Magnetometer-free Kalman filter for motor-based assessment of prodromal Parkinson's disease.

Observing the kinematics of specific motor tasks, such as finger tapping (FT), provides an objective and consistent quantification of the severity of neurodegenerative diseases. However, the current clinical practice mostly relies on visual observations performed by the clinician. Thus, the assessment is subjective. In this paper, we propose a magnetometer-free Kalman filter (KF) to assess FT features using wearable, inertial sensors. The KF was used to assess features during two different FT tasks, namely forefinger tapping (FTAP) and thumb-forefinger tapping (THFF). The proposed KF was validated against a camera-based reference and compared with a strap-down integration-based method. Comparison between KF method and camera reference showed low discrepancies in terms of root mean square error (RMSE) for considered features: namely number of repetitions (RMSE < 0.7), tapping frequency (RMSE < 0.1 Hz), and amplitude (RMSE < 2.6 deg). An high correlation coefficient between amplitudes was also obtained. The proposed KF performed better than the strap-down integration method on both FT tasks, showing lower RMSE on every feature as well as a higher correlation coefficient. Clinical Relevance- The wearable setup, as well as the proposed magnetometer-free KF, may provide a low-cost, easyto- use, non-invasive motion tracking system for protocols aimed to assess motor performances in neurodegenerative disorders.

SensRing, a novel wearable ring-shaped device for objective analysis of reachto-grasp movements.

Reach-to-grasp actions have been recently studied to highlight how intentions influence action planning and shapes the movement kinematics. Reach-to-grasp (RG) kinematics can reveal important information on motor planning and control in several pathologies, including neurodegenerative diseases. Current methods are mainly based on optoelectronic analysis systems, which provide accurate movement tracking but are expensive, time-consuming, and limited to constrained research-oriented space. In this study, we proposed an innovative, non-invasive, and easy-to-use ringshaped wearable system, named SensRing, able to record inertial data during the movement. To ensure accurate and precise measures, which are mandatory for clinical practice, a preliminary technical validation of the SensRing with respect to the Vicon (i.e., gold standard for motion analysis) was performed on two finger tapping exercises. Preliminary results pointed out very low discrepancies in terms of absolute errors (AbsErr) between the values of repetitions (AbsErr≤0.8), frequency (AbsErr=0.04Hz) and amplitude (AbsErr≤2.7deg) measured by the two systems, as well as high correlation between the measures obtained with the inertial and optical system. Therefore, inertial data from the SensRing were used in a "reach-to-grasp and move" protocol to calculate the performance of a group of healthy young subjects during three RG and move sequences. Particularly, subjects were instructed to reach and grasp a bottle to drink (DRINK), to place it on the table (IND) or to pass it to another partner (SOC). Results showed that SensRing could identify that, in the RG phase, different intentions determine different kinematic parameters of grasping the same object. As concerns the phase of moving, if the movement is different (drink vs IND/SOC) it's easier to find differences between the tasks, but also when the action is the same but with different social intent (IND vs SOC) SensRing found a significant difference.

How Dominant Hand and Foot Dexterity May Reveal Dementia Onset: A Motor and Cognitive Dual-Task Study.

The combined provision of an arising number of dementia cases, and the substantial absence of effective treatments, led the scientific community toward the identification of early phases of this condition. Such an effort aims at the recognition of therapeutic windows and the characterization of the disease's different grades. In the last years, Motor and Cognitive Dual-Tasks (MCDT) have been widely used to address the early diagnosis of several neurocognitive disorders, among which dementia. Here we present different protocols: the walking MCDT, the toe-tapping MCDT, and the forefinger-tapping MCDT. Moreover, each task has been performed under different cognitive conditions: no cognitive effort, counting backwards by 1, 3, and 7. In this work, we report the results obtained through the combination of different motor and cognitive tasks, and we present 2 brand-new MCDT protocols, attempting to identify a sweet-spot for early diagnosis of dementia.

Physiological response to Vibro-Acoustic stimulation in healthy subjects: a preliminary study.

