A Serious Game for Cognitive Stimulation of Older People With Mild Cognitive Impairment: Design and Pilot Usability Study.

Background: Cognitive stimulation of older people helps prevent, and even treat, age-related diseases, such as mild cognitive impairment. Playing games reduces the probability of experiencing this pathology, which is related to the loss of the ability to carry out some instrumental activities of daily living. Objective: This work describes the design and development of a serious game for the cognitive stimulation of older people, with exercises related to the daily life task of shopping. A pilot study for its preliminary usability validation is also presented. Methods: The designed serious game includes 4 exercises consisting of shopping in a hypermarket, ordering products, making payments, and organizing the purchase, thus dealing with the most frequent cognitive problems of older people associated with episodic declarative memory, naming, calculation, and organization, respectively. Results: A total of 19 older people participated in the pilot study for the usability validation of the serious game. They indicated that they like the aesthetic and interesting topic of the game. They reported that it provides a high level of entertainment and could be useful in daily life for mental stimulation. The participants found the serious game to be intuitive, but the ease of use and readability of the instructions could be improved. Conclusions: This study suggests that the innovative serious game developed could be accepted by older people for their cognitive stimulation to prevent or treat mild cognitive impairment, although a long-term intervention study should be performed as future work. Its ecological validity design, with everyday tasks, adaptable levels of difficulty, and motivational mechanisms, is a differentiating factor compared to similar serious games.

Colonic Electrical Stimulation for Chronic Constipation: A Perspective Review.

Chronic constipation affects around 20% of the population and there is no efficient solution. This perspective review explores the potential of colonic electric stimulation (CES) using neural implants and methods of bioelectronic medicine as a therapeutic way to treat chronic constipation. The review covers the neurophysiology of colonic peristaltic function, the pathophysiology of chronic constipation, the technical aspects of CES, including stimulation parameters, electrode placement, and neuromodulation target selection, as well as a comprehensive analysis of various animal models highlighting their advantages and limitations in elucidating the mechanistic insights and translational relevance for CES. Finally, the main challenges and trends in CES are discussed.

Influence of the time-task constraint on ocular metrics of semi-elite soccer players.

This study novelty aimed to investigate the influence of manipulating the available time to perform the training tasks on soccer players´ ocular metrics, following training. Specifically, pupillary response (pupil diameter) and saccadic features (latency, accuracy, velocity, and number) were measured with a portable eye tracker following training to reflect the mental load accumulated by players during the training sessions. Nine semi-elite soccer players performed two training sessions, based on large-sided games, on an artificial grass field. These two sessions were composed of the same tasks but varying the required time to complete the task goals (Session 1: No time limitations to perform the tasks; Session 2: Limited time to perform the tasks). The participants performed, before (pre-test) and after (post-test) each training session, a prosaccade task in a room near the playing field. Findings revealed a differentiated effect of the available time to complete the training tasks on ocular metrics because significant differences were found in all variables after training (p < .001 for pupil diameter; p < .01 for saccade accuracy and number of saccades; p < .05 for saccade velocity and latency). Ocular metrics could be a promising tool to evaluate mental load following practice because they were sensitive to the time-task constraint, providing researchers a valuable information for a better planning of the mental workload when designed training tasks.

Clinical Validation Benchmark Dataset and Expert Performance Baseline for Colorectal Polyp Localization Methods.

Colorectal cancer is one of the leading death causes worldwide, but, fortunately, early detection highly increases survival rates, with the adenoma detection rate being one surrogate marker for colonoscopy quality. Artificial intelligence and deep learning methods have been applied with great success to improve polyp detection and localization and, therefore, the adenoma detection rate. In this regard, a comparison with clinical experts is required to prove the added value of the systems. Nevertheless, there is no standardized comparison in a laboratory setting before their clinical validation. The ClinExpPICCOLO comprises 65 unedited endoscopic images that represent the clinical setting. They include white light imaging and narrow band imaging, with one third of the images containing a lesion but, differently to another public datasets, the lesion does not appear well-centered in the image. Together with the dataset, an expert clinical performance baseline has been established with the performance of 146 gastroenterologists, who were required to locate the lesions in the selected images. Results shows statistically significant differences between experience groups. Expert gastroenterologists' accuracy was 77.74, while sensitivity and specificity were 86.47 and 74.33, respectively. These values can be established as minimum values for a DL method before performing a clinical trial in the hospital setting.

Lapnurse-A Blended Learning Course for Nursing Education in Minimally Invasive Surgery: Design and Experts' Preliminary Validation of Its Online Theoretical Module.

