Feasibility of Heart Rate and Respiratory Rate Estimation by Inertial Sensors Embedded in a Virtual Reality Headset.

Virtual reality (VR) headsets, with embedded micro-electromechanical systems, have the potential to assess the mechanical heart's functionality and respiratory activity in a non-intrusive way and without additional sensors by utilizing the ballistocardiographic principle. To test the feasibility of this approach for opportunistic physiological monitoring, thirty healthy volunteers were studied at rest in different body postures (sitting (SIT), standing (STAND) and supine (SUP)) while accelerometric and gyroscope data were recorded for 30 s using a VR headset (Oculus Go, Oculus, Microsoft, USA) simultaneously with a 1-lead electrocardiogram (ECG) signal for mean heart rate (HR) estimation. In addition, longer VR acquisitions (50 s) were performed under controlled breathing in the same three postures to estimate the respiratory rate (RESP). Three frequency-based methods were evaluated to extract from the power spectral density the corresponding frequency. By the obtained results, the gyroscope outperformed the accelerometer in terms of accuracy with the gold standard. As regards HR estimation, the best results were obtained in SIT, with Rs2 (95% confidence interval) = 0.91 (0.81-0.96) and bias (95% Limits of Agreement) -1.6 (5.4) bpm, followed by STAND, with Rs2= 0.81 (0.64-0.91) and -1.7 (11.6) bpm, and SUP, with Rs2 = 0.44 (0.15-0.68) and 0.2 (19.4) bpm. For RESP rate estimation, SUP showed the best feasibility (98%) to obtain a reliable value from each gyroscope axis, leading to the identification of the transversal direction as the one containing the largest breathing information. These results provided evidence of the feasibility of the proposed approach with a degree of performance and feasibility dependent on the posture of the subject, under the conditions of keeping the head still, setting the grounds for future studies in real-world applications of HR and RESP rate measurement through VR headsets.

Integrated Method for Personal Thermal Comfort Assessment and Optimization through Users' Feedback, IoT and Machine Learning: A Case Study †.

Thermal comfort has become a topic issue in building performance assessment as well as energy efficiency. Three methods are mainly recognized for its assessment. Two of them based on standardized methodologies, face the problem by considering the indoor environment in steady-state conditions (PMV and PPD) and users as active subjects whose thermal perception is influenced by outdoor climatic conditions (adaptive approach). The latter method is the starting point to investigate thermal comfort from an overall perspective by considering endogenous variables besides the traditional physical and environmental ones. Following this perspective, the paper describes the results of an in-field investigation of thermal conditions through the use of nearable and wearable solutions, parametric models and machine learning techniques. The aim of the research is the exploration of the reliability of IoT-based solutions combined with advanced algorithms, in order to create a replicable framework for the assessment and improvement of user thermal satisfaction. For this purpose, an experimental test in real offices was carried out involving eight workers. Parametric models are applied for the assessment of thermal comfort; IoT solutions are used to monitor the environmental variables and the users' parameters; the machine learning CART method allows to predict the users' profile and the thermal comfort perception respect to the indoor environment.

DUALarm: An open-source and 3D-printable device for upper limb neurorehabilitation.

Positively advocating that low-cost additive 3D-printing technologies and open-source licensed software/hardware platforms represent an optimal solution to realize low-cost equipment, a mechanical and 3D-printable device for bilateral upper-limb rehabilitation is presented. The design and manufacturing process of this wheel-geared mechanism, enabling in-phase and anti-phase movements, will be openly provided online with the aim of making a set of customizable devices for neurorehabilitation exploitable all over the world even by people/countries with limited economical and technological resources. In order to characterize the interaction with the device, preliminary trials with EMG and kinematics recordings were performed on healthy subjects.

A construção da postura profissional para o encontro terapêutico / The construction of professional stance for the therapeutical meeting

A partir da vivência de atendimentos terapêuticos com equipe reflexiva baseados na teoria construcionista social e de práticas colaborativas, pudemos experimentar a construção e transformação de nossas posturas profissionais para a conversação terapêutica com pessoas e famílias que buscam nossos serviços. Este artigo traz o apanhado teórico com o qual dialogamos para fundamentar a prática que vivemos com nossos clientes. Em seguida selecionamos momentos transformadores destes atendimentos para compartilhar inovações e inspirações da prática clínica.(AU)

From the experience of therapeutic processes with reflective teams based in the social constructionism theory and collaborative practices, facilitated by a group of psychologists, we could experience the construction and transformation of our professional stances for the therapeutical conversation with persons and families that seek our services. This article presents the theory wich we invited to dialogue and support the practice we experienced with our clients. Furthermore we selected transformational moments of these sessions to share the innovations and inspirations of the clinical practice.(AU)

Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management.

BACKGROUND: Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several hospitals throughout the region provide primary treatment for these patients and it is well know that treatment quality is correlated to the hospital that delivers. The aim of this study was to investigate the management and treatment of EOC in a Region of the North Italy (Emilia-Romagna, Italy). METHODS: A multidisciplinary group made up of 11 physicians and 3 biostatisticians was formed in 2009 to perform clinical audits in order to identify quality indicators and to develop Region-wide workup in accordance with the principles of evidence-based medicine (EBM). The rationale was that, by setting up an oncogynecology network so as to achieve the best clinical practice, critical points would decrease or even be eliminated. Analysis of cases was based on the review of the medical records. RESULTS: 614 EOC patients treated between 2007 and 2008 were identified. We found only 2 high-volume hospitals (≥ 21 patients/year), 3 medium-volume hospitals (11-20 operated patients/year), and 7 low-volume hospitals (≤ 10 operated patients /year). Only 222 patients (76.3%) had a histological diagnosis, FIGO surgical staging was reported only in 206 patients (70.9%) but not all standard surgical procedures were always performed, residual disease were not reported in all patients. No standard number of neoadjuvant chemotherapy cycles was observed. CONCLUSIONS: The differences in terms of treatments provided led the multidisciplinary group to identify reference centers, to promote centralization, to ensure uniform and adequate treatment to patients treated in regional centers and to promote a new audit involving all regional hospitals to a complete review of the all the EOC patients.

Incidence and management of late postsurgical seizures in clinical practice.

AIM: Seizures are a frequent complication in patients who undergo neurosurgery, and can complicate the post-operative course and deteriorate patients' quality of life. Evidence on the prophylactic anticonvulsant therapy after craniotomy is still lacking. MATERIAL AND METHODS: We undertook an observational longitudinal study following neurosurgical supratentorial interventions, to evaluate seizures onset or persistence, and differences in effectiveness between conventional and newer AEDs. RESULTS: A total of 100 consecutive subjects were enrolled. Each patient underwent a neurosurgical treatment by craniotomy. Pre-operative seizures occurred in 33% patients, early seizures in 13%. Late seizures occurred in 46 patients. At baseline (1 month after surgery) and during follow up the main therapeutic regimen was monotherapy. At last follow up adjustment of antiepileptic regimen or AED dosage had rendered 27 subjects seizure free. People taking newer AEDs at baseline maintain the same antiepileptic regimen more often than patients taking conventional AEDs; late seizures tended to have a higher incidence in the latter group. Adverse events from baseline AEDs were reported by 17% of patients. CONCLUSION: In this study population late postsurgical seizures had a remarkable occurrence. Newer AEDs were continued more often than conventional AEDs, with a better tolerability but no significant differences in late seizures incidence.