Depression and Anxiety in Pediatric Patients with Beckwith-Wiedemann Syndrome: A Pilot Study.

The study's aim was to determine the prevalence of depression and anxiety in children with Beckwith-Wiedemann syndrome (BWS) and their effects on social relationships and family acceptance. The Pediatric Symptom Checklist-35 items (PSC-35), Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Vineland Adaptive Behavior Scale Second Edition (VABS-II) were administered to the children. The parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and Zarit Burden Inventory (ZBI) were administered to parents. In total, 6 patients and 10 parents were included. Patients showed a significant presence of internalizing behavior in PSC-35 (mean, 7.66 ± 3.67), anxiety symptoms (SCARED: mean, 46.33 ± 17.50) and socialization difficulties (mean, 90.83 ± 10.09). Parents reported a perceived good acceptance (mean, 56.33 ± 1.03) and a moderate control (mean, 24.17 ± 1.83), but the burden level was ranked moderate to severe (mean, 59.33 ± 16.78). It was found that the severity of the burden level reported by parents was related to internalizing behavior (OR = 2.000; 95% CI = 0.479-3.521; p = 0.022) and anxiety symptoms (SCARED total score: OR = 3.000; 95% CI = 1.479-4.521; p = 0.005) of children. During psychological counseling in the context of BWS treatment, it is important to identify specific resources that can support patients and families in dealing with stress and identify any critical areas that could hinder the adaptation process.

Awake Craniotomy in Conscious Sedation: The Role of A2 Agonists.

BACKGROUND: In Awake Craniotomy (AC), α2-agonists and remifentanil (clonidine and dexmedetomidine) are used in the preoperative phase and throughout the procedure to combine monitored anesthesia care and local anesthesia. The study aims were to specify the key role of α2-agonists administered and to evaluate complication presence/absence in anesthesiologic management. METHODS: 42 patients undergoing AC in 3 different centers in the south of Italy (Foggia, San Giovanni Rotondo, and Bari) were recruited. Our protocol involves analgo-sedation by administering Dexmedetomidine and Remifentanil in continuous intravenous infusion, allowing the patient to be sedated and in comfort but contactable and spontaneously breathing. During pre-surgery, the patient is premedicated with intramuscular clonidine (2 µg/kg). In the operating setting, Dexmedetomidine in infusion and Remifentanil in Target Controlled Infusion for effect are started. At the end of the surgical procedure, the infusion of drugs was suspended. RESULTS: There were no intraoperative side effects. The mean duration of interventions was 240 ± 62 min. The average quantity of Remifentanil and Dexmedetomidine infused during interventions were 4.2 ± 1.3 mg and 1.0 ± 0.3 mg, respectively. No significant side effects were described in the post-operative phase. A total of 86% of patients and 93% of surgeons were totally satisfied. CONCLUSIONS: Synergy between opioid drugs and α2 agonists plays a fundamental role in ensuring procedure success.

The Role of Coherent Robot Behavior and Embodiment in Emotion Perception and Recognition During Human-Robot Interaction: Experimental Study.

BACKGROUND: Social robots are becoming increasingly important as companions in our daily lives. Consequently, humans expect to interact with them using the same mental models applied to human-human interactions, including the use of cospeech gestures. Research efforts have been devoted to understanding users' needs and developing robot's behavioral models that can perceive the user state and properly plan a reaction. Despite the efforts made, some challenges regarding the effect of robot embodiment and behavior in the perception of emotions remain open. OBJECTIVE: The aim of this study is dual. First, it aims to assess the role of the robot's cospeech gestures and embodiment in the user's perceived emotions in terms of valence (stimulus pleasantness), arousal (intensity of evoked emotion), and dominance (degree of control exerted by the stimulus). Second, it aims to evaluate the robot's accuracy in identifying positive, negative, and neutral emotions displayed by interacting humans using 3 supervised machine learning algorithms: support vector machine, random forest, and K-nearest neighbor. METHODS: Pepper robot was used to elicit the 3 emotions in humans using a set of 60 images retrieved from a standardized database. In particular, 2 experimental conditions for emotion elicitation were performed with Pepper robot: with a static behavior or with a robot that expresses coherent (COH) cospeech behavior. Furthermore, to evaluate the role of the robot embodiment, the third elicitation was performed by asking the participant to interact with a PC, where a graphical interface showed the same images. Each participant was requested to undergo only 1 of the 3 experimental conditions. RESULTS: A total of 60 participants were recruited for this study, 20 for each experimental condition for a total of 3600 interactions. The results showed significant differences (P<.05) in valence, arousal, and dominance when stimulated with the Pepper robot behaving COH with respect to the PC condition, thus underlying the importance of the robot's nonverbal communication and embodiment. A higher valence score was obtained for the elicitation of the robot (COH and robot with static behavior) with respect to the PC. For emotion recognition, the K-nearest neighbor classifiers achieved the best accuracy results. In particular, the COH modality achieved the highest level of accuracy (0.97) when compared with the static behavior and PC elicitations (0.88 and 0.94, respectively). CONCLUSIONS: The results suggest that the use of multimodal communication channels, such as cospeech and visual channels, as in the COH modality, may improve the recognition accuracy of the user's emotional state and can reinforce the perceived emotion. Future studies should investigate the effect of age, culture, and cognitive profile on the emotion perception and recognition going beyond the limitation of this work.

