An augmented reality interface to control a collaborative robot in rehab: A preliminary usability evaluation.

Human emotions can be seen as a valuable variable to explore in Human-Computer Interaction for effective, efficient, and satisfying interface development. The inclusion of appropriate emotional triggers in the design of interactive systems can play a decisive role in users' acceptance or rejection. It is well known that the major problem in motor rehabilitation is the high dropout rate resulting from the frustrated expectations given the typical slow recovery process and consequent lack of motivation to endure. This work proposes grouping a collaborative robot with one specific augmented reality equipment to create a rehabilitation system where some gamification levels might be added to provide a better and more motivating experience to patients. Such a system, as a whole, is customizable to adapt to each patient's needs on the rehabilitation exercises. By transforming a tedious exercise into a game, we expect to create an additional layer of enjoyment that can help in triggering positive emotions and stimulate users to continue the rehabilitation process. A pre-prototype was developed to validate this system's usability, and a cross-sectional study using a non-probabilistic sample of 31 individuals is presented and discussed. This study included the application of three standard questionnaires on usability and user experience. The analyses of these questionnaires show that the majority of the users found the system easy and enjoyable. The system was also analysed by a rehabilitation expert who gave a positive output regarding its usefulness, and positive impact on its use in the upper-limb rehabilitation processes. These results clearly encourage further development of the proposed system.

Neural correlates of verbal recognition memory in obese adults with and without major depressive disorder.

BACKGROUND: Obesity and major depressive disorder (MDD) independently contribute to memory impairment. Little is known about shared neural mechanisms that may result in the cognitive impairment experienced by these populations. This study's aim was to determine how obesity impacts neural activity during a verbal recognition memory task in individuals both with and without MDD. METHODS: Functional magnetic resonance imaging was employed to examine whether differences in neural activation patterns would be seen across three groups during the Warrington's Recognition Memory Test. Three study groups are reported: 20 subjects with obesity but without MDD (bariatric controls), 23 subjects with past or current MDD and obesity, and 20 normal BMI controls (healthy controls). RESULTS: Three-group conjunction analyses indicated that overlapping neural regions were activated during both encoding and retrieval processes across all groups. However, second-level 2-group t-contrasts indicated that neural activation patterns differed when comparing healthy and bariatric controls, and when comparing bariatric controls and bariatric MDD participants. DISCUSSION: Results indicate that obesity in conjunction with MDD confers a subtle impact on neural functioning. Given high rates of obesity and MDD comorbidity, and the role of cognition on ability to return to premorbid level of functioning, this association should inform treatment decisions.

Biomedical musculoskeletal applications of infrared thermal imaging on arm and forearm: A systematic review.

Infrared thermal imaging (IRT) has been a target of research for biomedical musculoskeletal applications, due to the possible association of the physiological data that it provides, through skin temperature measurement, with pathological states. The aim of this systematic review is to acquaint the outcomes of the biomedical application of IRT in arm and forearm evaluation and its future perspectives of research. During the literature review, 926 articles were identified using the search engines PubMed and Scopus, and 10 articles were retrieved from other sources. After screening the abstracts and applying the eligibility criteria on those which were fully accessible, 33 articles were included in the review. It can be observed that IRT has the potential to provide physiological information on the arm and forearm, showing potential to serve as an aid in various pathologies and health situations. Future studies and challenges are identified and proposed, facilitating the improvement and acceptance of the application of IRT in the assessment of arm and forearm' health status.

Comparing classification techniques for identification of grasped objects.

BACKGROUND: This work presents a comparison and selection of different machine learning classification techniques applied in the identification of objects using data collected by an instrumented glove during a grasp process. The selected classifiers techniques can be applied to e-rehabilitation and e-training exercises for different pathologies, as in aphasic patients. METHODS: The adopted method uses the data from a commercial instrumented glove. An experiment was carried out, where three subjects using an instrumented glove had to grasp eight objects of common use. The collected data were submitted to nineteen different classification techniques (available on the scikit-learn library of Python) used in two classifier structures, with the objective of identifying the grasped object. The data were organized into two dataset scenarios: one with data from the three users and another with individual data. RESULTS: As a result of this work, three classification techniques presented similar accuracies for the classification of objects. Also, it was identified that when training the models with individual dataset the accuracy improves from 96 to 99%. CONCLUSIONS: Classification techniques were used in two classifier structures, one based on a single model and the other on a cascade model. For both classifier structure and scenarios, three of the classification techniques were selected due to the high reached accuracies. The highest results were obtained using the classifier structure that employed the cascade models and the scenario of individual dataset.

