Design of intelligent monitoring of loneliness in the elderly using a serverless architecture with real-time communication API.

BACKGROUND: Loneliness and social isolation are recognized as critical public health issues. Older people are at greater risk of loneliness and social isolation as they deal with things like living alone, loss of family or friends, chronic illness, and hearing loss. Loneliness increases a person's risk of premature death from all causes, including dementia, heart disease, and stroke. To address these issues, the inclusion of technological platforms and the use of commercial monitoring devices are vastly increasing in healthcare and elderly care. OBJECTIVE: The objective of this study is to design and develop a loneliness monitor serverless architecture to obtain real-time data from commercial activity wristbands through an Application Programming Interface. METHODS: For the design and development of the architecture, the Amazon Web Services platform has been used. To monitor loneliness, the Fitbit Charge 5 bracelet was selected. Through the web Application Programming Interface offered by the AWS Lambda service, the data is obtained and stored in AWS services with an automated frequency thanks to the event bridge. RESULTS: In the pilot stage in which the system is, it is showing great possibilities in the ease of collecting data and programming the sampling frequency. Once the request is made, the data is automatically analyzed to monitor loneliness. CONCLUSION: The proposed architecture shows great potential for easy data collection, analysis, security, personalization, real-time inference, and scalability of sensors and actuators in the future. It has powerful benefits to apply in the health sector and reduces cases of depression and loneliness.

Serious Games for Executive Functions Training for Adults with Intellectual Disability: Overview.

(1) Background: Throughout the history of medical and psychology practice, specialists have worked to improve the quality of treatment and rehabilitation, which has led to the emergence of concepts such as serious games. These tools focus on different areas of intervention procedures, one of which is to help people with intellectual disability (ID). Individuals with ID have problems with executive functions (EFs), which are related to adaptive functioning. Recent studies showed that serious games positively impact cognitive, social, and communication skills in people with ID. The purpose of this study is to analyze the solutions that have been found in EF training for adults with ID in recent years, evaluating them with a number of key parameters and identifying the features and possible problems in the further development of our system. (2) Methods: A review was conducted starting with 573 articles in English related to serious games and selected from studies that had been published since 2015. Finally, 10 were examined in detail as they focused on EFs in adults with ID. They were searched in seven major databases ("Association for Computing Machinery" (ACM), IEEE Xplore database, DBLP computer science bibliography, Google Scholar, PubMed, SCOPUS, and PsycInfo). (3) Results: It was determined that the most frequent EFs referred to in the studies analyzed were planning and decision-making, followed by working memory and social cognition, behavioral regulation, flexibility, and inhibition capacity. The basic approach to the creation of support systems was also analyzed in terms of technical and program execution. The trend results' analysis evidenced improvements in EFs, even though they were not significant. This comprehensive technique enabled the identification of the main features and aspects to be taken into account for further development of our system.

Executive Functioning in Adults with Down Syndrome: Machine-Learning-Based Prediction of Inhibitory Capacity.

The study of executive function decline in adults with Down syndrome (DS) is important, because it supports independent functioning in real-world settings. Inhibitory control is posited to be essential for self-regulation and adaptation to daily life activities. However, cognitive domains that most predict the capacity for inhibition in adults with DS have not been identified. The aim of this study was to identify cognitive domains that predict the capacity for inhibition, using novel data-driven techniques in a sample of adults with DS (n = 188; 49.47% men; 33.6 ± 8.8 years old), with low and moderate levels of intellectual disability. Neuropsychological tests, including assessment of memory, attention, language, executive functions, and praxis, were submitted to Random Forest, support vector machine, and logistic regression algorithms for the purpose of predicting inhibition capacity, assessed with the Cats-and-Dogs test. Convergent results from the three algorithms show that the best predictors for inhibition capacity were constructive praxis, verbal memory, immediate memory, planning, and written verbal comprehension. These results suggest the minimum set of neuropsychological assessments and potential intervention targets for individuals with DS and ID, which may optimize potential for independent living.

A Systematic Review of the Application of Camera-Based Human Pose Estimation in the Field of Sport and Physical Exercise.

Human Pose Estimation (HPE) has received considerable attention during the past years, improving its performance thanks to the use of Deep Learning, and introducing new interesting uses, such as its application in Sport and Physical Exercise (SPE). The aim of this systematic review is to analyze the literature related to the application of HPE in SPE, the available data, methods, performance, opportunities, and challenges. One reviewer applied different inclusion and exclusion criteria, as well as quality metrics, to perform the paper filtering through the paper databases. The Association for Computing Machinery Digital Library, Web of Science, and dblp included more than 500 related papers after the initial filtering, finally resulting in 20. In addition, research was carried out regarding the publicly available data related to this topic. It can be concluded that even if related public data can be found, much more data is needed to be able to obtain good performance in different contexts. In relation with the methods of the authors, the use of general purpose systems as base, such as Openpose, combined with other methods and adaptations to the specific use case can be found. Finally, the limitations, opportunities, and challenges are presented.