Over the last decade Vibro-Acoustic Therapy (VAT) was used for several clinical applications. This paper investigates the use of AcusticA®, an innovative VAT solution represented by a wooden chaise longue that follows the construction principles of a "musical instrument that stimulates the whole body" in relation to the sound frequencies produced by the music tracks. Ten healthy young subjects were enrolled for this study. Wearable sensors were used to monitor the human physiological response during the VAT session but also during a traditional acoustic therapy (AT) to highlight similarity and differences of those stimulations. Signals from heart activity, brain activity and electrodermal activity were analyzed to investigate the response during the non-stimulated and the stimulated phases. Additionally, two supervised classification algorithms were used to investigate whether the extracted instances could be grouped into two different groups. The results identify a trend of the attention and meditation features extracted from brain activity, which pointed out the relax efficacy of the VAT.Clinical Relevance - There are not significant differences (p<0.05) in the physiological response between the VAT and the AT stimulation, but during the VAT the alpha coefficients were significant different during the stimulated phase. Finally, the classification algorithms were able to classify the groups with an accuracy equal to 100% in the best case.

Nurses' illness perceptions during presenteeism and absenteeism.

BACKGROUND: Presenteeism has been linked with lost productivity, impaired health and absence. Whilst much research has focused on types of diseases associated with presenteeism and absenteeism, there has been little investigation into the role of individuals' illness perceptions in these episodes. AIMS: To assess how illness perceptions vary between presenteeism and absenteeism episodes. METHODS: A cross-sectional questionnaire was distributed to ward-based nurses working with older adults. Data on illness perceptions during presenteeism and absenteeism episodes were collected. Data were analysed via the Paired-Samples t-test, Wilcoxon test and McNemar test. RESULTS: Two hundred and seventy cases were analysed (88% response rate). Compared with presenteeism, illnesses during absenteeism were thought to affect lives more (P < 0.001), to have more serious symptoms (P < 0.001), to be more concerning (P = 0.003), more likely to be treated (P = 0.009), more infectious (P < 0.001) and perceived as more legitimate reasons for absenteeism (P < 0.001). Treatment was considered more effective during absenteeism (P < 0.001), whilst workability was better during presenteeism (P < 0.001). Presenteeism was perceived as harmful and absenteeism beneficial for illness. Individuals attended work when presenteeism was expected to be less harmful (P < 0.001) and avoided work when absenteeism was expected to be more beneficial for illness (P < 0.001). CONCLUSIONS: Illness perceptions varied significantly between presenteeism and absenteeism episodes and should be included in models of illness behaviour. Findings also highlight that policy may influence illness behaviour and that nurses may attend work despite concerning levels of illness.

The Iterative Model of Ethical Analysis for Large-Scale Implementation Of ICT Solutions.

This manuscript presents a model and the methodology to understand and define the ethical management of the large-scale implementation of ICT solutions for Active and Healthy Ageing. Based on project expertise, including experience from the Pharaon project Horizon 2020, this model includes an understanding of the main ethical challenges and the development of the necessary guidelines, measures, and tools for different stakeholder profiles. This model extends beyond conventional ethical guidelines, providing a methodology to actively discuss ethical and societal challenges within a project based on interactive and iterative dialogue between the entire value-chain of stakeholders. One of the cornerstones in the analysis of challenges is focused attention on policy and societal issues that emerge during a project. Accordingly, the model includes targeted reflections and tools delivered in the context of the recent Covid-19 pandemic. The tools developed in this process are organised in a guide that can be actively used throughout large-scale implementation projects related to ICT solutions.

Fine Motor Assessment With Unsupervised Learning For Personalized Rehabilitation in Parkinson Disease.

Parkinson disease (PD) is a common neurodegenerative disorders characterized by motor and non-motor impairments. Since the quality of life of PD patients becomes poor while pathology develops, it is imperative to improve the identification of personalized rehabilitation and treatments approaches based on the level of the neurodegeneration process. Objective and precise assessment of the severity of the pathology is crucial to identify the most appropriate treatments. In this context, this paper proposes a wearable system able to measure the motor performance of PD subjects. Two inertial devices were used to capture the motion of the lower and upper limbs respectively, while performing six motor tasks. Forty-one kinematic features were extracted from the inertial signals to describe the performance of each subjects. Three unsupervised learning algorithms (k-Means, Self-organizing maps (SOM) and hierarchical clustering) were applied with a blind approach to group the motor performance. The results show that SOM was the best classifier since it reached accuracy equal to 0.950 to group the instances in two classes (mild vs advanced), and 0.817 considering three classes (mild vs moderate vs severe). Therefore, this system enabled objective assessment of the PD severity through motion analysis, allowing the evaluation of residual motor capabilities and fostering personalized paths for PD rehabilitation and assistance.