Hysteresis Compensation in a Tactile Device for Arterial Pulse Reproduction.

This paper describes a system for training healthcare practitioners in the identification of different arterial pulses. The driving system uses a linear solenoid in an open loop force control. Due to the large hysteresis it exhibited, a form of compensation was implemented, based on the classic Preisach model of hysteresis. Implementation of said model resulted in a significant reduction of force tracking error, demonstrating the feasibility of the chosen approach for the intended application.

Comparison of Jamar and Bodygrip Dynamometers for Handgrip Strength Measurement.

Guerra, RS, Amaral, TF, Sousa, AS, Fonseca, I, Pichel, F, and Restivo, MT. Comparison of Jamar and Bodygrip dynamometers for handgrip strength measurement. J Strength Cond Res 31(7): 1931-1940, 2017-Studies that compared the agreement between Jamar and other models of dynamometers for handgrip strength (HGS) measurement have exhibited variability in the provided results. The lack of comparability between dynamometers led to the development of the Bodygrip dynamometer. This study aims to examine the reliability of the Bodygrip for HGS measurement, to compare it with the Jamar, and to explore the HGS differences between instruments considering the ergonomic effect of using the Bodygrip with 2 different handles. A cross-sectional study was conducted in free-living (n = 114, 18-89 years) and inpatient (n = 50, 65-93 years) volunteers. Nondominant HGS was tested randomly with the Jamar and Bodygrip, the latter using 2 different handles-curved and straight types. Handgrip strength was obtained for each participant under the same conditions. Each individual performed 2 HGS measurements with each dynamometer, and the maximum HGS value was considered for dynamometers comparison. Differences in the maximum HGS value between the 2 devices (Jamar-Bodygrip), intraclass correlation coefficients (ICCs), Bland and Altman plots, and limits of agreement were obtained. Correlation between the highest HGS measurement obtained for the nondominant hand with the Jamar and with the Bodygrip using each handle was excellent (ICCs: 0.93-0.95). Mean differences of -0.5 (limits of agreement: -4.6; 3.5) kgf with the curved handle and of 1.0 (-7.7; 9.7) kgf with the straight handle for the free-living participants were obtained, whereas for inpatients these values were -1.0 (-3.8; 1.9) kgf and 2.1 (-3.3; 7.5) kgf, respectively, for the curved and straight handles. The Bodygrip is comparable to the Jamar in free-living adults and in hospitalized older adults, exhibiting excellent interinstrument reliability. The Bodygrip with the curved handle produces results closer to the Jamar when compared with Bodygrip with the straight handle, which emphasizes the importance of grip handle ergonomics to measurement reliability.

The impact of obesity on neuropsychological functioning in adults with and without major depressive disorder.

BACKGROUND: Evidence suggests obesity exerts a negative impact on cognition. Major Depressive Disorder (MDD) is also linked to problems in cognitive functioning. Obesity is highly prevalent in individuals with MDD and is linked to a failure to return to a full level of functioning. The study's objective was to investigate the effect of obesity on cognitive impairment in participants with MDD. METHODS: This study compared cognitive performance in obese individuals with MDD and two control populations (obese individuals without a psychiatric illness and non-obese controls). A standardized battery of neuropsychological tests specifically designed to assess performance in declarative memory, executive functioning, processing speed and attention was administered. Mood ratings, physical measurements, nutritional and health questionnaires were also completed. RESULTS: We observed a consistent pattern across measures of memory, executive functioning, attention and processing speed. Whereas healthy controls performed better than both bariatric groups across the majority of measures administered, bariatric controls tended to outperform bariatric MDD patients. LIMITATIONS: The overall sample size of our study was small and thus largely explorative in nature. However, it provides compelling results (while controlling for extraneous variables such as medication load, nutritional status and common metabolic comordidities) that strongly urges for further investigation and study replication with larger sample sizes. CONCLUSIONS: We found obesity has a subtle impact on cognition in obese individuals, and when obesity is present in individuals with MDD, this impact may be significant. It is important to minimize all modifiable variables that can add to cognitive burden in this population.

