Shear-promoted drug encapsulation into red blood cells: a CFD model and μ-PIV analysis

The present work focuses on the main parameters that influence shear-promoted encapsulation of drugs into erythrocytes. A CFD model was built to investigate the fluid dynamics of a suspension of particles flowing in a commercial micro channel. Micro Particle Image Velocimetry (μ-PIV) allowed to take into account for the real properties of the red blood cell (RBC), thus having a deeper understanding of the process. Coupling these results with an analytical diffusion model, suitable working conditions were defined for different values of haematocrit

The influences of gamification on user experience in the healthcare sector

Abstract. Gamification is a considerably emerging trend focusing on the application of game mechanics to a nongame context. The objective of gamification implication in serious settings is to form the positive outcomes from the patients. While education and business have been taken advantages of gamification, the digital health domain just started the journey with this prevailing trend. That is why, there is an increasing demand for scientific research on the gamification in healthcare, especially the user experience under the gamified healthcare solution from the company perspective. With this inspiration, the study is conducted aiming at exploring the user experience under the impact of gamification in the healthcare context. Study indicates that it is the affordances, which are also known as game elements that stimulate various psychological and behavioural experience for the users. The combination of the achievement-oriented, social-oriented and immersion-oriented affordances in the gamified healthcare solution triggers the various psychological and behavioural experience. These experiences are examined under three perspectives which are stimulation, interaction and sense-making. Through the stimulation lens, the psychological experiences are favourably formed and dominant the behavioural experience. While, the interaction lens indicates the dominance of the behavioural experience, especially the performance-related outcomes. The sense-making view shows the actor-related behavioural experience outweighs of the other outcomes. The exploratory qualitative research and the semi-structured interviews are utilised to investigate the game affordances in the gamified solutions and the user experience from the gamified solution providers angles. The study expectedly contributes to the literature’ body of gamification by confirming the conceptualisation of the gamification and the formation of the user experience. The empirical implications are for the gamified healthcare solution design regarding the affordance combination and the utilisation of the insights from both patients and game players

Technologies and combination therapies for enhancing movement training for people with a disability

There has been a dramatic increase over the last decade in research on technologies for enhancing movement training and exercise for people with a disability. This paper reviews some of the recent developments in this area, using examples from a National Science Foundation initiated study of mobility research projects in Europe to illustrate important themes and key directions for future research. This paper also reviews several recent studies aimed at combining movement training with plasticity or regeneration therapies, again drawing in part from European research examples. Such combination therapies will likely involve complex interactions with motor training that must be understood in order to achieve the goal of eliminating severe motor impairment

A technology-aided multi-modal training approach to assist abdominal palpation training and its assessment in medical education

Computer-assisted multi-modal training is an effective way of learning complex motor skills in various applications. In particular disciplines (eg. healthcare) incompetency in performing dexterous hands-on examinations (clinical palpation) may result in misdiagnosis of symptoms, serious injuries or even death. Furthermore, a high quality clinical examination can help to exclude significant pathology, and reduce time and cost of diagnosis by eliminating the need for unnecessary medical imaging. Medical palpation is used regularly as an effective preliminary diagnosis method all around the world but years of training are required currently to achieve competency. This paper focuses on a multimodal palpation training system to teach and improve clinical examination skills in relation to the abdomen. It is our aim to shorten significantly the palpation training duration by increasing the frequency of rehearsals as well as providing essential augmented feedback on how to perform various abdominal palpation techniques which has been captured and modelled from medical experts. A comparative evaluation on usability and effectiveness of the method is presented in this study. Four professional tutors were invited to take part in the design, development and assessment stages of this study. Widely-used user centred design methods were employed to form a know-how document and an assessment criterion with help of medical professionals. Our interface was used to capture and develop a best practice model for each palpation tasks for further assessment. Twenty three first year medical students divided into a control group (n = 8), a semi-visually trained group (n = 8), and a fully visually trained group (n = 7) were invited to perform three palpation tasks (superficial, deep and liver). The medical students’ performances were assessed using both computer-based and human-based methods where a positive correlation was shown between the generated scores, r = .62, p (one-tailed) < .05. The visually-trained group significantly outperformed the control group in which abstract visualisation of applied forces and their palmar locations were provided to the students during each palpation examination (p < .05). Moreover, a positive trend was observed between groups when visual feedback was presented, J = 132, z = 2.62, r = 0.55

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio

SHELDON Smart habitat for the elderly.