Machine Learning based Physical Human-Robot Interaction for Walking Support of Frail People.

In the near future robots will permeate our daily life empowering human beings in several activities of daily living. Particular, service robots could actively support indoor mobility tasks thus to enhance the independent living of citizens. They should be able to provide tailored services to citizens to achieve higher physical human-robot interaction. Too often service robots were designed without taking into account end-users functional requirements, which can change with age and geriatric syndromes. In this paper, we present a robot smart control based on machine learning strategies and adaptable to different handgrip strengths. The smart control was implemented on ASTRO robot conceived to be a companion and to support indoor mobility, among other activities. Particularly, three smart controller strategies were implemented and tested with end users from technical and user point of view. The results show promising results that underline the proposed approach was suitable for the proposed application.

Wearable Sensors for Prodromal Motor Assessment of Parkinson's Disease using Supervised Learning.

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by disabling motor and non-motor symptoms. Idiopathic hyposmia (IH), a reduced olfactory sensitivity, is a preclinical marker for the pathology and affects >95% of PD patients. In this paper, SensHand V1 and SensFoot V2, two inertial wearable sensors for upper and lower limbs, were developed to acquire motion data in ten tasks of the MDS-UPDRS III. Fifteen healthy subjects of control, 15 IH people, and 15 PD patients were enrolled. Seventy-one parameters per side were computed by spatiotemporal and frequency data analysis, and the most significant were selected to distinguish among the different classes. Performances of supervised learning algorithms (i.e., Support Vector Machine (SVM), and Random Forest (RF)) were compared on two-group and three-group classification and considering upper and lower limbs separately or together as a full system. Excellent results were obtained for healthy vs. patients classification (accuracy 1.00 for RF, and 0.97 for SVM), and good results were achieved by including IH subjects (0.92 F-measure with RF) within a three-group classification. Overall, the best performances were obtained using the full system with an RF classifier. The system is, thus, suitable to support an objective PD diagnosis. Furthermore, combining motion analysis with a validated olfactory screening test, people at risk for PD can be appropriately analyzed, and subtle changes in motor performance that characterize the prodromal phase and the early PD onset can be identified.

Development and testing of a new cognitive technological tool for episodic memory: A feasibility study.

Cognitive Rehabilitation Therapy refers to any systemic therapy specifically designed to enhance cognitive performance. Recent studies have shown that physical exercise is beneficial for cognitive activity in patients with degenerative diseases. Therefore, the objective of the present study is to provide training for cognitive functions that take advantage of the physical activity in the execution of the task. A feasibility study concerning the application of a new bioengineering technique in cognitive rehabilitation is presented and it divided into two parts. The first one aims at developing a new cognitive tool, called SmartTapestry (ST), for motor and cognitive rehabilitation. The second part aims at understanding its technical viability and its level of sensitivity in measuring the same cognitive domains covered by the standardized tests. The hypothesis of this study is that, despite the introduction of this new variable, the proposed system has the same sensitivity of the traditional tests. The results suggest a good correlation between the two approaches and that SmartTapestry can train the same cognitive functions of traditional cognitive tasks.

Feasibility study on the assessment of auditory sustained attention through walking motor parameters in mild cognitive impairments and healthy subjects.

Dementia and other cognitive disorders affect more than 35 million people worldwide. Over the last years, cognitive training tools were used to improve the brain functioning, thus to slow down the cognitive decline. Recently, research studies have demonstrated that aerobic exercise could play an important restorative role toward cognitive impairments. Therefore, the aim of this work is to present an innovative sensorized approach which combines aerobic exercise and traditional cognitive tools for daily training.

Leptospiral TlyC is an extracellular matrix-binding protein and does not present hemolysin activity

The role of TlyA, TlyB and TlyC proteins in the biology of Leptospira is still uncertain. Although these proteins have been considered as putative hemolysins, we demonstrate that leptospiral recombinant TlyB and TlyC do not possess hemolytic activity. However, further experiments showed that TlyC is a surface-exposed protein that seems to bind to laminin, collagen IV and fibronectin. The expression of both proteins was detected both in vitro and in vivo. Our findings suggest that TlyB and TlyC are not directly involved in hemolysis, and that TlyC may contribute to Leptospira binding to extracellular matrix (ECM) during host infection.

