A Novel Metric for Alzheimer's Disease Detection Based on Brain Complexity Analysis via Multiscale Fuzzy Entropy.

Alzheimer's disease (AD) is a neurodegenerative brain disorder that affects cognitive functioning and memory. Current diagnostic tools, including neuroimaging techniques and cognitive questionnaires, present limitations such as invasiveness, high costs, and subjectivity. In recent years, interest has grown in using electroencephalography (EEG) for AD detection due to its non-invasiveness, low cost, and high temporal resolution. In this regard, this work introduces a novel metric for AD detection by using multiscale fuzzy entropy (MFE) to assess brain complexity, offering clinicians an objective, cost-effective diagnostic tool to aid early intervention and patient care. To this purpose, brain entropy patterns in different frequency bands for 35 healthy subjects (HS) and 35 AD patients were investigated. Then, based on the resulting MFE values, a specific detection algorithm, able to assess brain complexity abnormalities that are typical of AD, was developed and further validated on 24 EEG test recordings. This MFE-based method achieved an accuracy of 83% in differentiating between HS and AD, with a diagnostic odds ratio of 25, and a Matthews correlation coefficient of 0.67, indicating its viability for AD diagnosis. Furthermore, the algorithm showed potential for identifying anomalies in brain complexity when tested on a subject with mild cognitive impairment (MCI), warranting further investigation in future research.

Exploring Nutritional Influence on Blood Glucose Forecasting for Type 1 Diabetes Using Explainable AI.

Type 1 diabetes mellitus (T1DM) is characterized by insulin deficiency and blood sugar control issues. The state-of-the-art solution is the artificial pancreas (AP), which integrates basal insulin delivery and glucose monitoring. However, APs are unable to manage postprandial glucose response (PGR) due to limited knowledge of its determinants, requiring additional information for accurate bolus delivery, such as estimated carbohydrate intake. This study aims to quantify the influence of various meal-related factors on predicting postprandial blood glucose levels (BGLs) at different time intervals (15 min, 60 min, and 120 min) after meals by using deep neural network (DNN) models. The prediction models incorporate preprandial blood glucose values, insulin dosage, and various meal-related nutritional factors such as intake of energy, carbohydrates, proteins, lipids, fatty acids, fibers, glycemic index, and glycemic load as input variables. The impact of input features was assessed by exploiting eXplainable Artificial Intelligence (XAI) methodologies, specifically SHapley Additive exPlanations (SHAP), which provide insights into each feature's contribution to the model predictions. By leveraging XAI methodologies, this study aims to enhance the interpretability and transparency of BGL prediction models and validate clinical literature hypotheses. The findings can aid in the development of decision-support tools for individuals with T1DM, facilitating PGR management and reducing the risks of adverse events. The improved understanding of PGR determinants may lead to advancements in AP technology and improve the overall quality of life for T1DM patients.

Infrared Thermography for Real-Time Assessment of the Effectiveness of Scoliosis Braces.

This work proposes an innovative method, based on the use of low-cost infrared thermography (IRT) instrumentation, to assess in real time the effectiveness of scoliosis braces. Establishing the effectiveness of scoliosis braces means deciding whether the pressure exerted by the brace on the patient's back is adequate for the intended therapeutic purpose. Traditionally, the evaluation of brace effectiveness relies on empirical, qualitative assessments carried out by orthopedists during routine follow-up examinations. Hence, it heavily depends on the expertise of the orthopedists involved. In the state of the art, the only objective methods used to confirm orthopedists' opinions are based on the evaluation of how scoliosis progresses over time, often exposing people to ionizing radiation. To address these limitations, the method proposed in this work aims to provide a real-time, objective assessment of the effectiveness of scoliosis braces in a non-harmful way. This is achieved by exploiting the thermoelastic effect and correlating temperature changes on the patient's back with the mechanical pressure exerted by the braces. A system based on this method is implemented and then validated through an experimental study on 21 patients conducted at an accredited orthopedic center. The experimental results demonstrate a classification accuracy slightly below 70% in discriminating between adequate and inadequate pressure, which is an encouraging result for further advancement in view of the clinical use of such systems in orthopedic centers.

Uncovering the Correlation between COVID-19 and Neurodegenerative Processes: Toward a New Approach Based on EEG Entropic Analysis.