Stay cognitively and socially active with me: a six-month study of a socialization service.

50% of older adults over 60 years old are experiencing social isolation. Assistive technology can provide solutions that promote the connection with their families and other stakeholders. In this context, this paper presents a pilot study of a socialization service with 3 functions tested by 10 older adults and 10 informal caregivers. After a short training, participants were requested to use the system in their daily life for six months. At the beginning (T0) and at the end (T6) of the trial, qualitative structured questionnaires were addressed to investigate training, usability, acceptance (i.e. trust, anxiety, facilitating condition, enjoyment, and attitude), and user experience. Collected results underline good training, good usability of the system (SUS>68), and user experience for both groups. Furthermore, the values associated with acceptance domains are higher than 3.5 for intention to use and trust, at the end of the tests. We can observe a decreasing trend in stress associated with technology use. Informal caregivers have a higher evaluation of the system novelty with respect to older adults. Overall, qualitative feedback collected remarked the good impression of this service among the study's participants. Finally, this study represents a promising starting point for better investigating technology-based services that can improve the quality of life of older people living alone providing them with tools that can decrease their social isolation.Clinical Relevance- The results suggest the potential use of this type of service for promoting socialization among older adults thus reducing their loneliness.

Assessing Feasibility of Cognitive Impairment Testing Using Social Robotic Technology Augmented with Affective Computing and Emotional State Detection Systems.

Social robots represent a valid opportunity to manage the diagnosis, treatment, care, and support of older people with dementia. The aim of this study is to validate the Mini-Mental State Examination (MMSE) test administered by the Pepper robot equipped with systems to detect psychophysical and emotional states in older patients. Our main result is that the Pepper robot is capable of administering the MMSE and that cognitive status is not a determinant in the effective use of a social robot. People with mild cognitive impairment appreciate the robot, as it interacts with them. Acceptability does not relate strictly to the user experience, but the willingness to interact with the robot is an important variable for engagement. We demonstrate the feasibility of a novel approach that, in the future, could lead to more natural human-machine interaction when delivering cognitive tests with the aid of a social robot and a Computational Psychophysiology Module (CPM).

Evaluating the Use of a Robot in a Hematological Intensive Care Unit: A Pilot Study.

The aim of the SYRIACA project was to test the capability of a social robot to perform specific tasks in healthcare settings, reducing infection risks for patients and caregivers. The robot was piloted in an Intensive Hematological Unit, where the patients' and healthcare operators' acceptability of the robot was evaluated. The robot's functions, including logistics, surveillance, entertainment, and remote visits, were well accepted. Patients expressed interest in having multiple interactions with the robot, which testifies to its engaging potential and that it provides useful services. During remote visits, the robot reduced perceived stress among patients, alleviating feelings of isolation. The successful implementation of the robot suggests its potential to enhance safety and well-being in healthcare settings.

Perioperative Management of a Pediatric Patient with Beckwith-Wiedemann Syndrome Undergoing a Partial Glossectomy According to Egyedi/Obwegeser.

