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.

Estimation of the diagnostic accuracy of clinical parameters for monitoring peri-implantitis progression: An experimental canine study.

BACKGROUND: Lack of consensus on the clinical parameters of peri-implantitis may complicate accurate diagnosis of the disorder. Furthermore, the lack of reliable estimates of the diagnostic capacity of the clinical endpoints precludes the definition of an effective treatment protocol for peri-implantitis. The present canine study assesses the diagnostic accuracy of the clinical parameters for monitoring the peri-implant tissues in a controlled ligature-induced peri-implantitis model followed by a spontaneous progression phase. METHODS: Six beagle dogs were followed-up on during three episodes of ligature-induced peri-implantitis and a further episode of spontaneous progression. Probing depth (PD), bleeding on probing (BOP), mucosal recession (MR), and suppuration (SUP) were recorded at four sites per implant and at four study timepoints. Moreover, the implant mucosal index (IMI) was calculated at implant level. Marginal bone loss (MBL) was determined using computed tomography at four sites per implant. A linear regression model was used to estimate clinical and radiological parameters during peri-implantitis progression. RESULTS: Progressive peri-implant bone loss is characterized by an increase in PD, more profuse BOP, MR, and SUP in advanced cases (p < 0.001). However, even in the presence of severe bone loss, SUP was not a common finding, with an incidence of approximately 10% at the last timepoint. These clinical parameters were significantly correlated to MBL at most of the timepoints. The IMI, in turn, showed a positive correlation to MBL and the peri-implant inflammatory signs (r = 0.39; p < 0.001), with a tendency to exhibit higher scores during ligature-induced peri-implantitis, followed by a slight decrease during the spontaneous progression period. CONCLUSION: The clinical features of peri-implantitis and spontaneous progression of the disorder may facilitate an accurate monitoring of peri-implant pathologic bone loss.

Construct and face validity of SINERGIA laparoscopic virtual reality simulator.

PURPOSE: Laparoscopic techniques have nowadays become a gold standard in many surgical procedures, but they imply a more difficult learning skills process. Simulators have a fundamental role in the formative stage of new surgeons. This paper presents the construct and face validity of SINERGIA laparoscopic virtual reality simulator in order to decide whether it can be considered as an assessment tool. METHODS: Twenty people participated in this study, 14 were novices and 6 were experts. Five tasks of SINERGIA were included in the study: coordination, navigation, navigation and touch, precise grasping and coordinate traction. For each one of these tasks, a certain number of metrics are automatically recorded. All subjects accomplished each task only once and filled in two questionnaires. A statistical analysis was made and results from both groups were compared with the Mann-Whitney U-test, considering significant differences when P < or = 0.05. Internal consistency of the system has been analyzed with the Cronbach's alpha test. RESULTS: Novices and experts positively rated SINERGIA characteristics. At least one of the evaluated metrics of each exercise presented significant differences between both groups. Nevertheless, all metrics under study gave a better punctuation to the executions accomplished by experts (lower time, higher efficiency, fewer errors. . .) than to those made by novices. CONCLUSION: SINERGIA laparoscopic virtual reality simulator is able to discriminate subjects according to their level of experience in laparoscopic surgery; therefore, it can be used within a training program as an assessment tool.