Ambient Intelligence in Healthcare: A State-of-the-Art

Information technology advancement leads to an innovative paradigm called Ambient Intelligence (AmI). A digital environment is employed along with AmI to enable individuals to be aware to their behaviors, needs, emotions and gestures. Several applications of the AmI systems in healthcare environment attract several researchers. AmI is considered one of the recent technologies that support hospitals, patients, and specialists for personal healthcare with the aid of artificial intelligence techniques and wireless sensor networks. The improvement in the wearable devices, mobile devices, embedded software and wireless technologies open the doors to advanced applications in the AmI paradigm. The WSN and the BAN collect medical data to be used for the progress of the intelligent systems adapted inevitably. The current study outlines the AmI role in healthcare concerning with its relational and technological nature. Health

The Playing Brain. The Impact of Video Games on Cognition and Behavior in Pediatric Age at the Time of Lockdown: A Systematic Review.

A growing number of children and adolescents play video games (VGs) for long amounts of time. The current outbreak of the Coronavirus pandemic has significantly reduced outdoor activities and direct interpersonal relationships. Therefore, a higher use of VGs can become the response to stress and fear of illness. VGs and their practical, academic, vocational and educational implications have become an issue of increasing interest for scholars, parents, teachers, pediatricians and youth public policy makers. The current systematic review aims to identify, in recent literature, the most relevant problems of the complex issue of playing VGs in children and adolescents in order to provide suggestions for the correct management of VG practice. The method used searches through standardized search operators using keywords related to video games and the link with cognition, cognitive control and behaviors adopted during the pandemic. Ninety-nine studies were reviewed and included, whereas twelve studies were excluded because they were educationally irrelevant. Any debate on the effectiveness of VGs cannot refer to a dichotomous approach, according to which VGs are rigidly ‘good’ or ‘bad’. VGs should be approached in terms of complexity and differentiated by multiple dimensions interacting with each other

Применение компьютерных игровых технологий для развития регуляторных функций дошкольников

Introduction. Computer applications are important for the development of preschoolers’ executive functions. This paper is the first study to overview foreign studies of computer game-based methods for the development of executive functions. Theoretical Basis. The study describes (a) A. Miyake’s model of executive functions and (b) the cultural-historical approach. Results. The study revealed the main reasons for the use and development of serious videogames. Their advantages over standard methods were as follows: (a) Some data indicated the developmental effect of the existing games. (b) Such a format of training tasks had a positive impact on motivation. (c) The game adapted flexibly to a trainee’s level. (d) Such tasks had a high ecological compatibility. The review analyzed the existing programs and applications for the development of preschoolers’ executive functions, which required the participation of parents or teachers in the process of training and organized peer interaction. The paper described the basic principles of creating serious games, which can not only adapt to the user’s development level, but also maintain motivation when training executive functions. The literature on the creation of serious video games showed the importance of a subject’s learning of certain sets of actions and their use in appropriate situations for the development of memory and inhibition. Timely actions were important for the development of cognitive flexibility. Discussion. The comparison of the analyzed computer game-based methods made it possible to distinguish the most significant features, which can develop executive functions at preschool age. The findings can be successfully used for evaluating the existing applications and creating new videogames, aimed at the development of executive functions.Введение. Авторами показывается актуальность использования и разработки компьютерных приложений для детей дошкольного возраста с целью развития регуляторных функций. В работе впервые представлен обзор зарубежных исследований, посвященных компьютерным игровым методам развития регуляторных функций. Теоретическое обоснование. В статье описывается модель регуляторных функций А. Мияке, а также культурно-исторический подход, на который опирались авторы при проведении теоретического исследования. Результаты. Данный раздел включает рассмотрение основных причин популярности использования и разработки развивающих компьютерных игр и их преимуществ перед стандартными методами: наличие данных о развивающем эффекте существующих игр, о положительном влиянии такого формата тренировочных заданий на мотивацию, возможность гибко адаптировать игру под уровень тренирующегося и более высокая экологичность выполняемых заданий. В обзоре проанализированы существующие программы и приложения по развитию регуляторных функций у детей дошкольного возраста, требующие участия родителей или воспитателей в процессе тренировки, а также направленные на организацию взаимодействия сверстников. Также в статье рассмотрены основные принципы создания развивающих игр, способных не только адаптироваться к уровню развития пользователя, но и поддерживать необходимую мотивацию во время тренировки регуляторных функций. В исследованиях, посвященных созданию развивающих видеоигр, подчеркивается значение заучивания испытуемым определенных наборов действий и применение их в соответствующей ситуации для развития памяти и процессов торможения, а также значимость заданий на скорость для развития когнитивной гибкости. Обсуждение результатов. Авторы сопоставляют проанализированные разработки в области компьютерных игровых методов и выделяют наиболее значимые черты, способные оказывать развивающее воздействие на регуляторные функции в дошкольном возрасте, что может стать основанием как для оценки уже имеющихся приложений, так и для разработки новых компьютерных видеоигр, направленных на развитие регуляторных функций