BACKGROUND: The implantation of Minimally Invasive Surgery (MIS) leads to the specialization of nurses in this surgical field. However, there is no standard curriculum of MIS Nursing in Europe. Spanish and Portuguese nurses are inexperienced and have poor training in MIS. For that, a blended learning course for nursing education in MIS (Lapnurse) has been developed. This work aims to detail the course design and to preliminary validate by experts its online theoretical module. METHODS: Lapnurse consists of an online module with nine theoretical lessons and a face-to-face module with three practical lessons. The e-learning environment created to provide the online module, with didactic contents based on surgical videos and innovative 3D designs, has been validated by two technicians (functionality) and four nurses with teaching experience in MIS (usability and content). RESULTS: The E-learning platform meets all technical requirements, provides whole and updated multimedia contents correctly applied for educational purposes, incorporates interactivity with 3D designs, and has an attractive, easy-to-use and intuitive design. CONCLUSIONS: The lack of knowledge in MIS of Spanish and Portuguese nurses could be addressed by the blended learning course created, Lapnurse, where the e-learning environment that provides theoretical training has obtained a positive validation.

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis.

BACKGROUND: The high incidence and mortality rate of colorectal cancer require new technologies to improve its early diagnosis. This study aims at extracting the medical needs related to the endoscopic technology and the colonoscopy procedure currently used for colorectal cancer diagnosis, essential for designing these demanded technologies. METHODS: Semi-structured interviews and an online survey were used. RESULTS: Six endoscopists were interviewed and 103 were surveyed, obtaining the demanded needs that can be divided into: a) clinical needs, for better polyp detection and classification (especially flat polyps), location, size, margins and penetration depth; b) computer-aided diagnosis (CAD) system needs, for additional visual information supporting polyp characterization and diagnosis; and c) operational/physical needs, related to limitations of image quality, colon lighting, flexibility of the endoscope tip, and even poor bowel preparation. CONCLUSIONS: This study shows some undertaken initiatives to meet the detected medical needs and challenges to be solved. The great potential of advanced optical technologies suggests their use for a better polyp detection and classification since they provide additional functional and structural information than the currently used image enhancement technologies. The inspection of remaining tissue of diminutive polyps (< 5 mm) should be addressed to reduce recurrence rates. Few progresses have been made in estimating the infiltration depth. Detection and classification methods should be combined into one CAD system, providing visual aids over polyps for detection and displaying a Kudo-based diagnosis suggestion to assist the endoscopist on real-time decision making. Estimated size and location of polyps should also be provided. Endoscopes with 360° vision are still a challenge not met by the mechanical and optical systems developed to improve the colon inspection. Patients and healthcare providers should be trained to improve the patient's bowel preparation.

Validation of the online theoretical module of a minimally invasive surgery blended learning course for nurses: A quantitative research study.

BACKGROUND: The progressive development of Minimally Invasive Surgery (MIS) implies the need to train health professionals in such field, for which e-learning and blended learning methods are increasingly been used. Most nurses lack experience and training in MIS, so a laparoscopic blended learning course for nursing has been created. OBJECTIVES: To perform the validation of the online theoretical module of such course to evaluate student perception and satisfaction, sociability and usability metrics, and also the interest of nurses in blended learning. DESIGN: A quantitative design has been used. PARTICIPANTS: 24 nurses participated in the validation tests performing the online module of the course. METHODS: Subjective (questionnaires) and objective (performance statistics) metrics were analysed. RESULTS: The e-learning environment has ease of access, good layout, consistency and intuitive navigation. Chat and forums have not been used and nurses miss a moderator. Participants consider that videos provide added value to the course, and contents are easily understandable and of high quality. However, questionnaires are not well balanced in difficulty and few interactive 3D designs have been viewed. Participants consider blended learning as the most effective training method for its flexibility in time and place. CONCLUSIONS: This study suggests that a simple, easy-to-use and attractive e-learning environment has been developed to train nurses in MIS. However, installation of additional software should be avoided. A moderator/tutor should manage forums to encourage user participation, using conversational agents. But nevertheless, chats have no interest. Questionnaires for content evaluation should be designed with efficiency and equity. Videos designed according to micro-learning, with audio and interactivity, should be included. These courses should be designed to meet factors to promote the engagement of students. Blended learning is considered by nurses as ideal method for training, but further research to assess whether it improves learning outcomes is needed.

Efecto de las experiencias corporales sobre el patrón perceptivo y el juicio en ballet: Un estudio de casos en danza clásica / Effect of body experiences on the perceptual pattern and judgment in ballet: A cases study in classic dance / Efeito da experiência corporal no padrão perceptivo e no julgamento em ballet: um estudo de caso em dança clásica

Este estudio de casos analizó la influencia de tener experiencias corporales previas (a nivel visual, motriz y de enseñanza) en danza clásica sobre las estrategias de búsqueda visual y de juicio perceptivo. Tres participantes de danza clásica, con diferentes experiencias visuales, motrices, y de enseñanza (i.e., participante experto, participante intermedio, participante novel) percibieron nueve secuencias video-proyectadas de ballet en laboratorio. Se registró el comportamiento visual con un sistema de registro ocular (SMI EYE TRACKING GLASSES 2 WIRELESS). Tras cada ensayo, los participantes emitían un juicio sobre la calidad con que la bailarina había realizado la secuencia de movimientos. La puntuación se realizó con la planilla de observación validada en danza (Score Sheet for Performance Competence Evaluation in Dance), y posteriormente comparada con la realizada por un profesor experto de danza. Los resultados mostraron un patrón perceptivo diferenciado entre participantes, con diferencias en el número y tiempo de jme paciones en la mayoría de localizaciones corporales. La participante experta mostró un juicio perceptivo similar al profesor de danza ya que no mostraron diferencias en las puntuaciones otorgadas a las ejecuciones de la bailarina. Sin embargo, tuvo una puntuación diferente a la de la participante intermedia y novel. Tampoco hubo diferencias de puntuaciones entre la participante intermedia y novel. Las experiencias corporales previas de las participantes del estudio en danza clásica influyeron en sus estrategias visuales. Especícamente, las experiencias de enseñanza parece que aportaron un valor añadido al juicio perceptivo de la participante experta ya que su juicio fue el más similar al realizado por el profesor experto de danza