Effect of obesity on cognition in adults with and without a mood disorder: study design and methods.

INTRODUCTION: Obesity is a common medical illness that is increasingly recognised as conferring risk of decline in cognitive performance, independent of other comorbid medical conditions. Individuals with mood disorders (bipolar disorder (BD) or major depressive disorder (MDD)) display an increased prevalence of both obesity and risk factors for cardiovascular diseases. Moreover, BD and MDD are associated with impairment in cognitive functioning across multiple domains. The independent contribution of obesity to cognitive decline in this population has not been explored. This study examines the impact of obesity on cognition by comparing neuropsychological performance in obese individuals, with or without a mood disorder before and after undergoing bariatric surgery. METHODS AND ANALYSIS: This study compares measures of declarative memory, executive functioning and attention in obese individuals (body mass index >35 kg/m(2)) with BD or MDD, and 2 control populations (obese individuals without a psychiatric illness and healthy non-obese controls) prior to and following bariatric surgery. Participants (ages 18-60) receive a psychiatric diagnosis via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; SCID). Mood ratings, physical measurements, nutritional and health questionnaires are also administered. A standardised battery of neuropsychological tests aimed at establishing performance in areas of declarative memory, executive functioning and attention are administered. Warrington's Recognition Memory Task (RMT) and an N-Back Task are performed in a 3 T functional MRI to investigate patterns of neural activation during cognitive performance. Additionally, anatomical MRI data are obtained to investigate potential changes in neural structures. Baseline data will be analysed for between-group differences and later compared with postsurgical data to investigate cognitive change. ETHICS AND DISSEMINATION: This study has been approved by the Hamilton Integrated Research Ethics Board (09-3254). Results will be available in peer-reviewed scientific publications and scientific meetings presentations, and released in lay form to media.

An Overview of Links Between Obesity and Mental Health.

The American Medical Association recently recognized obesity as both an illness and a leading cause of preventable death and chronic disease. This association is not only linked to physical health outcomes, however, as obesity has also been extensively associated with mental illness as well. Both obesity and severe mental illness decrease quality of life and are associated with an increase in disability, morbidity, and mortality, and when they occur together, these adverse health outcomes are magnified. Despite educational campaigns, increased awareness, and improved treatment options, the high prevalence of mental illness and comorbid obesity remains a serious problem. This review examines this overlap, highlighting clinical and biological factors that have been linked to this association in order to improve our understanding and help elucidate potential therapeutic avenues.

Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis.

INTRODUCTION: Depression is the leading cause of disability worldwide, affecting approximately 350 million people. Evidence indicates that only 60-70% of persons with major depressive disorder who tolerate antidepressants respond to first-line drug treatment; the remainder become treatment resistant. Electroconvulsive therapy (ECT) is considered an effective therapy in persons with treatment-resistant depression. The use of ECT is controversial due to concerns about temporary cognitive impairment in the acute post-treatment period. We will conduct a meta-analysis to examine the effects of ECT on cognition in persons with depression. METHODS: This systematic review and meta-analysis has been registered with PROSPERO (registration number: CRD42014009100). We developed our methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We are searching MEDLINE, PsychINFO, EMBASE, CINAHL and Cochrane from the date of database inception to the end of October 2014. We are also searching the reference lists of published reviews and evidence reports for additional citations. Comparative studies (randomised controlled trials, cohort and case-control) published in English will be included in the meta-analysis. Three clinical neuropsychologists will group the cognitive tests in each included article into a set of mutually exclusive cognitive subdomains. The risk of bias of randomised controlled trials will be assessed using the Jadad scale. We will supplement the Jadad scale with additional questions based on the Cochrane risk of bias tool. The risk of bias of cohort and case-control studies will be assessed using the Newcastle-Ottawa Scale. We will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence. STATISTICAL ANALYSIS: Separate meta-analyses will be conducted for each ECT treatment modality and cognitive subdomain using Comprehensive Meta-Analysis V.2.0.

Usefulness of six diagnostic and screening measures for undernutrition in predicting length of hospital stay: a comparative analysis.

