New methods and tools to assess nutritive sucking in new-borns: effect of different feeding bottles on nutritive performance.

Nutritive sucking is a fundamental process assuring the primary infant nourishment in the first months of life. When feeding is impaired for pathological conditions, the growth of the infant may be delayed with a cascade effect on the overall development. While literature studied nutritive sucking development in infants with feeding problems, like in severe premature babies or with low weight at birth, few works assesses to what extent different feeding bottles may influence feeding performance of healthy new-borns. This work proposes a method for functional characterization of feeding bottles based on the most promising and reliable indices used to quantitatively assess feeding skills in clinical applications. Thirty healthy newborns have been fed with two different bottles instrumented with a device for feeding monitoring. Their impact on feeding performance is objectively assessed and discussed. The approach presented here, even if preliminary, paves the way to a new method for functional characterization of feeding bottles. Further studies may allow to confirm our analyses with a higher number of bottles and infants.

Assessing bradykinesia in Parkinson's disease using gyroscope signals.

Parkinson's disease (PD) is a neurodegenerative brain disorder that slowly brings on the dopaminergic neurons death. The depletion of the dopaminergic signal causes the onset of motor symptoms such as tremor, bradykinesia and rigidity. Usually, neurologists regularly monitor motor symptoms and motor fluctuations using the MDS-UPDRS part III clinical scale. Nevertheless, to have a more objective and quantitative evaluation, it is possible to assess the cardinal motor symptoms of PD using wearable sensors and portable robotic devices. Unfortunately while there are several research papers on the use of these devices on PD patients, their use is not so common in clinical practice. In this work we recorded specific MDS-UPDRS motor tasks using magneto-inertial devices, worn by seven PD subjects and seven age-matched controls, in order to deeply analyze the kinematic and dynamic characteristics of goal-directed movements of upper limb, in addition to extract quantitative indices (peak velocity, smoothness, etc) useful for the assessment of motor symptoms. Using only gyroscope signals we looked at those parameters useful to assess bradykinesia. We observed parameters changes from OFF to ON phase congruent with the MDS-UPDRS changes, especially in the frequency domain. Our results suggest the prono-supination task is the more consistent to describe the bradykinesia symptom with the gyroscopes. Probably because of the amplitude of the movement performed. Moreover the peak power looks appropriate for bradykinesia symptom evaluation. We can conclude that, similar to the studies in which tremor symptom is evaluated, it is possible to monitor the bradykinesia using few wearable sensors and few simple parameters.

Temperature monitoring during radiofrequency ablation of liver: in vivo trials.

Radiofrequency ablation (RFA) is a minimally invasive procedure used to treat tumors by means of hyperthermia, mostly through percutaneous approach. The tissue temperature plays a pivotal role in the achievement of the target volume heating, while sparing the surrounding healthy tissue from thermal damage. Several techniques for thermometry during RFA are investigated, most of them based on the use of single-point measurement system (e.g., thermocouples). The measurement of temperature map is crucial for the real-time control and fine adjustment of the treatment settings, to optimize the shape and size of the ablated volume. The recent interest about fiber optic sensors and, among them, fiber Bragg gratings (FBGs) for the monitoring of thermal effects motivated further investigation. In particular, the feature of FBGs to form an array of several elements, thus to be inscribed within the same fiber, allows the use of a single probe for the multi-points monitoring of the tissue temperature during RFA. Hence, the aim of this study is the development and characterization of a needle-like probe embedding an array of three FBGs, which was tested on pig liver during in vivo trials. The needle allows a safe and easy insertion of the fiber optic within the liver. It was inserted by ultrasound guidance into the liver, and monitored the change of tissue temperature during RFA controlled by the roll-off technique. Also the measurement error induced by breathing movements of the liver was assessed (less than 3 °C). Results encourage the use of the probe in clinical settings, as well as the improvement of some features, e.g., a higher number of FBGs for performing quasi-distributed measurement.

Design and development of a sensorized cylindrical object for grasping assessment.

Aim of this work is to design and develop an instrumented cylindrical object equipped with force sensors, which is able to assess grasping performance of both human and robotic hands. The object is made of two concentric shells between which sixteen piezoresistive sensors have been located in order to measure the forces applied by the hand fingers during grasping. Furthermore, a magneto-inertial unit has been positioned inside the object for acquiring information about object orientation during manipulation. A wireless communication between the electronic boards, responsible for acquiring the data from the sensors, and a remote laptop has been guaranteed. The object has been conceived in such a way to be adopted for evaluating both power and precision grasps and for measuring the forces applied by each finger of the hand. In order to evaluate object performance, a finite element analysis for estimating the deformation of the external shell for different force values has been carried out. Moreover, to evaluate object sensitivity, a static analysis of the force transmitted by the external shell to the underlying sensors has been performed by varying the thickness of the shells. The obtained preliminary results have validated the feasibility of using the developed object for assessing grasping performed by human and robotic hands.

