensorFlow is constantly updating functions to support GPU use, maintaining an historical archive of experimental results that can be used to calibrate algorithm research is quite a challenge. This makes it very difficult to optimize the system or select the best configurations. The overall impact of all of these issues described above is significant as error rates can fluctuate by as much as 25% due to these types of computational issues. Cross-validation is one technique used to mitigate this, but that is expensive since you need to do multiple runs over the data, which further taxes a computing infrastructure already running at max capacity. GPUs are preferred when training a large network since these systems train at least two orders of magnitude faster than CPUs [7]. Large-scale experiments are simply not feasible without using GPUs. However, there is a tradeoff to gain this performance. Since all our GPUs use the NVIDIA CUDA® Deep Neural Network library (cuDNN) [8], a GPU-accelerated library of primitives for deep neural networks, it adds an element of randomness into the experiment. When a GPU is used to train a network in TensorFlow, it automatically searches for a cuDNN implementation. NVIDIA’s cuDNN implementation provides algorithms that increase the performance and help the model train quicker, but they are non-deterministic algorithms [9,10]. Since our networks have many complex layers, there is no easy way to avoid this randomness. Instead of comparing each epoch, we compare the average performance of the experiment because it gives us a hint of how our model is performing per experiment, and if the changes we make are efficient. In this poster, we will discuss a variety of issues related to reproducibility and introduce ways we mitigate these effects. For example, TensorFlow uses a random number generator (RNG) which is not seeded by default. TensorFlow determines the initialization point and how certain functions execute using the RNG. The solution for this is seeding all the necessary components before training the model. This forces TensorFlow to use the same initialization point and sets how certain layers work (e.g., dropout layers). However, seeding all the RNGs will not guarantee a controlled experiment. Other variables can affect the outcome of the experiment such as training using GPUs, allowing multi-threading on CPUs, using certain layers, etc. To mitigate our problems with reproducibility, we first make sure that the data is processed in the same order during training. Therefore, we save the data from the last experiment and to make sure the newer experiment follows the same order. If we allow the data to be shuffled, it can affect the performance due to how the model was exposed to the data. We also specify the float data type to be 32-bit since Python defaults to 64-bit. We try to avoid using 64-bit precision because the numbers produced by a GPU can vary significantly depending on the GPU architecture [11-13]. Controlling precision somewhat reduces differences due to computational noise even though technically it increases the amount of computational noise. We are currently developing more advanced techniques for preserving the efficiency of our training process while also maintaining the ability to reproduce models. In our poster presentation we will demonstrate these issues using some novel visualization tools, present several examples of the extent to which these issues influence research results on electroencephalography (EEG) and digital pathology experiments and introduce new ways to manage such computational issues.« less
3. CPU Energy-Aware Parallel Real-Time Scheduling

   https://doi.org/10.4230/LIPIcs.ECRTS.2020.2  

   Saifullah, Abusayeed ; Fahmida, Sezana ; Modekurthy, Venkata P. ; Fisher, Nathan ; Guo, Zhishan ( July 2020 , Leibniz international proceedings in informatics)

   Both energy-efficiency and real-time performance are critical requirements in many embedded systems applications such as self-driving car, robotic system, disaster response, and security/safety control. These systems entail a myriad of real-time tasks, where each task itself is a parallel task that can utilize multiple computing units at the same time. Driven by the increasing demand for parallel tasks, multi-core embedded processors are inevitably evolving to many-core. Existing work on real-time parallel tasks mostly focused on real-time scheduling without addressing energy consumption. In this paper, we address hard real-time scheduling of parallel tasks while minimizing their CPU energy consumption on multicoremore »embedded systems. Each task is represented as a directed acyclic graph (DAG) with nodes indicating different threads of execution and edges indicating their dependencies. Our technique is to determine the execution speeds of the nodes of the DAGs to minimize the overall energy consumption while meeting all task deadlines. It incorporates a frequency optimization engine and the dynamic voltage and frequency scaling (DVFS) scheme into the classical real-time scheduling policies (both federated and global) and makes them energy-aware. The contributions of this paper thus include the first energy-aware online federated scheduling and also the first energy-aware global scheduling of DAGs. Evaluation using synthetic workload through simulation shows that our energy-aware real-time scheduling policies can achieve up to 68% energy-saving compared to classical (energy-unaware) policies. We have also performed a proof of concept system evaluation using physical hardware demonstrating the energy efficiency through our proposed approach.« less
4. Expanding an HPC Cluster to Support the Computational Demands of Digital Pathology