Monitoring and Follow-up of Chronic Heart Failure: a Literature Review of eHealth Applications and Systems.

In developed countries heart failure is one of the most important causes of death, followed closely by strokes and other cerebrovascular diseases. It is one of the major healthcare issues in terms of increasing number of patients, rate of hospitalizations and costs. The main aim of this paper is to present telemedicine applications for monitoring and follow-up of heart failure and to show how these systems can help reduce costs of administering heart failure. The search for e-health applications and systems in the field of telemonitoring of heart failure was pursued in IEEE Xplore, Science Direct, PubMed and Scopus systems between 2005 and the present time. This search was conducted between May and June 2015, and the articles deemed to be of most interest about treatment, prevention, self-empowerment and stabilization of patients were selected. Over 100 articles about telemonitoring of heart failure have been found in the literature reviewed since 2005, although the most interesting ones have been selected from the scientific standpoint. Many of them show that telemonitoring of patients with a high risk of heart failure is a measure that might help to reduce the risk of suffering from the disease. Following the review conducted, in can be stated that via the research articles analysed that telemonitoring systems can help to reduce the costs of administering heart failure and result in less re-hospitalization of patients.

Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers.

BACKGROUND: The combination of eHealth applications and/or services with cloud technology provides health care staff­with sufficient mobility and accessibility for them­to be able to transparently check any data they may need without having to worry about its physical location. OBJECTIVE: The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. METHODS: The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. RESULTS: We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. CONCLUSIONS: The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost.

An iPad-Based Tool for Improving the Skills of Children with Attention Deficit Disorder.

Attention Deficit Hyperactivity Disorder (ADHD), with a worldwide prevalence of 5.29%-7.1%, is one of the most common neurodevelopmental disorders among children and adolescents. Apart from typical symptoms like inattention, hyperactivity and impulsiveness, patients also evidence attention deficit problems with reading comprehension. This in turn causes poor school performance and widens the gap with peers without ADHD. This paper presents a novel and interactive tool based on Serious Games for Health, whose aim is not only to improve comprehension, but also hold the user's attention. This tool is geared towards assessing reading quality and is intended for iPad devices. Preliminary results obtained from the experiment performed to evaluate the game are included in this report. A group of six typically developing children from Colegio Vizcaya aged between 8 and 12 took part in the evaluation of motivation, satisfaction and usability of the same therapy in the new media. Results obtained by participants playing the game were analysed together with questionnaires concerning the usability of the system. Game evaluation resulted in relatively good statistics-average score was 3 points out of 4 and average time for completing the exercise was 59 seconds. A SUS questionnaire with an average score of 92.75 out of 100 indicates that the game presented is user-friendly and an effective tool. Moreover, based on the feedback obtained from participants, the game had been improved and additional functionality introduced. Older participants completed the first game faster than the younger ones, but age was not influential in subsequent games.

Eye/head tracking technology to improve HCI with iPad applications.

In order to improve human computer interaction (HCI) for people with special needs, this paper presents an alternative form of interaction, which uses the iPad's front camera and eye/head tracking technology. With this functional nature/capability operating in the background, the user can control already developed or new applications for the iPad by moving their eyes and/or head. There are many techniques, which are currently used to detect facial features, such as eyes or even the face itself. Open source bookstores exist for such purpose, such as OpenCV, which enable very reliable and accurate detection algorithms to be applied, such as Haar Cascade using very high-level programming. All processing is undertaken in real time, and it is therefore important to pay close attention to the use of limited resources (processing capacity) of devices, such as the iPad. The system was validated in tests involving 22 users of different ages and characteristics (people with dark and light-colored eyes and with/without glasses). These tests are performed to assess user/device interaction and to ascertain whether it works properly. The system obtained an accuracy of between 60% and 100% in the three test exercises taken into consideration. The results showed that the Haar Cascade had a significant effect by detecting faces in 100% of cases, unlike eyes and the pupil where interference (light and shade) evidenced less effectiveness. In addition to ascertaining the effectiveness of the system via these exercises, the demo application has also helped to show that user constraints need not affect the enjoyment and use of a particular type of technology. In short, the results obtained are encouraging and these systems may continue to be developed if extended and updated in the future.

Technological solution for determining gait parameters using pressure sensors: a case study of multiple sclerosis patients.