An insightful document concerning active and assisted living under different perspectives: Furniture and habitat, ICT solutions and Healthcare

Nutzerorientierte Evaluation zweier altersgerechter Assistenzroboter zur Unterstützung von Alltagsaktivitäten („Ambient Assisted Living-Roboter“) bei älteren Menschen mit funktionellen Einschränkungen: MOBOT-Rollator und I-SUPPORT-Duschroboter

Ziel der vorliegenden Arbeit ist die nutzerorientierte Evaluation zweier Prototypen für altersgerechte Assistenzroboter zur Unterstützung von Alltagsaktivitäten („Ambient Assisted Living“ [AAL]-Roboter) bei älteren Menschen mit funktionellen Einschränkungen. Bei den Prototypen handelt es sich dabei um (1) einen robotergestützten Rollator zur Unterstützung der Mobilität (MOBOT) und (2) einen Assistenzroboter zur Unterstützung von Duschaktivitäten (I-SUPPORT). Manuskript I dokumentiert eine systematische Literaturanalyse des methodischen Vorgehens bisheriger Studien zur Evaluation robotergestützter Rollatoren aus der Nutzerperspektive. Die meisten Studien zeigen erhebliche methodische Mängel, wie unzureichende Stichprobengrößen/-beschreibungen; Teilnehmer nicht repräsentativ für die Nutzergruppe der robotergestützten Rollatoren; keine geeigneten, standardisierten und validierten Assessmentmethoden und/oder keine Inferenzstatistik. Ein generisches methodisches Vorgehen für die Evaluation robotergestützter Rollatoren konnte nicht identifiziert werden. Für die Konzeption und Durchführung zukünftiger Studien zur Evaluation robotergestützter Rollatoren, aber auch anderer AAL-Systeme werden in Manuskript I abschließend Handlungsempfehlungen formuliert. Manuskript II analysiert die Untersuchungsergebnisse der in Manuskript I identifizierten Studien. Es zeigen sich sehr heterogene Ergebnisse hinsichtlich des Mehrwerts der innovativen Assistenzfunktionen von robotergestützten Rollatoren. Im Allgemeinen werden sie jedoch als positiv von den Nutzern wahrgenommen. Die große Heterogenität und methodischen Mängel der Studien schränken die Interpretierbarkeit ihre Untersuchungsergebnisse stark ein. Insgesamt verdeutlicht Manuskript II, dass die Evidenz zur Effektivität und positiven Wahrnehmung robotergestützter Rollatoren aus der Nutzerperspektive noch unzureichend ist. Basierend auf den Erkenntnissen und Handlungsempfehlungen der systematischen Literaturanalysen aus Manuskript I und II wurden die nutzerorientierten Evaluationsstudien des MOBOT-Rollators konzipiert und durchgeführt (Manuskript III-VI). Manuskript III überprüft die Effektivität des in den MOBOT-Rollator integrierten Navigationssystems bei potentiellen Nutzern (= ältere Personen mit Gangstörungen bzw. Rollator als Gehhilfe im Alltag). Es liefert erstmals einen statistischen Nachweis dafür, dass eine solche Assistenzfunktion effektiv ist, um die Navigationsleistung der Nutzer (z. B. geringer Stoppzeit, kürzere Wegstrecke) – insbesondere derjenigen mit kognitiven Einschränkungen – in einem realitätsnahen Anwendungsszenario zu verbessern. Manuskript IV untersucht die konkurrente Validität des MOBOT-integrierten Ganganalysesystems bei potentiellen Nutzern. Im Vergleich zu einem etablierten Referenzstandard (GAITRite®-System) zeigt es eine hohe konkurrente Validität für die Erfassung zeitlicher, nicht jedoch raumbezogener Gangparameter. Diese können zwar ebenfalls mit hoher Konsistenz gemessen werden, aber lediglich mit einer begrenzten absoluten Genauigkeit. Manuskript V umfasst die nutzerorientierte Evaluation der im MOBOT-Rollator integrierten Assistenzfunktion zur Hindernisvermeidung und belegt erstmals die Effektivität einer solchen Funktionen bei potentiellen