   https://doi.org/10.1109/SPMB.2018.8615614  

   Campbell, C. ; Mecca, N. ; Duong, T. ; Obeid, I. ; Picone, J. ( December 2018 , IEEE Signal Processing in Medicine and Biology Symposium (SPMB))

   Obeid, Iyad ; Selesnick, Ivan ; Picone, Joseph (Ed.)

   The goal of this work was to design a low-cost computing facility that can support the development of an open source digital pathology corpus containing 1M images [1]. A single image from a clinical-grade digital pathology scanner can range in size from hundreds of megabytes to five gigabytes. A 1M image database requires over a petabyte (PB) of disk space. To do meaningful work in this problem space requires a significant allocation of computing resources. The improvements and expansions to our HPC (highperformance computing) cluster, known as Neuronix [2], required to support working with digital pathology fall into two broadmore »categories: computation and storage. To handle the increased computational burden and increase job throughput, we are using Slurm [3] as our scheduler and resource manager. For storage, we have designed and implemented a multi-layer filesystem architecture to distribute a filesystem across multiple machines. These enhancements, which are entirely based on open source software, have extended the capabilities of our cluster and increased its cost-effectiveness. Slurm has numerous features that allow it to generalize to a number of different scenarios. Among the most notable is its support for GPU (graphics processing unit) scheduling. GPUs can offer a tremendous performance increase in machine learning applications [4] and Slurm’s built-in mechanisms for handling them was a key factor in making this choice. Slurm has a general resource (GRES) mechanism that can be used to configure and enable support for resources beyond the ones provided by the traditional HPC scheduler (e.g. memory, wall-clock time), and GPUs are among the GRES types that can be supported by Slurm [5]. In addition to being able to track resources, Slurm does strict enforcement of resource allocation. This becomes very important as the computational demands of the jobs increase, so that they have all the resources they need, and that they don’t take resources from other jobs. It is a common practice among GPU-enabled frameworks to query the CUDA runtime library/drivers and iterate over the list of GPUs, attempting to establish a context on all of them. Slurm is able to affect the hardware discovery process of these jobs, which enables a number of these jobs to run alongside each other, even if the GPUs are in exclusive-process mode. To store large quantities of digital pathology slides, we developed a robust, extensible distributed storage solution. We utilized a number of open source tools to create a single filesystem, which can be mounted by any machine on the network. At the lowest layer of abstraction are the hard drives, which were split into 4 60-disk chassis, using 8TB drives. To support these disks, we have two server units, each equipped with Intel Xeon CPUs and 128GB of RAM. At the filesystem level, we have implemented a multi-layer solution that: (1) connects the disks together into a single filesystem/mountpoint using the ZFS (Zettabyte File System) [6], and (2) connects filesystems on multiple machines together to form a single mountpoint using Gluster [7]. ZFS, initially developed by Sun Microsystems, provides disk-level awareness and a filesystem which takes advantage of that awareness to provide fault tolerance. At the filesystem level, ZFS protects against data corruption and the infamous RAID write-hole bug by implementing a journaling scheme (the ZFS intent log, or ZIL) and copy-on-write functionality. Each machine (1 controller + 2 disk chassis) has its own separate ZFS filesystem. Gluster, essentially a meta-filesystem, takes each of these, and provides the means to connect them together over the network and using distributed (similar to RAID 0 but without striping individual files), and mirrored (similar to RAID 1) configurations [8]. By implementing these improvements, it has been possible to expand the storage and computational power of the Neuronix cluster arbitrarily to support the most computationally-intensive endeavors by scaling horizontally. We have greatly improved the scalability of the cluster while maintaining its excellent price/performance ratio [1].« less
5. Augmented reality head-up displays effect on drivers’ spatial knowledge acquisition

   https://doi.org/10.1177/1071181319631287  

   de Oliveira Faria, Nayara ; Kandil, Dina ; Gabbard, Joseph L. ( November 2019 , Proceedings of the Human Factors and Ergonomics Society Annual Meeting)