Here, we report the perioperative management of a clinical case of a 6 year, 5 month old girl suffering from Beckwith-Wiedemann syndrome undergoing a partial glossectomy procedure in a patient with surgical indication for obstructive sleep apnea syndrome (OSAS), difficulty swallowing, feeding, and speech. On surgery day, Clonidine (4 µg/kg) was administered. Following this, a general anesthesia induction was performed by administering Sevoflurane, Fentanyl, continuous intravenous Remifentanil, and lidocaine to the vocal cords, and a rhinotracheal intubation with a size 4.5 tube was carried out. Before starting the procedure, a block of the Lingual Nerve was performed with Levobupivacaine. Analgosedation was maintained with 3% Sevoflurane in air and oxygen (FiO2 of 40%) and Remifentanil in continuous intravenous infusion at a rate of 0.08-0.15 µg/kg/min. The surgical procedure lasted 2 h and 32 min. At the end of the surgery, the patient was under close observation during the first 72 h. In the pediatric patient with Beckwith-Wiedemann syndrome submitted to major maxillofacial surgery, the difficulty in managing the airways in the preoperative phase during intubation and in the post-operative phase during extubation should be considered.

Real-Time Neuropsychological Testing (RTNT) and Music Listening during Glioblastoma Excision in Awake Surgery: A Case Report.

In this case report, real-time neuropsychological testing (RTNT) and music listening were applied for resections in the left temporal-parietal lobe during awake surgery (AS). The case is based on a 66-year-old with glioblastoma and alterations in expressive language and memory deficit. Neuropsychological assessment was run at baseline (2-3 days before surgery), discharge from hospital (2-3 days after surgery), and follow-up (1 month and 3 months). RTNT was started before beginning the anesthetic approach (T0) and during tumor excision (T1 and T2). At T0, T1, and T2 (before performing neuropsychological tests), music listening was applied. Before AS and after music listening, the patient reported a decrease in depression and anxiety. During AS, an improvement was shown in all cognitive parameters collected at T0, T1, and T2. After the excision and music listening, the patient reported a further decrease in depression and anxiety. Three days post surgery, and at follow-ups of one month and three months, the patient reported a further improvement in cognitive aspects, the absence of depression, and a reduction in anxiety symptoms. In conclusion, RTNT has been useful in detecting cognitive function levels during tumor excision. Music listening during AS decreased the patient's anxiety and depression symptoms.

Anesthetic Management for Awake Craniotomy Applied to Neurosurgery.

Our anesthetic technique proposed for awake craniotomy is the monitored anesthesia care (MAC) technique, with the patient in sedation throughout the intervention. Our protocol involves analgo-sedation through the administration of dexmedetomidine and remifentanil in a continuous intravenous infusion, allowing the patient to be sedated and in comfort, but contactable and spontaneously breathing. Pre-surgery, the patient is pre-medicated with intramuscular clonidine (2 µg/kg); it acts both as an anxiolytic and as an adjuvant in pain management and improves hemodynamic stability. In the operating setting, dexmedetomidine in infusion and remifentanil in target controlled infusion (TCI) for effect are started. The purpose of the association is to exploit the pharmacodynamics of dexmedetomidine which guarantees the control of respiratory drive, and the pharmacokinetics of remifentanil characterized by insensitivity to the drug. Post-operative management: at the end of the surgical procedure, the infusion of drugs was suspended. Wake-up craniotomy is associated with reduced hospital costs compared to craniotomy performed in general anesthesia, mainly due to reduced costs in the operating room and shorter hospital stays. Greater patient satisfaction and the benefits of avoiding hospital stay have led to the evolution of outpatient intracranial neurosurgery.

Vascular Schizophrenia-like Psychosis in Older Adults.

BACKGROUND: The aims of this study were to analyze prevalence and severity of vascular risk factors in older patients referred to our clinic due to onset of Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP) and to create a specific phenotype based on pathophysiological insight rather than age of onset. METHODS: In a longitudinal study, 103 (M = 39, F = 64; mean age of 80.32 ± 7.65 years) patients were evaluated with cognitive, neuropsychiatric, and functional assessment scales. Blood concentration of hemoglobin (Hb), mean corpuscular volume (MCV), platelets, total protein test (TPT), creatinine, azotemia, glycemia, total cholesterol (TC), triglycerides (TG), uric acid (UA), sodium (Na), potassium (K), chlorine (Cl), calcium (Ca), folate, vitamin B12 (Vit-B12), and homocysteine were measured. Presence/absence of tobacco use, alcohol consumption, psychoactive substance use, hypertension, hyperlipidemia, diabetes mellitus, and history of vascular disease were collected. RESULTS: Females were more apathetic than males (NPI-Apathy: p = 0.040). Males had a significantly higher level of Hb (p = 0.019) and UA (p = 0.001), and a lower level of platelets (p = 0.004) and Ca (p = 0.003), and used more tobacco (p = 0.046) and alcohol (p = 0.024) than females. Comparing patients < 80 and ≥80 years, we found differences in frequency of vascular risk factors among men (p = 0.027). In total, 102 patients were treated for psychosis (59.16% of them were using atypical antipsychotics). CONCLUSIONS: The results of this study could be useful for a progressive demonstration of the causal relationship between cardiac and cerebral vascular events and VLOSLP.