COVID-19 is an ongoing global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Although it primarily attacks the respiratory tract, inflammation can also affect the central nervous system (CNS), leading to chemo-sensory deficits such as anosmia and serious cognitive problems. Recent studies have shown a connection between COVID-19 and neurodegenerative diseases, particularly Alzheimer's disease (AD). In fact, AD appears to exhibit neurological mechanisms of protein interactions similar to those that occur during COVID-19. Starting from these considerations, this perspective paper outlines a new approach based on the analysis of the complexity of brain signals to identify and quantify common features between COVID-19 and neurodegenerative disorders. Considering the relation between olfactory deficits, AD, and COVID-19, we present an experimental design involving olfactory tasks using multiscale fuzzy entropy (MFE) for electroencephalographic (EEG) signal analysis. Additionally, we present the open challenges and future perspectives. More specifically, the challenges are related to the lack of clinical standards regarding EEG signal entropy and public data that can be exploited in the experimental phase. Furthermore, the integration of EEG analysis with machine learning still requires further investigation.

Assessment of blood perfusion quality in laparoscopic colorectal surgery by means of Machine Learning.

An innovative algorithm to automatically assess blood perfusion quality of the intestinal sector in laparoscopic colorectal surgery is proposed. Traditionally, the uniformity of the brightness in indocyanine green-based fluorescence consists only in a qualitative, empirical evaluation, which heavily relies on the surgeon's subjective assessment. As such, this leads to assessments that are strongly experience-dependent. To overcome this limitation, the proposed algorithm assesses the level and uniformity of indocyanine green used during laparoscopic surgery. The algorithm adopts a Feed Forward Neural Network receiving as input a feature vector based on the histogram of the green band of the input image. It is used to (i) acquire information related to perfusion during laparoscopic colorectal surgery, and (ii) support the surgeon in assessing objectively the outcome of the procedure. In particular, the algorithm provides an output that classifies the perfusion as adequate or inadequate. The algorithm was validated on videos captured during surgical procedures carried out at the University Hospital Federico II in Naples, Italy. The obtained results show a classification accuracy equal to [Formula: see text], with a repeatability of [Formula: see text]. Finally, the real-time operation of the proposed algorithm was tested by analyzing the video streaming captured directly from an endoscope available in the OR.

Assessment and Scientific Progresses in the Analysis of Olfactory Evoked Potentials.

The human sense of smell is important for many vital functions, but with the current state of the art, there is a lack of objective and non-invasive methods for smell disorder diagnostics. In recent years, increasing attention is being paid to olfactory event-related potentials (OERPs) of the brain, as a viable tool for the objective assessment of olfactory dysfunctions. The aim of this review is to describe the main features of OERPs signals, the most widely used recording and processing techniques, and the scientific progress and relevance in the use of OERPs in many important application fields. In particular, the innovative role of OERPs is exploited in olfactory disorders that can influence emotions and personality or can be potential indicators of the onset or progression of neurological disorders. For all these reasons, this review presents and analyzes the latest scientific results and future challenges in the use of OERPs signals as an attractive solution for the objective monitoring technique of olfactory disorders.

Performance and Usability Evaluation of an Extended Reality Platform to Monitor Patient's Health during Surgical Procedures.

An extended-reality (XR) platform for real-time monitoring of patients' health during surgical procedures is proposed. The proposed system provides real-time access to a comprehensive set of patients' information, which are made promptly available to the surgical team in the operating room (OR). In particular, the XR platform supports the medical staff by automatically acquiring the patient's vitals from the operating room instrumentation and displaying them in real-time directly on an XR headset. Furthermore, information regarding the patient clinical record is also shown upon request. Finally, the XR-based monitoring platform also allows displaying in XR the video stream coming directly from the endoscope. The innovative aspect of the proposed XR-based monitoring platform lies in the comprehensiveness of the available information, in its modularity and flexibility (in terms of adaption to different sources of data), ease of use, and most importantly, in a reliable communication, which are critical requirements for the healthcare field. To validate the proposed system, experimental tests were conducted using instrumentation typically available in the operating room (i.e., a respiratory ventilator, a patient monitor for intensive care, and an endoscope). The overall results showed (i) an accuracy of the data communication greater than 99 %, along with (ii) an average time response below ms, and (iii) satisfying feedback from the SUS questionnaires filled out by the physicians after intensive use.

Soft Transducer for Patient's Vitals Telemonitoring with Deep Learning-Based Personalized Anomaly Detection.

This work addresses the design, development and implementation of a 4.0-based wearable soft transducer for patient-centered vitals telemonitoring. In particular, first, the soft transducer measures hypertension-related vitals (heart rate, oxygen saturation and systolic/diastolic pressure) and sends the data to a remote database (which can be easily consulted both by the patient and the physician). In addition to this, a dedicated deep learning algorithm, based on a Long-Short-Term-Memory Autoencoder, was designed, implemented and tested for providing an alert when the patient's vitals exceed certain thresholds, which are automatically personalized for the specific patient. Furthermore, a mobile application (EcO2u) was developed to manage the entire data flow and facilitate the data fruition; this application also implements an innovative face-detection algorithm that ensures the identity of the patient. The robustness of the proposed soft transducer was validated experimentally on five individuals, who used the system for 30 days. The experimental results demonstrated an accuracy in anomaly detection greater than 93%, with a true positive rate of more than 94%.