This paper describes a study dealing with a technological solution to measure gait quality in people suffering from multiple sclerosis (MS) by selecting objective parameters that focus on their step. Android mobile technology, online services and four wireless pressure sensors are used in concert for this purpose. The objective of this work is the early detection of deterioration of the patient so that a physician can quickly intervene. Tests were carried out on a group of 8 persons with MS, and these results were compared with a control a group of 6 healthy participants. The results indicated a statistical difference in 7 of 40 general step features, with a minimum σ=0.013 and a maximum σ=0.029. These characteristics showed differences between first and fifth metatarsals for each group. It was concluded that these parameters can be used to evaluate gait degeneration in people with MS and that further information could be obtained from measurements with sensors to monitor activities such as bending and inertial sensors.

Shoe-integrated sensors in physical rehabilitation.

This paper presents a shoe-integrated sensor device which collects objective information concerning the gait quality in patients' physical rehabilitation. It involves four pressure sensors, two bending sensors, an ultrasonic sensor and a 9dof IMU, an Inertial Measurement Unit with three accelerometers, three gyroscopes and three magnetometers. The device includes a SDRAMPS with the aim of storing the information for long periods of time. The collected data can be sent to the server for later visualization by the specialist and the patient on a web platform. An interface shows the data in real time, allowing it to verify the connections and to check different movements.

Memory and accurate processing brain rehabilitation for the elderly: LEGO robot and iPad case study.

This paper presents the results of research that applies cognitive therapies associated with memory and mathematical problem-solving in elderly people. The exercises are programmed in an iPad and can be performed both from the Tablet and in an interactive format with a LEGO robot. The system has been tested with 2 men and 7 women over the age of 65 who have slight physical and cognitive impairment. Evaluation with the SUS resulted in a mean of 48.45 with a standard deviation of 5.82. The score of overall satisfaction was 84.37 with a standard deviation of 18.6. Interaction with the touch screen caused some usability problems due to the elderly people's visual difficulties and clicking accuracy. Future versions will include visualization with more color contrast and less use of the keyboard.

Gait analysis methods: an overview of wearable and non-wearable systems, highlighting clinical applications.

This article presents a review of the methods used in recognition and analysis of the human gait from three different approaches: image processing, floor sensors and sensors placed on the body. Progress in new technologies has led the development of a series of devices and techniques which allow for objective evaluation, making measurements more efficient and effective and providing specialists with reliable information. Firstly, an introduction of the key gait parameters and semi-subjective methods is presented. Secondly, technologies and studies on the different objective methods are reviewed. Finally, based on the latest research, the characteristics of each method are discussed. 40% of the reviewed articles published in late 2012 and 2013 were related to non-wearable systems, 37.5% presented inertial sensor-based systems, and the remaining 22.5% corresponded to other wearable systems. An increasing number of research works demonstrate that various parameters such as precision, conformability, usability or transportability have indicated that the portable systems based on body sensors are promising methods for gait analysis.

A telemonitoring tool based on serious games addressing money management skills for people with intellectual disability.

This article presents a telemonitoring tool based on computer games, aimed at money management skill improvement for people with Intellectual Disabilities (ID). The presented tool is divided into two parts: on one hand, some training activities related to payments and currency discrimination based on Serious Games are proposed to the user using a multitouch device. On the other hand, the psychologists and specialist who work with them, can access to the Serious Games results using an online application in order to evaluate their evolution. The results are measured according to the number of errors they have during the proposed activities, the time they need to complete them and the score. The article show the results of an experiment made with a clinical sample of 12 users with ID between 12 and 15 years, taking into account that all of them are capable of correct oral communication and they do not have severe physical coordination problems. Only two users completed all the games without errors. Males obtained a mean of 28.25 errors, whereas females obtained a mean of 17.75. The results show significant difference between the selection of games 1, 2 or 3, because all of them prefer the game 1 related with "Payments" probably because it permits more interaction using the multitouch device. The authors also made a qualitative evaluation and the results have been very promising and satisfactory.

Wireless prototype based on pressure and bending sensors for measuring gait [corrected] quality.

This paper presents a technological solution based on sensors controlled remotely in order to monitor, track and evaluate the gait quality in people with or without associated pathology. Special hardware simulating a shoe was developed, which consists of three pressure sensors, two bending sensors, an Arduino mini and a Bluetooth module. The obtained signals are digitally processed, calculating the standard deviation and establishing thresholds obtained empirically. A group of users was chosen with the aim of executing two modalities: natural walking and dragging the left foot. The gait was parameterized with the following variables: as far as pressure sensors are concerned, one pressure sensor under the first metatarsal (right sensor), another one under the fifth metatarsal (left) and a third one under the heel were placed. With respect to bending sensors, one bending sensor was placed for the ankle movement and another one for the foot sole. The obtained results show a rate accuracy oscillating between 85% (right sensor) and 100% (heel and bending sensors). Therefore, the developed prototype is able to differentiate between healthy gait and pathological gait, and it will be used as the base of a more complex and integral technological solution, which is being developed currently.