Nutzern. Unter Verwendung des für den MOBOT-Rollator neu entwickelten technischen Ansatzes für die Hindernisvermeidung zeigten die Teilnehmer signifikante Verbesserungen bei der Bewältigung eines Hindernisparcours (weniger Kollisionen und geringere Annäherungsgeschwindigkeit an die Hindernisse). Manuskript VI dokumentiert die Effektivität und Zufriedenheit mit der Aufstehhilfe des MOBOT-Rollators von potentiellen Nutzern. Es wird gezeigt, dass die Erfolgsrate für den Sitzen-Stehen-Transfer älterer Personen mit motorischen Einschränkungen durch die Aufstehhilfe signifikant verbessert werden kann. Die Ergebnisse belegen zudem eine hohe Nutzerzufriedenheit mit dieser Assistenzfunktion, insbesondere bei Personen mit höherem Body-Mass-Index. Manuskript VII untersucht die Mensch-Roboter-Interaktion zwischen dem I-SUPPORT-Duschroboter und seiner potentiellen Nutzer (= ältere Personen mit Problemen bei Baden/Duschen) und überprüft deren Effektivität sowie Zufriedenheit mit drei unterschiedlich autonomen Betriebsmodi. Die Studienergebnisse dokumentieren, dass sich mit zunehmender Kontrolle des Nutzers (= abnehmende Autonomie des Duschroboters) nicht nur die Effektivität für das Abduschen eines definierten Körperbereichs verringert, sondern auch die Nutzerzufriedenheit sinkt. Manuskript VIII umfasst die Evaluation eines spezifischen Nutzertrainings auf die gestenbasierte Mensch-Roboter-Interaktion mit dem I-SUPPORT-Duschroboter. Es wird gezeigt, dass ein solches Training die Ausführung der Gesten potentieller Nutzer und sowie die Gestenerkennungsrate des Duschroboters signifikant verbessern, was insgesamt auf eine optimierte Mensch-Roboter-Interaktion in Folge des Trainings schließen lässt. Teilnehmer mit der schlechtesten Ausgangsleistung in der Ausführung der Gesten und mit der größten Angst vor Technologien profitierten am meisten vom Nutzertraining. Insgesamt belegen die Studienergebnisse zur nutzerorientierten Evaluation des MOBOT-Rollators die Effektivität und Gültigkeit seiner innovativen Teilfunktionen. Sie weisen auf ein hohes Potential der Assistenzfunktionen (Navigationssystem, Hindernisvermeidung, Aufstehhilfe) zur Verbesserung der Mobilität älterer Menschen mit motorischen Einschränkungen hin. Vor dem Hintergrund der methodischen Mängel und unzureichenden evidenzbasierten Datenlage hierzu, liefert diese Dissertationsschrift erstmals statistische Belege für den Mehrwert solcher Teilfunktionen bei potentiellen Nutzern und leistet somit einen wichtigen Beitrag zur Schließung der bisherigen Forschungslücke hinsichtlich des nutzerorientierten Wirksamkeits- und Gültigkeitsnachweises robotergestützter Rollatoren und ihrer innovativen Teilfunktionen. Die Ergebnisse der Studien des I-SUPPORT-Duschroboters liefern wichtige Erkenntnisse hinsichtlich der Mensch-Roboter-Interaktion im höheren Alter. Sie zeigen, dass bei älteren Nutzern für eine effektive Interaktion Betriebsmodi mit einem hohen Maß an Autonomie des Duschroboters notwendig sind. Trotz ihrer eingeschränkten Kontrolle über den Roboter, waren die Nutzer mit dem autonomsten Betriebsmodus sogar am zufriedensten. Darüber hinaus unterstreichen die Ergebnisse hinsichtlich der gestenbasierten Interaktion mit dem I-SUPPORT-Duschroboter, dass zukünftige Entwicklungen von altersgerechten Assistenzrobotern mit gestenbasierter Interaktion nicht nur die Verbesserungen technischer Aspekte, sondern auch die Sicherstellung und Verbesserungen der Qualität der Nutzergesten für die Mensch-Roboter-Interaktion durch geeignete Trainings- oder Schulungsmaßnahmen berücksichtigen sollten. Das vorgestellte Nutzertraining könnte hierfür ein mögliches Modell darstellen