BACKGROUND: Undernutrition has been associated with longer length of hospital stay (LOS). However, an analysis that investigates the association of recommended undernutrition diagnostic and screening indicators with LOS conducted in patients with a varied spectrum of pathologies and considering confounders would help to clarify their clinical value. OBJECTIVE: We aimed to quantify the association of being undernourished as evaluated by different methodologies with LOS and their validity in predicting inpatient LOS. DESIGN: A prospective observational study was conducted. Undernutrition was evaluated by the Academy of Nutrition and Dietetics-American Society for Parental and Enteral Nutrition recommended clinical characteristics of malnutrition (AA-CCM) tool, the Patient-Generated Subjective Global Assessment (PG-SGA), the Nutritional Risk Screening (NRS-2002) tool, and the Malnutrition Universal Screening tool (MUST). Handgrip strength (HGS) quartiles by sex and phase angle (PA) categories were also used as indicators of undernutrition. PARTICIPANTS AND SETTING: Six hundred eighty-two inpatients from a Portuguese university hospital participated between 2011 and 2013. MAIN OUTCOME MEASURES: LOS was determined between the date of hospital admission and discharge. STATISTICAL ANALYSES PERFORMED: Kaplan-Meier and adjusted Cox proportional hazard ratio (HR) methods were applied. RESULTS: Moderate or severe undernutrition by AA-CCM (HR 0.58, 95% CI 0.49 to 0.69), by PG-SGA (moderate or suspected: HR 0.60, 95% CI 0.49 to 0.73 and severe: HR 0.52, 95% CI 0.42 to 0.64), risk of undernutrition assessed by NRS-2002 (HR 0.61, 95% CI 0.52 to 0.73), by MUST (medium: HR 0.75, 95% CI 0.60 to 0.95 and high: HR 0.67, 95% CI 0.55 to 0.81), HGS quartile (second: HR 0.64, 95% CI 0.50 to 0.80 and first [lowest]: HR 0.50, 95% CI 0.39 to 0.64) and nutritional risk defined by low PA (HR 0.62, 95% CI 0.48 to 0.81) were all independently associated with lower probability of being discharged from the hospital. CONCLUSIONS: Despite assessing different dimensions of nutritional status, undernutrition by AA-CCM and PG-SGA, risk of undernutrition assessed by NRS-2002 and MUST, and low HGS and PA independently predict longer LOS in hospitalized patients. All these methodologies share a similar validity in predicting LOS.

Handgrip strength and associated factors in hospitalized patients.

BACKGROUND: Handgrip strength (HGS) is a marker of nutrition status. Many factors are associated with HGS. Age, height, body mass index, number of diagnoses, and number and type of drugs have been shown to modify the association between undernutrition and HGS. Nevertheless, other patient characteristics that could modify this association and its joint modifier effect have not been studied yet. OBJECTIVE: To evaluate the association of inpatients' HGS and undernutrition considering the potential modifier effect of cognitive status, functional activity, disease severity, anthropometrics, and other patient characteristics on HGS. METHODS: A cross-sectional study was conducted in a university hospital. Sex, age, abbreviated mental test score, functional activity score, Charlson index, number of drugs, Patient-Generated Subjective Global Assessment (PG-SGA) score, body weight, mid-arm muscle circumference, adductor pollicis muscle thickness, body height, wrist circumference, hand length, and palm width were included in a linear regression model to identify independent factors associated with HGS (dependent variable). RESULTS: The study sample was composed of 688 inpatients (18-91 years old). All variables included in the model were associated with HGS (ß, -0.16 to 0.38; P ≤ .049) and explained 68.5% of HGS. Age, functional activity decline, Charlson index, number of drugs, PG-SGA score, body weight, and wrist circumference had a negative association with HGS. All other studied variables were positively associated with HGS. CONCLUSION: Nutrition status evaluated by PG-SGA was still associated with HGS after considering the joint effect of other patient characteristics, which reinforces the value of HGS as an indicator of undernutrition.

A digital calliper for training and study purposes.