Visualization and Interaction Technologies in Serious and Exergames for Cognitive Assessment and Training: A Survey on Available Solutions and Their Validation

Exergames and serious games, based on standard personal computers, mobile devices and gaming consoles or on novel immersive Virtual and Augmented Reality techniques, have become popular in the last few years and are now applied in various research fields, among which cognitive assessment and training of heterogeneous target populations. Moreover, the adoption of Web based solutions together with the integration of Artificial Intelligence and Machine Learning algorithms could bring countless advantages, both for the patients and the clinical personnel, as allowing the early detection of some pathological conditions, improving the efficacy and adherence to rehabilitation processes, through the personalisation of training sessions, and optimizing the allocation of resources by the healthcare system. The current work proposes a systematic survey of existing solutions in the field of cognitive assessment and training. We evaluate the visualization and interaction technologies commonly adopted and the measures taken to fulfil the need of the pathological target populations. Moreover, we analyze how implemented solutions are validated, i.e. The chosen experimental designs, data collection and analysis. Finally, we consider the availability of the applications and raw data to the large community of researchers and medical professionals and the actual application of proposed solutions in the standard clinical practice. Despite the potential of these technologies, research is still at an early stage. Although the recent release of accessible immersive virtual reality headsets and the increasing interest on vision-based techniques for tracking body and hands movements, many studies still rely on non-immersive virtual reality (67.2%), mainly mobile and personal computers, and standard gaming tools for interactions (41.5%). Finally, we highlight that although the interest of research community in this field is increasingly higher, the sharing of dataset (10.6%) and implemented applications (3.8%) should be promoted and the number of healthcare structures which have successfully introduced the new technological approaches in the treatment of their host patients is limited (10.2%)

Executive Functions, Motor Development, and Digital Games Applied to Elementary School Children: A Systematic Mapping Study

Studies show that executive functions and motor development are associated with each other and with learning ability. A more technological lifestyle combined with digital culture should be considered a viable alternative to stimulate children’s development. Therefore, this study aimed to present a systematic mapping of the literature involving executive functions, motor development, and the use of digital games in intervention programs for elementary school children from 6 to 11 years old. Four databases were researched: PubMed, Scielo, Science Direct, and SCOPUS, including publications between 2012 and March 2021. The initial results indicated 4881 records. After the selection process, 15 manuscripts that presented the central theme of the study were selected. The main results indicated that intervention strategies are rather heterogeneous. Most of the studies demonstrated efficient results after intervention protocols, many of them were conducted in Europe, and 46% occurred in a school environment. No research was identified involving technological solutions using executive functions, motor development, and digital games in an integrated manner. Hence, this constitutes a field of future scientific research.N/