Assistive Robots for Healthcare and Human-Robot Interaction.

Assistive robots are still mostly prototypes that only remotely recall human interactive dynamics [...].

Design and Evaluation of Personalized Services to Foster Active Aging: The Experience of Technology Pre-Validation in Italian Pilots.

Assistive devices could promote independent living and support the active and healthy aging of an older population; however, several factors can badly influence the long-term use of new technologies. In this context, this paper presents a two-step methodology called "pre-validation" that aims to identify the factors that can bias the use of new services, thus minimizing the risk of an unsuccessful longer trial. The proposed pre-validation methodology is composed of two main phases that aim to assess the usability and the reliability of the technology assessed in a laboratory environment and the usability, acceptability, user experience, and reliability of the technology in real environments. The tested services include the socialization scenario, in which older adults are better connected to the community via technological solutions (i.e., socialization applications), and the monitoring scenario, which allows for the introduction of timely interventions (technologies involved include environmental monitoring sensors, a telepresence robot, wearable sensors, and a personalized dashboard). The obtained results underline an acceptable usability level (average System Usability Scale score > 65) for the tested technologies (i.e., socialization applications and a telepresence robot). Phase Two also underlines the good acceptability, user experience, and usability of the tested services. The statistical analysis underlines a correlation between the stress related to the use of technology, digital skills, and intention of use, among other factors. Qualitative feedback also remarks on a correlation between older adults with low digital skills and an anxiety about using technology. Positive correlation indexes were highlighted between the trust and usability scores. Eventually, future long-term trials with assistive technology should rely on motivated caregivers, be founded on a strong recruitment process, and should reassure older adults­especially the ones with low digital literacy­about the use of technology by proposing personalized training and mentoring, if necessary, to increase the trust.

User Profiling to Enhance Clinical Assessment and Human-Robot Interaction: A Feasibility Study.

Socially Assistive Robots (SARs) are designed to support us in our daily life as a companion, and assistance but also to support the caregivers' work. SARs should show personalized and human-like behavior to improve their acceptance and, consequently, their use. Additionally, they should be trustworthy by caregivers and professionals to be used as support for their work (e.g. objective assessment, decision support tools). In this context the aim of the paper is dual. Firstly, this paper aims to present and discuss the robot behavioral model based on sensing, perception, decision support, and interaction modules. The novel idea behind the proposed model is to extract and use the same multimodal features set for two purposes: (i) to profile the user, so to be used by the caregiver as a decision support tool for the assessment and monitoring of the patient; (ii) to fine-tune the human-robot interaction if they can be correlated to the social cues. Secondly, this paper aims to test in a real environment the proposed model using a SAR robot, namely ASTRO. Particularly, it measures the body posture, the gait cycle, and the handgrip strength during the walking support task. Those collected data were analyzed to assess the clinical profile and to fine-tune the physical interaction. Ten older people (65.2 ± 15.6 years) were enrolled for this study and were asked to walk with ASTRO at their normal speed for 10 m. The obtained results underline a good estimation (p < 0.05) of gait parameters, handgrip strength, and angular excursion of the torso with respect to most used instruments. Additionally, the sensory outputs were combined in the perceptual model to profile the user using non-classical and unsupervised techniques for dimensionality reduction namely T-distributed Stochastic Neighbor Embedding (t-SNE) and non-classic multidimensional scaling (nMDS). Indeed, these methods can group the participants according to their residual walking abilities.

Knowledge Engineering Framework for IoT Robotics Applied to Smart Healthcare and Emotional Well-Being.