A technology-aided multi-modal training approach to assist abdominal palpation training and its assessment in medical education

Kinaesthetic Learning Activities (KLA) are techniques for enhancing the motor learning process to provide a deep understanding of fundamental skills in particular disciplines. With KLA learning takes place by carrying out a physical activity to transform empirical achievements into representative cognitive understanding. In disciplines such as medical education, frequent hands-on practice of certain motor skills plays a key role in the development of medical students' competency. Therefore it is essential that clinicians master these core skills early on in their educational journey as well as retain them for the entirety of their career. Transferring knowledge of performing dexterous motor skills, such as clinical examinations, from experts to novices demands a systematic approach to quantify relevant motor variables with the help of medical experts in order to form a reference best practice model for target skills. Additional information (augmented feedback) on certain aspects of movements could be extracted from this model and visualised via multi-modal sensory channels in order to enhance motor performance and learning processes. This thesis proposes a novel KLA methodology to significantly improve the quality of palpation training in medical students. In particular, it investigates whether it is possible to enhance the existing abdominal palpation skills acquisition process (motor performance and learning) with provision of instructional concurrent and terminal augmented feedback on applied forces by the learner's hand via an autonomous multimodal displays. This is achieved by considering the following: identifying key motor variables with help of medical experts; forming a gold standard model for target skills by collecting pre-defined motor variables with an innovative quantification technique; designing an assessment criteria by analysing the medical experts' data; and systematically evaluating the impact of instructional augmented feedback on medical students' motor performance with two distinct assessment approaches(a machine-based and a human-based). In addition, an evaluation of performance on a simpler task is carried out using a game-based training method, to compare feedback visualisation techniques, such as concurrent visual and auditory feedback as used in a serious games environment, with abstract visualisation of motor variables. A detailed between-participants study is presented to evaluate the effect of concurrent augmented feedback on participants' skills acquisition in the motor learning process. Significant improvement on medical students' motor performance was observed when augmented feedback on applied forces were visually presented (H(2) = 6:033, p < :05). Moreover, a positive correlation was reported between computer-generated scores and human-generated scores, r = :62, p (one-tailed) < :05. This indicates the potential of the computer-based assessment technique to assist the current assessment process in medical education. The same results were also achieved in a blind-folded (no-feedback) transfer test to evaluate performance and short-term retention of skills in the game-based training approach. The accuracy in the exerted target force for participants in the game-playing group, who were trained using the game approach (Mdn = 0:86), differed significantly from the participants in control group, who trained using the abstract visualisation of the exerted force value (Mdn = 1:56), U = 61, z = -2:137, p < :05, r = -0:36. Finally, the usability of both motor learning approaches were surveyed via feedback questionnaires and positive responses were achieved from users. The research presented shows that concurrent augmented feedback significantly improves the participants' motor control abilities. Furthermore, advanced visualisation techniques such as multi-modal displays increases the participants' motivation to engage in learning and to retain motor skills