White blood cell DNA adducts and fruit and vegetable consumption in bladder cancer.

The 'Mediterranean diet', a diet rich in cereals, fruit and vegetables, has been associated with lowering the risk of a variety of cancers of the digestive tract and the bladder. In a previous study, we showed that the high phenolic content these dietary components produce in the urine could be associated with higher antimutagenic properties of the urine and lower arylamine-DNA adducts in exfoliated bladder cells. We have conducted a case-control study on 162 bladder cancer patients and 104 hospital controls. Total aromatic DNA adducts were measured in white blood cells (WBC) of all subjects by (32)P-post-labelling. Genetically based metabolic polymorphisms were analysed by PCR-RFLP (NAT2, GSTM1, GSTT1, GSTP1, COMT and NQO1). All subjects were interviewed about their tobacco use, dietary habits and other risk factors. The odds ratio (OR) for the risk of bladder cancer according to the presence/absence of WBC DNA adducts (detection limit 0.1 RALx10(8)) was 3.7 [95% confidence interval (CI) 2.2-6.3] and a dose-response relationship with levels of adducts was apparent. The association between case/control status and the presence of WBC DNA adducts was significantly stronger in the subjects who consumed fewer portions of fruit or vegetables per day (OR 7.80, 95% CI 3.0-20.30 for 0-1 portions of vegetables) than in the heavy consumers (OR 4.98 for consumers of 2 portions daily, OR 1.97 for consumers of > or =3 portions; similar but lower estimates were found for the intake of fruit). No association was noticed between tobacco smoking and WBC DNA adducts. Only NAT-2, among the several genotypes considered, was associated in a statistically significant way with the risk of bladder cancer (OR 1.72, 95% CI 1.03-2.87) and with the levels of WBC DNA adducts. Our report suggests that fruit and vegetables could protect against bladder cancer by inhibiting the formation of DNA adducts.

Searching for the role of protein phosphatases in eukaryotic microorganisms.

Preference for specific protein substrates together with differential sensitivity to activators and inhibitors has allowed classification of serine/threonine protein phosphatases (PPs) into four major types designated types 1, 2A, 2B and 2C (PP1, PP2A, PP2B and PP2C, respectively). Comparison of sequences within their catalytic domains has indicated that PP1, PP2A and PP2B are members of the same gene family named PPP. On the other hand, the type 2C enzyme does not share sequence homology with the PPP members and thus represents another gene family, known as PPM. In this report we briefly summarize some of our studies about the role of serine/threonine phosphatases in growth and differentiation of three different eukaryotic models: Blastocladiella emersonii, Neurospora crassa and Dictyostelium discoideum. Our observations suggest that PP2C is the major phosphatase responsible for dephosphorylation of amidotransferase, an enzyme that controls cell wall synthesis during Blastocladiella emersonii zoospore germination. We also report the existence of a novel acid- and thermo-stable protein purified from Neurospora crassa mycelia, which specifically inhibits the PP1 activity of this fungus and mammals. Finally, we comment on our recent results demonstrating that Dictyostelium discoideum expresses a gene that codes for PP1, although this activity has never been demonstrated biochemically in this organism.

Searching for the role of protein phosphatases in eukaryotic microorganisms

Preference for specific protein substrates together with differential sensitivity to activators and inhibitors has allowed classification of serine/threonine protein phosphatases (PPs) into four major types designated types 1, 2A, 2B and 2C (PP1, PP2A, PP2B and PP2C, respectively). Comparison of sequences within their catalytic domains has indicated that PP1, PP2A and PP2B are members of the same gene family named PPP. On the other hand, the type 2C enzyme does not share sequence homology with the PPP members and thus represents another gene family, known as PPM. In this report we briefly summarize some of our studies about the role of serine/threonine phosphatases in growth and differentiation of three different eukaryotic models: Blastocladiella emersonii, Neurospora crassa and Dictyostelium discoideum. Our observations suggest that PP2C is the major phosphatase responsible for dephosphorylation of amidotransferase, an enzyme that controls cell wall synthesis during Blastocladiella emersonii zoospore germination. We also report the existence of a novel acid- and thermo-stable protein purified from Neurospora crassa mycelia, which specifically inhibits the PP1 activity of this fungus and mammals. Finally, we comment on our recent results demonstrating that Dictyostelium discoideum expresses a gene that codes for PP1, although this activity has never been demonstrated biochemically in this organism