Learning-based personalisation of robot behaviour for robot-assisted therapy.

During robot-assisted therapy, a robot typically needs to be partially or fully controlled by therapists, for instance using a Wizard-of-Oz protocol; this makes therapeutic sessions tedious to conduct, as therapists cannot fully focus on the interaction with the person under therapy. In this work, we develop a learning-based behaviour model that can be used to increase the autonomy of a robot's decision-making process. We investigate reinforcement learning as a model training technique and compare different reward functions that consider a user's engagement and activity performance. We also analyse various strategies that aim to make the learning process more tractable, namely i) behaviour model training with a learned user model, ii) policy transfer between user groups, and iii) policy learning from expert feedback. We demonstrate that policy transfer can significantly speed up the policy learning process, although the reward function has an important effect on the actions that a robot can choose. Although the main focus of this paper is the personalisation pipeline itself, we further evaluate the learned behaviour models in a small-scale real-world feasibility study in which six users participated in a sequence learning game with an assistive robot. The results of this study seem to suggest that learning from guidance may result in the most adequate policies in terms of increasing the engagement and game performance of users, but a large-scale user study is needed to verify the validity of that observation.

The feasibility of finger prick autologous blood (FAB) as a novel treatment for severe dry eye disease (DED): protocol for a randomised controlled trial.

INTRODUCTION: Patients with severe dry eye disease (DED) often have limited treatment options with standard non-surgical management focused on the use of artificial tears for lubrication and anti-inflammatory drugs. However, artificial tears do not address the extraordinary complexity of human tears. Crudely, human tears with its vast constituents is essentially filtered blood. Blood and several blood-derived products including autologous serum, have been studied as tear substitutes. This study proposes to test the use of whole, fresh, autologous blood obtained from a finger prick for treatment of severe DED. METHODS AND ANALYSIS: The research team at the two participating sites will approach patients with severe DED for this study. Recruitment will take place over 12 months and we expect to recruit 60 patients in total. The primary outcome of this feasibility study is to estimate the proportion of eligible patients approached who consent to and comply with study procedures including treatment regimen and completion of required questionnaires. The secondary outcome measures, although not powered for in this feasibility, include corneal inflammation (assessed by the Oxford corneal staining guide), patient pain and symptoms scores (assessed by the Ocular Surface Disease Index Score), and objective signs of DED as indicated by visual acuity (assessed by Schirmer's test, tear break-up time, lower and/or upper tear meniscus height measurement). Other secondary outcomes include patients' quality of life (assessed using the validated EQ-5D-5L Questionnaire), cost to the National Health Service (NHS) and patient (assessed via use of NHS services and privately purchased over-the-counter treatment related to DED) and safety measure of pressure within the eye (assessed by the Intraocular Pressure (IOP) Score). ETHICS AND DISSEMINATION: This protocol and any subsequent amendments, along with any accompanying material provided to the participant in addition to any advertising material used in this trial have been approved by the East of England - Cambridgeshire and Hertfordshire Research Ethics Committee (REC reference: 17/EE/0508). Written approval from the committee was obtained and subsequently submitted to the respective Trust's Research and Development (R&D) office with final NHS R&D approval obtained. Data obtained from this study will be published in a suitable peer-review journal and will also presented at international ophthalmic conferences including the American Academy of Ophthalmology, the Royal College of Ophthalmology Annual Congress, the Association for Research and Vision and Ophthalmology, and the European Society of Cataract and Refractive Surgery. Information will be provided to patient groups and charities such as the Sjogren's Society and the Royal National Institute of Blind People. This will also be shared with the study participants as well as with relevant patient groups and charities. TRIAL REGISTRATION NUMBER: NCT03395431; Pre-results.

Tyramine conjugation deficit in patients with chronic idiopathic temporomandibular joint and orofacial pain.

This study was carried out to explore the value of the tyramine conjugation test, an established trait marker for 'endogenous unipolar depression', in patients with chronic idiopathic temporomandibular joint and orofacial pain. Our results show that the pain patients excrete significantly lower amounts of tyramine sulphate than controls (P < 0.0004). Psychiatric assessment by the structured clinical interview for the diagnosis of mental disorders according to DSM-III-R revealed that 48% of the patients had a history of depression and 10% were currently depressed. However, the never-depressed group of patients had the lowest tyramine sulphate excretion values. These findings suggest that a common biological abnormality underlies the pathogenesis of both chronic idiopathic facial pain and depression.