   Background: Drivers gather most of the information they need to drive by looking at the world around them and at visual displays within the vehicle. Navigation systems automate the way drivers navigate. In using these systems, drivers offload both tactical (route following) and strategic aspects (route planning) of navigational tasks to the automated SatNav system, freeing up cognitive and attentional resources that can be used in other tasks (Burnett, 2009). Despite the potential benefits and opportunities that navigation systems provide, their use can also be problematic. For example, research suggests that drivers using SatNav do not develop as much environmentalmore »spatial knowledge as drivers using paper maps (Waters & Winter, 2011; Parush, Ahuvia, & Erev, 2007). With recent growth and advances of augmented reality (AR) head-up displays (HUDs), there are new opportunities to display navigation information directly within a driver’s forward field of view, allowing them to gather information needed to navigate without looking away from the road. While the technology is promising, the nuances of interface design and its impacts on drivers must be further understood before AR can be widely and safely incorporated into vehicles. Specifically, an impact that warrants investigation is the role of AR HUDS in spatial knowledge acquisition while driving. Acquiring high levels of spatial knowledge is crucial for navigation tasks because individuals who have greater levels of spatial knowledge acquisition are more capable of navigating based on their own internal knowledge (Bolton, Burnett, & Large, 2015). Moreover, the ability to develop an accurate and comprehensive cognitive map acts as a social function in which individuals are able to navigate for others, provide verbal directions and sketch direction maps (Hill, 1987). Given these points, the relationship between spatial knowledge acquisition and novel technologies such as AR HUDs in driving is a relevant topic for investigation. Objectives: This work explored whether providing conformal AR navigational cues improves spatial knowledge acquisition (as compared to traditional HUD visual cues) to assess the plausibility and justification for investment in generating larger FOV AR HUDs with potentially multiple focal planes. Methods: This study employed a 2x2 between-subjects design in which twenty-four participants were counterbalanced by gender. We used a fixed base, medium fidelity driving simulator for where participants drove while navigating with one of two possible HUD interface designs: a world-relative arrow post sign and a screen-relative traditional arrow. During the 10-15 minute drive, participants drove the route and were encouraged to verbally share feedback as they proceeded. After the drive, participants completed a NASA-TLX questionnaire to record their perceived workload. We measured spatial knowledge at two levels: landmark and route knowledge. Landmark knowledge was assessed using an iconic recognition task, while route knowledge was assessed using a scene ordering task. After completion of the study, individuals signed a post-trial consent form and were compensated $10 for their time. Results: NASA-TLX performance subscale ratings revealed that participants felt that they performed better during the world-relative condition but at a higher rate of perceived workload. However, in terms of perceived workload, results suggest there is no significant difference between interface design conditions. Landmark knowledge results suggest that the mean number of remembered scenes among both conditions is statistically similar, indicating participants using both interface designs remembered the same proportion of on-route scenes. Deviance analysis show that only maneuver direction had an influence on landmark knowledge testing performance. Route knowledge results suggest that the proportion of scenes on-route which were correctly sequenced by participants is similar under both conditions. Finally, participants exhibited poorer performance in the route knowledge task as compared to landmark knowledge task (independent of HUD interface design). Conclusions: This study described a driving simulator study which evaluated the head-up provision of two types of AR navigation interface designs. The world-relative condition placed an artificial post sign at the corner of an approaching intersection containing a real landmark. The screen-relative condition displayed turn directions using a screen-fixed traditional arrow located directly ahead of the participant on the right or left side on the HUD. Overall results of this initial study provide evidence that the use of both screen-relative and world-relative AR head-up display interfaces have similar impact on spatial knowledge acquisition and perceived workload while driving. These results contrast a common perspective in the AR community that conformal, world-relative graphics are inherently more effective. This study instead suggests that simple, screen-fixed designs may indeed be effective in certain contexts.« less