Design, development and experimental validation of a non-invasive device for recording respiratory events during bottle feeding.

In newborns, a poor coordination between sucking, swallowing and breathing may undermine the effectiveness of oral feeding and signal immaturity of Central Nervous System. The aim of this work is to develop and validate a non-invasive device for recording respiratory events of newborns during bottle feeding. The proposed device working principle is based on the convective heat exchanged between two hot bodies and the infants' breathing. The sensing elements are inserted into a duct and the gas exchanged by infants is conveyed into this duct thanks to an ad hoc designed system to be mounted on a commercial feeding bottle. Two sets of experiments have been carried out in order to investigate the discrimination threshold of the device and characterize the sensor response at oscillating flows. The effect of distance and tilt between nostrils and device, and the breathing frequency, have been investigated simulating nostrils and neonatal respiratory pattern. The device has a discrimination threshold lower than 0.5 L/min at both 10° and 20° of tilt. Distance for these two settings does not affect the threshold in the investigated range (10-20 mm). Moreover, the device is able to detect breathing events, and to discriminate the onset of expiratory phase, during a neonatal respiratory task delivered by a lung simulator. The results foster the successful application of this device to the assessment of the temporal breathing pattern of newborns during bottle feeding with a non-invasive approach.

A transistors-based, bidirectional flowmeter for neonatal ventilation: design and experimental characterization.

A bidirectional, low cost flowmeter for neonatal artificial ventilation, suitable for application in mono-patient breathing circuits, is described here. The sensing element consists of two nominally identical bipolar junction transistors employed as hot bodies. The sensor working principle is based on the convective heat transfer between the transistors, heated by Joule phenomenon, and the colder hitting fluid which represents the measurand. The proposed design allows the sensor to discriminate flow direction. Static calibration has been carried out in a range of flowrate values (from -8 L·min(-1) up to +8 L L·min(-1)) covering the ones employed in neonatal ventilation, at different pipe diameters (ie., 10 mm and 30 mm) and collector currents (i.e., 500 mA, 300 mA, and 100 mA) in order to assess the influence of these two parameters on sensor's response. Results show that the configuration with a pipe diameter of 10 mm at the highest collector current guarantees the highest sensitivity (i.e., 763 mV/Lmin1 at low flowrate ± 1 L-min(-1)) and ensures the minimum dead space (2 mL vs 18 mL for 30 mm of diameter). On the other hand, the 30 mm pipe diameter allows extending the range of measurement (up to ±6 L-min 1 vs ±3.5 L· min(-1) at 10 mm), and improving both the discrimination threshold (<;0.1 L·min-(1)) and the symmetry of response. These characteristics together with the low dead space and low cost foster its application to neonatal ventilation.

A technological approach to studying motor planning ability in children at high risk for ASD.

In this work we propose a new method to study the development of motor planning abilities in children and, in particular, in children at high risk for ASD. Although several modified motor signs have been found in children with ASD, no specific markers enabling the early assessment of risk have been found yet. In this work, we discuss the problem posed by objective and quantitative behavioral analysis in non-structured environment. After an initial description of the main constraints imposed by the ecological approach, a technological and methodological solution to these issues is presented. Preliminary results on 12 children are reported and briefly discussed.

An MR-compatible force sensor based on FBG technology for biomedical application.

Fiber Bragg Grating (FBG) technology is very attractive to develop sensors for the measurement of thermal and mechanical parameters in biological applications, particularly in presence of electromagnetic interferences. This work presents the design, working principle and experimental characterization of a force sensor based on two FBGs, with the feature of being compatible with Magnetic Resonance. Two prototypes based on different designs are considered and characterized: 1) the fiber with the FBGs is encapsulated in a polydimethylsiloxane (PDMS) sheet; 2) the fiber with the FBGs is free without the employment of any polymeric layer. Results show that the prototype which adopts the polymeric sheet has a wider range of measurement (4200 mN vs 250 mN) and good linearity; although it has lower sensitivity (≈0.1 nm-N(1) vs 7 nm-N(1)). The sensor without polymeric layer is also characterized by employing a differential configuration which allows neglecting the influence of temperature. This solution improves the linearity of the sensor, on the other hand the sensitivity decreases. The resulting good metrological properties of the prototypes here tested make them attractive for the intended application and in general for force measurement during biomedical applications in presence of electromagnetic interferences.