A quick and valid method for evaluating percentage body fat is based on the use of skinfold callipers. However, limitations associated to their use and characteristics led the authors to improve a traditional calliper (Harpenden) and to integrate it with a software application. Such a measuring system, LipoTool, is meant to have better accuracy and reliability, including data processing and digital recording at a very low cost. At first, a sample of 49 older adults was used to evaluate the performance of LipoTool by comparing its results to those obtained with the traditional Harpenden calliper. A strong positive association in %BF was achieved. This digital sensing system was later improved by incorporating wireless communication between the calliper and the software application, adding other functionalities. The software application works in any computer and is flexible to incorporate new coming models, linear regressions or new algorithms. This new system was validated against the standard Dual-Energy X-Ray Absorptiometry system, using a sample of 40 adults with positive results. This solution is a valid and reliable alternative to traditional reference callipers, simplifying the percentage of body fat evaluation and providing a more effective use in daily practice with less expenditure of time and resources. Its implemented guided procedure turns it into a precious training tool based on a non-invasive, portable device, and not requiring special individual preparation. Ongoing activities are focused on the design of a new mechanical structure, with novel functionalities and for exploring other studies.

Olanzapine-induced weight gain in patients with bipolar I disorder: a meta-analysis.

OBJECTIVE: The weight impact produced by the atypical antipsychotic olanzapine has been explored in meta-analyses focusing on patients with schizophrenia. However, outcomes identified for schizophrenia patients cannot always be generalized to patients with bipolar disorder. This study aims to quantitatively estimate the impact of olanzapine on the weight of patients with bipolar disorder. DATA SOURCES: EMBASE, Medline, and PsycINFO were searched using the keywords olanzapine AND (bipolar OR acute mania) in conjunction with (weight gain OR weight increase) (last search: October 2010, with no restrictions on dates of publication). English language was used as a restriction. STUDY SELECTION: The search identified 110 articles for review. The inclusion criteria for the chosen studies were a diagnosis of bipolar disorder, the presence of an olanzapine monotherapy group, a comparator placebo or monotherapy group, and mean weight gain and/or incidences of weight gain data. This process identified 13 studies for inclusion. DATA EXTRACTION: The primary outcome measure was the mean weight change between olanzapine monotherapy and comparator monotherapy, reported in kilograms. Standard deviation was extracted directly from studies when possible and imputed for 3 studies. The secondary outcome measure was the reported incidences of ≥ 7% weight gain. DATA SYNTHESIS: The mean difference in weight gain was calculated for the continuous data of the primary outcome. Olanzapine monotherapy was associated with more weight gain when compared to placebo (mean difference = 2.10 kg; 95% CI, 1.16-3.05; P < .001) and other bipolar monotherapy (mean difference = 1.34 kg; 95% CI, 0.95-1.72; P < .001). Odds ratio analysis of the dichotomous secondary outcome also showed more weight gain with olanzapine monotherapy compared to placebo (odds ratio [OR] = 10.12; 95% CI, 1.93-53.14; P = .006) and other bipolar monotherapy (OR = 2.09; 95% CI, 1.27-3.44; P = .004). CONCLUSIONS: Currently available data suggest that olanzapine is associated with significant weight gain in bipolar patients. Issues related to side effect profiles and their impact on treatment compliance and physical health outcomes need to be considered when selecting pharmacotherapy.

Accuracy of a digital skinfold system for measuring skinfold thickness and estimating body fat.

The use of skinfold thickness measurements to evaluate the distribution of subcutaneous adipose tissue and to predict body fat has recognised advantages. However, the different types of skinfold calliper available present limitations that make them unattractive and perhaps less used in daily practice. The purpose of the present study was to evaluate the accuracy and functionality of a new digital skinfold system, the Liposoft 2008+Adipsmeter V0 (LA), for measuring skinfold thickness and determining body fat proportion (%BF). Skinfold thickness measurements made by the LA were compared with those obtained with a Harpenden (H) calliper from two samples of adults (n 45) and older adults (n 56) in a university-based cross-sectional study. A comparison was also conducted between estimated %BF from skinfolds and dual-energy X-ray absorptiometry. Bland and Altman plots show that skinfolds measured by the LA and H calliper are in high agreement, with a mean difference of 0·3 (95% CI -3·1, 3·4) mm. In regard to the %BF estimated from LA and H skinfolds measurement, the LA produced a similar approximation to dual-energy X-ray absorptiometry %BF, with a mean difference of 0·2 (95% CI -0·8, 1·2) %, compared with %BF obtained with the H calliper. The LA system is an accurate instrumentation and represents an innovation in the evaluation of skinfold thickness and body composition based on anthropometric measurement.