This cases study addressed the inuence of previous body (visual, motor, and teaching) experiences in classic dance on visual search strategies and perceptual judgments. Three participants of classic dance, with different visual, motor, and teaching experiences (i.e., expert-, intermediate-, and novel- participant) perceived nine video-projected sequences of ballet in a laboratory setting. The visual behaviour was collected with an eye tracking system (SMI EYE TRACKING GLASSES 2 WIRELESS). After each trial, the participants made a judgment about the quality of dancer's performance. The measure of the scores was carried out with the Score Sheet for Performance Competence Evaluation in dance, and after that compared with the scores of an expert teacher of dance. The results revealed a different perceptual pattern between participants, with differences in the number and time of fixations for the most of body locations. The expert participant showed a similar perceptual judgment to the teacher of dance because they did not reported dierences in the scores marked to the dancer's performance. However, dierent scores were found between expert participant vs intermediate and novel participants. There were no dierences between the intermediate and novel participants. The previous body experiences in classic dance constrained the participants' visual behaviour. Specifically, the teaching experiences seem to sum an added value to the expert participant' judgment because it was the most similar to the expert teacher's one

Este estudo de caso analisou a influência de ter experiências corporais anteriores (visual, motor e de ensino) em dança clásica em estratégias de busca visual e julgamento perceptivo. Três participantes de dança clássica, com diferença visual, experiencia de condução, e actividades de formação (um participante especialista, participante intermediária, participante novato) recebeu nove sequências de balé projetada com vídeo no laboratório. O comportamento visual com um sistema de registo olho (SMI EYE TRACKING GLASSES 2 WIRELESS) foi registado. Após cada ensaio, os participantes tiveram de fazer um juízo sobre aqualidade com que a dançarina tinha realizado a sequência de movimentos. A pontuação foi realizada com um formulário validado de observação (Score Sheet for Performance Competence Evaluation in Dance), e depois comparados por um professor especialista dança. Os resultados mostraram um padrão de percepção distinta entre os participantes, com ciferenças no número e tempo de Exações na maioria dos locais do corpo. O participante especialista mostrou um julgamento e professora de dança semelhante que não mostrou diferença nas pontuações dadas aos execuções do dançarino. No entanto, ele teve um pontuação diferente que a participante intermediária e novato. Houve também há dezenas diferença entre o participante intermediário e novato. As diferentes experiências corporais anteriores em dança clássica condicionado estratégias visuais dos participantes do estudo. Especificamente, as experiências de ensino na dança clássica parecem ter adicionado valor ao julgamento do participante especialista, uma vez que foi o mais parecido com o realizado pelo professor de dança especialista

Validation of the three web quality dimensions of a minimally invasive surgery e-learning platform.

INTRODUCTION: E-learning web environments, including the new TELMA platform, are increasingly being used to provide cognitive training in minimally invasive surgery (MIS) to surgeons. A complete validation of this MIS e-learning platform has been performed to determine whether it complies with the three web quality dimensions: usability, content and functionality. METHODS: 21 Surgeons participated in the validation trials. They performed a set of tasks in the TELMA platform, where an e-MIS validity approach was followed. Subjective (questionnaires and checklists) and objective (web analytics) metrics were analysed to achieve the complete validation of usability, content and functionality. RESULTS: The TELMA platform allowed access to didactic content with easy and intuitive navigation. Surgeons performed all tasks with a close-to-ideal number of clicks and amount of time. They considered the design of the website to be consistent (95.24%), organised (90.48%) and attractive (85.71%). Moreover, they gave the content a high score (4.06 out of 5) and considered it adequate for teaching purposes. The surgeons scored the professional language and content (4.35), logo (4.24) and recommendations (4.20) the highest. Regarding functionality, the TELMA platform received an acceptance of 95.24% for navigation and 90.48% for interactivity. CONCLUSIONS: According to the study, it seems that TELMA had an attractive design, innovative content and interactive navigation, which are three key features of an e-learning platform. TELMA successfully met the three criteria necessary for consideration as a website of quality by achieving more than 70% of agreements regarding all usability, content and functionality items validated; this constitutes a preliminary requirement for an effective e-learning platform. However, the content completeness, authoring tool and registration process required improvement. Finally, the e-MIS validity methodology used to measure the three dimensions of web quality in this work can be applied to other clinical areas or training fields.