Autonomous Assessment of Videogame Difficulty Using Physiological Signals

Given the well-explored relation between challenge and involvement in a task, (e.g., as described in Csikszentmihalyi’s theory of flow), it could be argued that the presence of challenge in videogames is a core element that shapes player experiences and should, therefore, be matched to the player’s skills and attitude towards the game. However, handling videogame difficulty, is a challenging problem in game design, as too easy a task can lead to boredom and too hard can lead to frustration. Thus, by exploring the relationship between difficulty and emotion, the current work intends to propose an artificial intelligence model that autonomously predicts difficulty according to the set of emotions elicited in the player. To test the validity of this approach, we developed a simple puzzle-based Virtual Reality (VR) videogame, based on the Trail Making Test (TMT), and whose objective was to elicit different emotions according to three levels of difficulty. A study was carried out in which physiological responses as well as player self- reports were collected during gameplay. Statistical analysis of the self-reports showed that different levels of experience with either VR or videogames didn’t have a measurable impact on how players performed during the three levels. Additionally, the self-assessed emotional ratings indicated that playing the game at different difficulty levels gave rise to different emotional states. Next, classification using a Support Vector Machine (SVM) was performed to verify if it was possible to detect difficulty considering the physiological responses associated with the elicited emotions. Results report an overall F1-score of 68% in detecting the three levels of difficulty, which verifies the effectiveness of the adopted methodology and encourages further research with a larger dataset.Dada a relação bem explorada entre desafio e envolvimento numa tarefa (p. ex., con- forme descrito na teoria do fluxo de Csikszentmihalyi), pode-se argumentar que a pre- sença de desafio em videojogos é um elemento central que molda a experiência do jogador e deve, portanto, ser compatível com as habilidades e a atitude que jogador exibe perante o jogo. No entanto, saber como lidar com a dificuldade de um videojogo é um problema desafiante no design de jogos, pois uma tarefa muito fácil pode gerar tédio e muito di- fícil pode levar à frustração. Assim, ao explorar a relação entre dificuldade e emoção, o presente trabalho pretende propor um modelo de inteligência artificial que preveja de forma autônoma a dificuldade de acordo com o conjunto de emoções elicitadas no jogador. Para testar a validade desta abordagem, desenvolveu-se um jogo de puzzle em Realidade Virtual (RV), baseado no Trail Making Test (TMT), e cujo objetivo era elicitar diferentes emoções tendo em conta três níveis de dificuldade. Foi realizado um estudo no qual se recolheram as respostas fisiológicas, juntamente com os autorrelatos dos jogado- res, durante o jogo. A análise estatística dos autorelatos mostrou que diferentes níveis de experiência com RV ou videojogos não tiveram um impacto mensurável no desempenho dos jogadores durante os três níveis. Além disso, as respostas emocionais auto-avaliadas indicaram que jogar o jogo em diferentes níveis de dificuldade deu origem a diferentes estados emocionais. Em seguida, foi realizada a classificação por intermédio de uma Má- quina de Vetores de Suporte (SVM) para verificar se era possível detectar dificuldade, considerando as respostas fisiológicas associadas às emoções elicitadas. Os resultados re- latam um F1-score geral de 68% na detecção dos três níveis de dificuldade, o que verifica a eficácia da metodologia adotada e incentiva novas pesquisas com um conjunto de dados maior

Using EEG data as Dynamic Difficulty Adjustment in a serious game about the plastic pollution in the oceans

In this work, it is explored whether real-time EEG (Electroencephalography) can adjust the difficulty in a serious game focused on engagement, attention, and learning about plastic pollution in our oceans. Using EEG to balance the game around the players’ affective state by measuring brain activity in real time, it is aimed to better fit the player’s skill level, enabling a stable flow state. The experimental study included 34 participants with an experimental group (n=17), and a control group (n=17). The experimental group played the game about the plastic pollution in our oceans with anadaptive difficulty adjustment (DDA) based on changes in their levels of attention and calm measured by EEG. The evaluation is based on a user engagement questionnaire, structured interviews, the EEG data, and a knowledge test. The results revealed high engagement in the game from both the experimental group and the control group. However, the participants in the control group were more attentive while playing the game and scored higher on all questions in the knowledge test compared to the experimental group. In conclusion, our study cannot provide evidence for usingEEG-DDA to increase the engagement, attention, and learnings about pollution in the oceans in a serious game. However, there are still advantages for including EEG in game related research, and much future research is needed in how to provide optimal learning in serious games

Attention deficit hyperactivity disorder assessment based on patient behavior exhibited in a car video game: A pilot study

This article belongs to the Special Issue Advances in ADHD.Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the experience of the medical professional. Attempts to obtain additional measures to support the medical diagnosis, such as reaction time when performing a task, can be found in the literature. We propose an information recording system that allows to study in detail the behavior shown by children already diagnosed with ADHD during a car driving video game. We continuously record the participants" activity throughout the task and calculate the error committed. Studying the trajectory graphs, some children showed uniform patterns, others lost attention from one point onwards, and others alternated attention/inattention intervals. Results show a dependence between the age of the children and their performance. Moreover, by analyzing the positions by age over time using clustering, we show that it is possible to classify children according to their performance. Future studies will examine whether this detailed information about each child"s performance pattern can be used to fine-tune treatment.This research was partially funded by: Ministerio de Ciencia, Innovación y Universidades, Spanish National Project, grant number RTI2018-101857-B-I00, Ministerio de Universidades (Grant for the requalification of permanent lectures, David Delgado-Gómez), Instituto Salud Carlos III, grant number DTS21/00091