An automatized system for the assessment of nutritive sucking behavior in infants: a preliminary analysis on term neonates.

Nutritive Sucking (NS) is a highly organized process that can reflect infants' maturation during the early post-natal period. The assessment of NS may provide a sensitive means of evaluating early motor skills and their development. Thus, a reliable tool for assessing sucking behavior may benefit diagnostics and treatment of newborns since the first days of life. The aim of this work is to propose an automatized system to measure sucking ability and calculate a set of objective and quantitative indices for its assessment. We focused on the analysis of the Intraoral Pressure (IP) generated by infants while feeding: an ad-hoc designed software application was developed to analyze the signal obtained by a pressure transducer connected with a catheter placed through a standard bottle teat into the oral cavity during feeding. Automatic algorithms for suck and burst identification and for their characterization are described. We carried out a preliminary test of the system, analyzing data from two healthy term newborns, tested twice over time (1-2 days old and 6-10 weeks later). We calculated a set of different sucking parameters (e.g. sucking amplitude, frequency and area), and proposed some indices, that are typically used for the assessment of motor control, in order to assess the smoothness of IP. Results encourage further investigation of the proposed system for monitoring the development of early sucking skills.

An experimental protocol for the definition of upper limb anatomical frames on children using magneto-inertial sensors.

Motion capture based on magneto-inertial sensors is a technology enabling data collection in unstructured environments, allowing "out of the lab" motion analysis. This technology is a good candidate for motion analysis of children thanks to the reduced weight and size as well as the use of wireless communication that has improved its wearability and reduced its obtrusivity. A key issue in the application of such technology for motion analysis is its calibration, i.e. a process that allows mapping orientation information from each sensor to a physiological reference frame. To date, even if there are several calibration procedures available for adults, no specific calibration procedures have been developed for children. This work addresses this specific issue presenting a calibration procedure for motion capture of thorax and upper limbs on healthy children. Reported results suggest comparable performance with similar studies on adults and emphasize some critical issues, opening the way to further improvements.

An alignment procedure for ambulatory measurements of lower limb kinematic using magneto-inertial sensors.

In this work, an alignment procedure of magneto-inertial units in the Special Orthogonal Space SO(3) is presented and discussed. The procedure, designed for ambulatory measurements of lower limb kinematic, is based on simple rotation movements around anatomical axes of hip joint and its accuracy is independent of the speed as well as the range of the movements. This is particularly important for movement analysis of subjects with motor impairments. Despite such procedure was designed for lower limb movement analysis, it can be applied to every anatomical compartment (e.g.: upper limb).

TACT glossary: toys.

Toys denote objects used in playing. From the first examples of toys made of materials available in the environment and manufactured by parents or by children themselves only for recreational purpose, toys have evolved into more sophisticated devices which integrate mechanics, electronics and informatics (mechatronic toys) used in several different application fields. There are two main kinds of mechatronic toys: sensorized toys are passive toys equipped with a set of sensors used to record user/toy interactions; robotic toys are artefacts or computers, usually self-propelled with the help of motors, which collect information from the surrounding environment by sensors, and decode this information into behaviors consistent with them. This entry explores the use of the word "toys" from a technological point of view focussing on mechatronic toys and their applications.

Block-box instrumented toy: a new platform for assessing spatial cognition in infants.

This paper describes an interdisciplinary approach to the assessment on infants' behavior, with a focus on the technology. The goal is an objective, quantitative analysis of concurrent maturation of sensory, motor and cognitive abilities in young children, in relation to the achievement of developmental milestones. An instrumented block-box toy specifically developed to assess the ability to insert objects into holes is presented. The functional specifications are derived from experimental protocols devised by neuroscientists to assess spatial cognition skills. Technological choices are emphasized with respect to ecological requirements. An ad-hoc calibration procedure is also presented which is suitable to unstructured environments. Finally, preliminary tests carried out at a local day-care with 12-24 months old infants are presented which prove the in-field usability of the proposed technology.

A novel technological approach towards the early diagnosis of neurodevelopmental disorders.

In this work, a novel technological approach to the early diagnosis of neuro-developmental disorders is presented. Disorders such as Autism are typically diagnosed after language development, i.e. after the 2-3 years of age. In this paper, three different typologies of instruments are presented which are designed to assess infants behavior in different perceptual and motor domains. The first is an instrumented toy embedding kinematic and force sensors for studying grasping and manipulation in infants as young as 6 months old. The second is a wearable device for sensing the kinematics of the upper and lower limbs of infants, designed to assess spontaneous movements in premature babies. The third is a multimodal audio-visuo-vestibular cap which was designed to assess infants orienting behaviors in social situations in response to audio and visual stimuli.