Social companion robots are getting more attention to assist elderly people to stay independent at home and to decrease their social isolation. When developing solutions, one remaining challenge is to design the right applications that are usable by elderly people. For this purpose, co-creation methodologies involving multiple stakeholders and a multidisciplinary researcher team (e.g., elderly people, medical professionals, and computer scientists such as roboticists or IoT engineers) are designed within the ACCRA (Agile Co-Creation of Robots for Ageing) project. This paper will address this research question: How can Internet of Robotic Things (IoRT) technology and co-creation methodologies help to design emotional-based robotic applications? This is supported by the ACCRA project that develops advanced social robots to support active and healthy ageing, co-created by various stakeholders such as ageing people and physicians. We demonstra this with three robots, Buddy, ASTRO, and RoboHon, used for daily life, mobility, and conversation. The three robots understand and convey emotions in real-time using the Internet of Things and Artificial Intelligence technologies (e.g., knowledge-based reasoning).

On the Use of Assistive Technology during the COVID-19 Outbreak: Results and Lessons Learned from Pilot Studies.

As a consequence of the COVID-19 emergency, frail citizens felt isolated because of social isolation, suspended and/or strongly reduced home assistance, and limited access to hospitals. In this sense, assistive technology could play a pivotal role in empowering frail older adults reducing their isolation, as well as in reinforcing the work of formal caregivers and professionals. In this context, the goal of this paper is to present four pilot studies-conducted from March 2020 to April 2021-to promptly react to COVID-19 by providing assistive technology solutions, aiming to (1) guarantee high-quality service to older adults in-home or in residential facility contexts, (2) promote social inclusion, and (3) reduce the virus transmission. In particular, four services, namely, telepresence service, remote monitoring service, virtual visit, and environmental disinfection, were designed, implemented, and tested in real environments involving 85 end-users to assess the user experience and/or preliminary assess the technical feasibility. The results underlined that all the proposed services were generally accepted by older adults and professionals. Additionally, the results remarked that the use of telepresence robots in private homes and residential facilities increased enjoyment reducing anxiety, whereas the monitoring service supported the clinicians in monitoring the discharged COVID-19 patients. It is also worth mentioning that two new services/products were developed to disinfect the environment and to allow virtual visits within the framework of a hospital information system. The virtual visits service offered the opportunity to expand the portfolio of hospital services. The main barriers were found in education, technology interoperability, and ethical/legal/privacy compliance. It is also worth mentioning the key role played by an appropriate design and customer needs analysis since not all assistive devices were designed for older persons.

CT-Detected MTA Score Related to Disability and Behavior in Older People with Cognitive Impairment.

Our study aims to investigate the relationship between medial temporal lobe atrophy (MTA) score, assessed by computed tomography (CT) scans, and functional impairment, cognitive deficit, and psycho-behavioral disorder severity. Overall, 239 (M = 92, F = 147; mean age of 79.3 ± 6.8 years) patients were evaluated with cognitive, neuropsychiatric, affective, and functional assessment scales. MTA was evaluated from 0 (no atrophy) to 4 (severe atrophy). The homocysteine serum was set to two levels: between 0 and 10 µmol/L, and >10 µmol/L. The cholesterol and glycemia blood concentrations were measured. Hypertension and atrial fibrillation presence/absence were collected. A total of 14 patients were MTA 0, 44 patients were MTA 1, 63 patients were MTA 2, 79 patients were MTA 3, and 39 patients were MTA 4. Cognitive (p < 0.0001) and functional (p < 0.0001) parameters decreased according to the MTA severity. According to the diagnosis distribution, AD patient percentages increased by MTA severity (p < 0.0001). In addition, the homocysteine levels increased according to MTA severity (p < 0.0001). Depression (p < 0.0001) and anxiety (p = 0.001) increased according to MTA severity. This study encourages and supports the potential role of MTA score and CT scan in the field of neurodegenerative disorder research and diagnosis.

Psychological Interventions in a Pandemic Emergency: A Systematic Review and Meta-Analysis of SARS-CoV-2 Studies.

Background: The study aim was to review the evidence and effectiveness of psychological interventions applied during Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. Methods: A literature search was run from April 2020 to April 2021. The inclusion criteria were: (1) RCTs or observational studies; (2) professional health carers and patients who had contracted coronavirus during the pandemic; (3) adults and elderly people with a viral infection diagnosis; (4) suitable measures to assess intervention effectiveness on clinical status and psychological and behavioral aspects. An internal validity assessment was planned using robvis. Data were synthesized according to PICO criteria. Results: A total of 12 studies were selected. Studies measuring mental health outcomes demonstrated the greatest reduction in symptoms, with eight out of the twelve studies demonstrating a reduction in symptoms that reached statistical significance (p < 0.05) and four of the studies reaching a higher significance level of p < 0.01. The type of psychological intervention was predominantly cognitive behavioral therapy (CBT). All studies except one was run online. Conclusion: Psychological interventions have a benefit on mental health outcomes, even if performed online. In particular, CBT seems to be the psychological intervention that is used more and also seems to have a larger effect size on the mitigation of mental health symptoms and increasing resilience.