Combined Punctual and Diffused Monitoring of Concrete Structures Based on Dielectric Measurements.

This work presents a microwave reflectometry-based system for monitoring large concrete structures (during the curing process and also while the structure is in use), through the combined use of punctual and diffused sensing elements. In particular, the adoption of punctual probes on a reference concrete specimen allows the development of an innovative and accurate calibration procedure, useful to obtain the value of the water content on a larger structure made of the same material. Additionally, a wire-like diffused sensing element can be permanently embedded in buildings and used to monitor the structure along the entire length of the sensing element. The adopted diffused sensing element can be used not only to detect dielectric variation during the curing process, but also throughout the service life of the structure. The combined use of punctual and diffused sensing elements represents an important innovation from a procedural point of view, able to provide detailed and quantitative information on the health status of the structure both during and after construction.

Feasibility of a Wearable Reflectometric System for Sensing Skin Hydration.

One of the major goals of Health 4.0 is to offer personalized care to patients, also through real-time, remote monitoring of their biomedical parameters. In this regard, wearable monitoring systems are crucial to deliver continuous appropriate care. For some biomedical parameters, there are a number of well established systems that offer adequate solutions for real-time, continuous patient monitoring. On the other hand, monitoring skin hydration still remains a challenging task. The continuous monitoring of this physiological parameter is extremely important in several contexts, for example for athletes, sick people, workers in hostile environments or for the elderly. State-of-the-art systems, however, exhibit some limitations, especially related with the possibility of continuous, real-time monitoring. Starting from these considerations, in this work, the feasibility of an innovative time-domain reflectometry (TDR)-based wearable, skin hydration sensing system for real-time, continuous monitoring of skin hydration level was investigated. The applicability of the proposed system was demonstrated, first, through experimental tests on reference substances, then, directly on human skin. The obtained results demonstrate the TDR technique and the proposed system holds unexplored potential for the aforementioned purposes.

Fully-Textile, Wearable Chipless Tags for Identification and Tracking Applications.

In this work, two fully-textile wearable devices, to be used as chipless identification tags in identification and tracking applications are presented. For the fabrication of the fully-textile tags, a layer of fleece was used as a substrate, while an adhesive non-woven conductive fabric was employed for the conductive parts. To allow radio-frequency identification of these chipless tags, two alternative techniques were used. One relies on associating a binary code with the resonance frequency of resonant devices: the presence/absence of the resonance peaks in the transmission scattering parameter, | S 21 | , of a set of resonators is used to encode a string of bits. The second technique for accomplishing radio-frequency identification of the chipless tags resorts to a frequency-shift coding technique, which is implemented by modifying the configuration of a hairpin resonator. The obtained numerical and experimental results confirm the suitability of the proposed strategies for obtaining entirely-textile, wearable chipless tags for identification and tracking purposes, which can be particularly useful, especially in the industrial sector. In this field, in fact, the proposed solutions would guarantee a seamless integration with clothes and would facilitate the user's interaction with the IoT infrastructure. In this regard, one of the envisaged application scenarios related to the tracking of hides in the leather industry is also presented.

Encapsulation of Lactobacillus kefiri in alginate microbeads using a double novel aerosol technique.

Alginate micro beads containing Lactobacillus kefiri (the principal bacteria present in the kefir probiotic drink) were produced by a novel technique based on dual aerosols spaying of alginate based solution and CaCl2 as cross linking agent. Carboxymethylcellulose (CMC) has been also added to the alginate in order to change the physic-chemical properties (viscosity and permeability) of the microbeads. Calcium alginate and CMC are biopolymers that can be used for developing oral drug-delivery systems. These biopolymers have been reported to show a pH-dependent swelling behaviour. Calcium alginate and CMC have also been known to possess an excellent mucoadhesive property. The loaded microbeads have been characterized in terms of morphology, chemical composition and stability in different conditions mimicking the gastric environment. In this study, we demonstrate the feasibility of a continuous fabrication of alginate microbeads in a range of 50-70µm size, encapsulating L. kefiri as active ingredient. The technique involves the use of a double aerosols of alginate based solution and CaCl2 as crosslinking agent. Moreover, the encapsulation process was proved to be effective and not detrimental to bacteria viability. At the same time, it was verified the protective efficacy of the microcapsules against the gastric environment using both SGF pH1.2 (fasted state) and pH2.2 (feed state).