Internet-Based Psychological Interventions during SARS-CoV-2 Pandemic: An Experience in South of Italy.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led to an increasing demand for online psychological intervention. The aim of this study is to evaluate the efficacy of received support in internet-based psychological intervention group (I-IG) patients, compared with a wait-list control group (CG). The Impact of Event Scale­Revised, Patient Health Questionnaire 9-item and Generalized Anxiety Disorder scale 7-item were administered. After participants had used the internet-based solution, the System Usability Scale was administered. In total, 221 patients (194 patients supported by internet-based interventions and 27 patients supported onsite) were included in intervention group, and 194 patients were included in CG. In a 6-month follow-up, participants in the I-IG demonstrated significant improvements in terms of PTSD risk (p < 0.0001, d = 0.64), depression (p < 0.0001, d = 0.68), and anxiety (p < 0.0001, d = 1.33), compared to the CG. Significant improvements in onsite intervention group patients with a large to very large effect size of PTSD risk (p < 0.0001, d = 0.91), depression (p < 0.0001, d = 0.81), and anxiety (p < 0.0001, d = 1.62) were found. After internet-based solution use, I-IG patients reported a very high usability and functionality (72.87 ± 13.11) of online intervention. In conclusion, SARS-CoV-2-related mental health problems can be improved by internet-based psychological intervention. The usability and functionality evaluation of online solutions by technological tools showed very positive results for the I-IG patients.

Emotion Recognizing by a Robotic Solution Initiative (EMOTIVE Project).

BACKGROUND: Emotion recognition skills are predicted to be fundamental features in social robots. Since facial detection and recognition algorithms are compute-intensive operations, it needs to identify methods that can parallelize the algorithmic operations for large-scale information exchange in real time. The study aims were to identify if traditional machine learning algorithms could be used to assess every user emotions separately, to relate emotion recognizing in two robotic modalities: static or motion robot, and to evaluate the acceptability and usability of assistive robot from an end-user point of view. METHODS: Twenty-seven hospital employees (M = 12; F = 15) were recruited to perform the experiment showing 60 positive, negative, or neutral images selected in the International Affective Picture System (IAPS) database. The experiment was performed with the Pepper robot. Concerning experimental phase with Pepper in active mode, a concordant mimicry was programmed based on types of images (positive, negative, and neutral). During the experimentation, the images were shown by a tablet on robot chest and a web interface lasting 7 s for each slide. For each image, the participants were asked to perform a subjective assessment of the perceived emotional experience using the Self-Assessment Manikin (SAM). After participants used robotic solution, Almere model questionnaire (AMQ) and system usability scale (SUS) were administered to assess acceptability, usability, and functionality of robotic solution. Analysis wasperformed on video recordings. The evaluation of three types of attitude (positive, negative, andneutral) wasperformed through two classification algorithms of machine learning: k-nearest neighbors (KNN) and random forest (RF). RESULTS: According to the analysis of emotions performed on the recorded videos, RF algorithm performance wasbetter in terms of accuracy (mean ± sd = 0.98 ± 0.01) and execution time (mean ± sd = 5.73 ± 0.86 s) than KNN algorithm. By RF algorithm, all neutral, positive and negative attitudes had an equal and high precision (mean = 0.98) and F-measure (mean = 0.98). Most of the participants confirmed a high level of usability and acceptability of the robotic solution. CONCLUSIONS: RF algorithm performance was better in terms of accuracy and execution time than KNN algorithm. The robot was not a disturbing factor in the arousal of emotions.

Involving Older Adults During COVID-19 Restrictions in Developing an Ecosystem Supporting Active Aging: Overview of Alternative Elicitation Methods and Common Requirements From Five European Countries.

Background: Information and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults. Methods: Originally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals. Results: Different elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and (semi-)virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were "Monitor health," "Receive advice," "Receive information." "Easy to use/comfortable," "personalized/tailored," "automatic/smart" were identified as most prevalent quality goals. Most frequently occurring emotional goals were "involved," "empowered," and "informed." Conclusion: There are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes.