Exploring the Potential of Conversational Interfaces for Care of Older Adults: Insights from Stakeholder Workshops

This study aimed to explore the utilisation of conversational interfaces (CIs) by local care service providers (CSPs) and their potential applications in improving the quality of life for older adults. Two workshops were conducted with stakeholders to gather insights and requirements. Although currently not yet utilised by CSPs, stakeholders expressed their openness towards CIs and believed that older adults are very likely to appear receptive to them. Loneliness and isolation were identified as significant challenges, even among older adults living in care institutions. Key requirements for chatbots included complementarity to in-person interactions, user-friendliness, 24/7 availability, and seamless integration into daily life. Ethical considerations, data privacy, and security were emphasised, also highlighting the importance of transparency and limited data retention. Various use cases were discussed, such as assistance, self-management tools, and reminders. The financing issues remained inconclusive, but health insurances showed their potential interest in solutions targeting loneliness.

Light as a Possible Guidance in the Toilet Room from the View of Dementia Experts

Digital assistants and guidance systems may support persons with dementia (PwD) during the independent use of the toilet room. The paper investigates the possible use of different light sources to provide visual stimuli for guidance. Demonstrators were presented to dementia experts to gather their views. While there is no evidence yet, it can be concluded that light stimuli in the toilet environment could be a (maybe only additional) option for guidance to be further investigated. The different methods must be always adapted to the local situation and the individual user characteristics.

Privacy by design in systems for assisted living, personalised care, and wellbeing: A stakeholder analysis

Privacy by design within a system for assisted living, personalised care, and wellbeing is crucial to protect users from misuse of the data collected about their health. Especially if the information is collected through audio-video devices, the question is even more delicate due to the nature of these data. In addition to guaranteeing a high level of privacy, it is necessary to reassure end users about the correct use of these streams. The evolution of data analysis techniques began to take on an important role and increasingly defined characteristics in recent years. The purpose of this paper is twofold: on the one hand, it presents a state of the art about privacy in European Active Healthy Ageing/Active Healthy Ageing projects, with a focus on those related to audio and video processing. On the other hand, it proposes a methodology, developed in the context of the European project PlatfromUptake.eu, to identify clusters of stakeholders and application dimensions (technical, contextual, and business), define their characteristics, and show how privacy constraints affect them. From this study, we then generated a Strengths, Weaknesses, Opportunities, and Threats analysis in which we aim to identify the critical features connected to the selection and involvement of relevant stakeholders for the success of a project. Applying this type of methodology to the initial stages of a project allows understanding of which privacy issues could be related to the various stakeholder groups and which problems can then affect the correct development of the project. The idea is, therefore, to suggest a privacy-by-design approach according to the categories of stakeholders and project dimensions. The analysis will cover technical aspects, legislative and policies-related aspects also regarding the point of view of the municipalities, and aspects related to the acceptance and, therefore, to the perception of the safety of these technologies by the final end users.

Coaching Robots for Older Seniors: Do They Get What They Expect? Insights from an Austrian Study

To support the increasing number of older people, new (assistive) technologies are constantly being developed. For these technologies to be used successfully, future users need to be trained. Due to demographic change, this will become difficult in the future, as the resources for training will no longer be available. In this respect, coaching robots could have great potential to support younger seniors in particular. However, there is little evidence in the literature about the perceptions and potential impact of this technology on the well-being of older people. This paper provides insights into the use of a robot coach (robo-coach) to train younger seniors in the use of a new technology. The study was carried out in Austria in autumn 2020, involving 34 participants equally distributed among employees in their last three years of service and retirees in their first three years of retirement (23 female; 11 male). The aim was to assess participants' expectations and perceptions by examining the perceived ease of use and user experience of the robot in providing assistance during a learning session. The findings reveal a positive impression of the participants and promising results for using the robot as a coaching assistant in daily tasks.

Selection of an Efficient Classification Algorithm for Ambient Assisted Living: Supportive Care for Elderly People

Ambient Assisted Living (AAL) is a medical surveillance system comprised of connected devices, healthcare sensor systems, wireless communications, computer hardware, and software implementations. AAL could be used for an extensive variety of purposes, comprising preventing, healing, as well as improving the health and wellness of elderly individuals. AAL intends to ensure the wellbeing of elderly persons while also spanning the number of years seniors can remain independent in their preferred surroundings. It also decreases the quantity of family caregivers by giving patients control over their health situations. To avert huge costs as well as possible adverse effects on standard of living, classifiers must be used to distinguish between adopters as well as nonadopters of such innovations. With the development of numerous classification algorithms, selecting the best classifier became a vital and challenging step in technology acceptance. Decision makers must consider several criteria from different domains when selecting the best classifier. Furthermore, it is critical to define the best multicriteria decision-making strategy for modelling technology acceptance. Considering the foregoing, this research reports the incorporation of the multicriteria decision-making (MCDM) method which is founded on the fuzzy method for order of preference by similarity to ideal solution (TOPSIS) to identify the top classifier for continuing toward supporting AAL implementation research. The results indicate that the classification algorithm KNN is the preferred technique among the collection of different classification algorithms for the ambient assisted living system.

Design and Development of a Heterogeneous Active Assisted Living Solution for Monitoring and Following Up with Chronic Heart Failure Patients in Spain

Heart failure is the most common disease among elderly people, and the risk increases with age. The use of smart Internet of Things (IoT) systems for monitoring patients with chronic heart failure (CHF) in a non-intrusive manner can result in better control of the disease, improving proactive healthcare through real-time and historical patient's data, promoting self-care in patients, reducing unneeded interaction between patients and doctors, reducing the number of hospitalizations and saving healthcare costs. This work presents an active assisted living (AAL) solution based on the IoT to provide a tele-assistance platform for CHF patients from the public health service of the region of Murcia in Spain, with formal and informal caregivers and health professionals also as key actors. In this article, we have detailed the methodology, results, and conclusions of the prevalidation phase for the set of IoT technologies to be integrated in the AAL platform, the first mandatory step before the deployment of a large-scale pilot that will lead to improving the innovation of the system from its current technology readiness level to the market. The work presented, in the framework of the H2020 Pharaon project, aims to serve as inspiration to the R&D community for the design, development, and deployment of AAL solutions based on heterogeneous IoT technologies, or similar approaches, for smart healthcare solutions in real healthcare institutions.

AAL and Internet of Medical Things for Monitoring Type-2 Diabetic Patients

Due to an aging population, assisted-care options are required so that senior citizens may maintain their independence at home for a longer time and rely less on caretakers. Ambient Assisted Living (AAL) encourages the creation of solutions that can help to optimize the environment for senior citizens with assistance while greatly reducing their challenges. A framework based on the Internet of Medical Things (IoMT) is used in the current study for the implementation of AAL technology to help patients with Type-2 diabetes. A glucose oxide sensor is used to monitor diabetic elderly people continuously. Spectrogram images are created from the recorded data from the sensor to assess and detect aberrant glucose levels. DenseNet-169 examines and analyzes the spectrogram pictures, and messages are sent to caregivers when aberrant glucose levels are detected. The current work describes both the spectrogram image analysis and the signal-to-spectrogram generating method. The study presents a future perspective model for a mobile application for real-time patient monitoring. Benchmark metrics evaluate the application's performances, including sensitivity, specificity, accuracy, and F1-score. Several cross--validations are used to evaluate the model's performance. The findings demonstrate that the proposed model can correctly identify patients with abnormal blood glucose levels.

Design Considerations for Novel Self-Adapting Toilets for Semi-Public Spaces

People with physical limitations face significant challenges when using existing toilets. User requirements work shows the wide range of user needs and confirms the high demand for innovative toilets, enabling people to leave home more often and participate more in societal life. The Toilet For Me too (T4ME2) project aims to implement and test a new ICT-based toilet system capable of physically supporting users, allowing autonomous and safe use outside the home.

Tracking Activities of Daily Living in the Home Office

Due to the COVID-19 pandemic, home-office has turned to be a common practice in many companies to limit physical contact to reduce the rate of infections in the workplace. To quantify office workers' ADLs, this work demonstrates unobtrusive monitoring of activities of daily living (ADLs) of an office worker in a home-office environment with three low-cost sensors: an accelerometer and two light sensors. We extract four elementary events: distinct and fain chair movement, monitor, and fridge usage, from which we derived seven ADLs using predefined rules. This simple system can support the quantification of ADLs of home-office workers.

Identification of Fucosylated SERPINA1 as a Novel Plasma Marker for Pancreatic Cancer Using Lectin Affinity Capture Coupled with iTRAQ-Based Quantitative Glycoproteomics

Pancreatic cancer (PC) is an aggressive cancer with a high mortality rate, necessitating the development of effective diagnostic, prognostic and predictive biomarkers for disease management. Aberrantly fucosylated proteins in PC are considered a valuable resource of clinically useful biomarkers. The main objective of the present study was to identify novel plasma glycobiomarkers of PC using the iTRAQ quantitative proteomics approach coupled with Aleuria aurantia lectin (AAL)-based glycopeptide enrichment and isotope-coded glycosylation site-specific tagging, with a view to analyzing the glycoproteome profiles of plasma samples from patients with non-metastatic and metastatic PC and gallstones (GS). As a result, 22 glycopeptides with significantly elevated levels in plasma samples of PC were identified. Fucosylated SERPINA1 (fuco-SERPINA1) was selected for further validation in 121 plasma samples (50 GS and 71 PC) using an AAL-based reverse lectin ELISA technique developed in-house. Our analyses revealed significantly higher plasma levels of fuco-SERPINA1 in PC than GS subjects (310.7 ng/mL v.s. 153.6 ng/mL, p = 0.0114). Elevated fuco-SERPINA1 levels were associated with higher TNM stage (p = 0.024) and poorer prognosis for overall survival (log-rank test, p = 0.0083). The increased plasma fuco-SERPINA1 levels support the utility of this protein as a novel prognosticator for PC.

What Characterizes Safety of Ambient Assisted Living Technologies?

Ambient assisted living (AAL) technologies aim at increasing an individual's safety at home by early recognizing risks or events that might otherwise harm the individual. A clear definition of safety in the context of AAL is still missing and facets of safety still have to be shaped. The objective of this paper is to characterize the facets of AAL-related safety, to identify opportunities and challenges of AAL regarding safety and to identify open research issues in this context. Papers reporting aspects of AAL-related safety were selected in a literature search. Out of 395 citations retrieved, 28 studies were included in the current review. Two main facets of safety were identified: user safety and system safety. System safety concerns an AAL system's reliability, correctness and data quality. User safety reflects impact on physical and mental health of an individual. Privacy, data safety and security issues, sensor quality and integration of sensor data, as well as technical failures of sensors and systems are reported challenges. To conclude, there is a research gap regarding methods and metrics for measuring user and system safety in the context of AAL technologies.

Smart Assistive Architecture for the Integration of IoT Devices, Robotic Systems, and Multimodal Interfaces in Healthcare Environments

This paper presents a new architecture that integrates Internet of Things (IoT) devices, service robots, and users in a smart assistive environment. A new intuitive and multimodal interaction system supporting people with disabilities and bedbound patients is presented. This interaction system allows the user to control service robots and devices inside the room in five different ways: touch control, eye control, gesture control, voice control, and augmented reality control. The interaction system is comprised of an assistive robotic arm holding a tablet PC. The robotic arm can place the tablet PC in front of the user. A demonstration of the developed technology, a prototype of a smart room equipped with home automation devices, and the robotic assistive arm are presented. The results obtained from the use of the various interfaces and technologies are presented in the article. The results include user preference with regard to eye-base control (performing clicks, and using winks or gaze) and the use of mobile phones over augmented reality glasses, among others.

Reference architectures for ambient assisted living: a scoping review protocol

INTRODUCTION

For the first time in human history, the number of older people will be higher than the number of children. The prevalence of chronic diseases, such as hypertension, cardiovascular disease, diabetes and mental disorders in older adults is high. Given that, it is essential to make usage of related technology to provide improved health conditions and reduce the costs for promoting ageing in place, and that is precisely the aim of Ambient Assisted Living technology. Considering that these systems provide significant benefit to a vast number of stakeholders, can be applied to the functional diversity of application domains and have high economic and social impacts, it is essential to create reusable and interoperable platforms and standards that are able to deal with the heterogeneity of applications and domains. In this sense, reference architectures have been proposed and evaluated. A comprehensive scoping review concerning the reference architectures must clarify specific aspects, such as what the main domains are and how the solutions effectively deal with them.

METHODS

This scoping review will follow the methodology framework defined in 'Scoping studies: advancing the methodology'. In this methodological framework, six stages are proposed for scoping review studies: identifying the research question; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions aim to investigate what are the motivations, stakeholders, benefits, domains, approaches, architectural components and governance aspects of the proposed reference architectures and models. The team will focus on the Scopus Document Search, PubMed (MEDLINE), IEEE Xplore Digital Library, ACM Digital Library and Science Direct electronic research databases. The search query is a combination of terms related to Ambient Assisted Living AND Reference Architecture.

ETHICS AND DISSEMINATION

This is a scoping review study and there is no requirement for ethical approval, as primary data will not be collected. The results from this scoping review will be published in a peer-reviewed journal and reported at scientific meetings. We intend to share the results with the International Standards and Conformity Assessment - SyC AAL from Canada to use the review as a basis for establishing an assessment model of reference architectures.

Hardware for Recognition of Human Activities: A Review of Smart Home and AAL Related Technologies

Activity recognition (AR) from an applied perspective of ambient assisted living (AAL) and smart homes (SH) has become a subject of great interest. Promising a better quality of life, AR applied in contexts such as health, security, and energy consumption can lead to solutions capable of reaching even the people most in need. This study was strongly motivated because levels of development, deployment, and technology of AR solutions transferred to society and industry are based on software development, but also depend on the hardware devices used. The current paper identifies contributions to hardware uses for activity recognition through a scientific literature review in the Web of Science (WoS) database. This work found four dominant groups of technologies used for AR in SH and AAL-smartphones, wearables, video, and electronic components-and two emerging technologies: Wi-Fi and assistive robots. Many of these technologies overlap across many research works. Through bibliometric networks analysis, the present review identified some gaps and new potential combinations of technologies for advances in this emerging worldwide field and their uses. The review also relates the use of these six technologies in health conditions, health care, emotion recognition, occupancy, mobility, posture recognition, localization, fall detection, and generic activity recognition applications. The above can serve as a road map that allows readers to execute approachable projects and deploy applications in different socioeconomic contexts, and the possibility to establish networks with the community involved in this topic. This analysis shows that the research field in activity recognition accepts that specific goals cannot be achieved using one single hardware technology, but can be using joint solutions, this paper shows how such technology works in this regard.

Digitalizing Nursing in the Bavarian Swabia Region of Germany - Presentation of the Joint Project CARE REGIO

The joint research project CARE REGIO aims to modernize the care system with digital solutions. We focus on the development of a uniform electronic care record, uniform data exchange between care facilities, and technical assistive systems, which shall all be unified in a standardized care-based storage solution.

Overview of Policies, Guidelines, and Standards for Active Assisted Living Data Exchange: Thematic Analysis

Background

A primary concern for governments and health care systems is the rapid growth of the aging population. To provide a better quality of life for the elderly, researchers have explored the use of wearables, sensors, actuators, and mobile health technologies. The term AAL can be referred to as active assisted living or ambient assisted living, with both sometimes used interchangeably. AAL technologies describes systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for those who need assistance at any stage of their lives.

Objective

The aim of this study was to understand the standards and policy guidelines that companies use in the creation of AAL technologies and to highlight the gap between available technologies, standards, and policies and what should be available for use.

Methods

A literature review was conducted to identify critical standards and frameworks related to AAL. Interviews with 15 different stakeholders across Canada were carried out to complement this review. The results from interviews were coded using a thematic analysis and then presented in two workshops about standards, policies, and governance to identify future steps and opportunities regarding AAL.

Results

Our study showed that the base technology, standards, and policies necessary for the creation of AAL technology are not the primary problem causing disparity between existing and accessible technologies; instead nontechnical issues and integration between existing technologies present the most significant issue. A total of five themes have been identified for further analysis: (1) end user and purpose; (2) accessibility; (3) interoperability; (4) data sharing; and (5) privacy and security.

Conclusions

Interoperability is currently the biggest challenge for the future of data sharing related to AAL technology. Additionally, the majority of stakeholders consider privacy and security to be the main concerns related to data sharing in the AAL scope. Further research is necessary to explore each identified gap in detail.

An FMCW Radar for Localization and Vital Signs Measurement for Different Chest Orientations

This work tests the ability of fmcw radar to measure the respiratory rate and the heartbeat of a subject in challenging indoor scenarios. To simulate a realistic configuration for ambient assisted living (AAL) applications, in which the thorax orientation towards the antenna is typically unknown, four different scenarios were considered. Measurements were performed on five volunteers positioned with the chest, left, back, and right side facing the antenna, respectively. The 5 . 8 radar and the antennas used for the measurements were suitably designed for the considered application. To obtain a low cost and compact system, series-fed arrays were preferred over other antenna topologies. The geometry of the patches was opportunely shaped to reduce the side lobe level (SLL) and increase the bandwidth, thus ensuring good system performances. In all scenarios, the vital signs extracted from the radar signal were compared with the ones collected by a photoplethysmograph and a respiratory belt, used as references. A statistical analysis of the measured data on the different subjects and orientations was performed, showing that the radar was able to measure with high accuracy both the respiratory rate and the heartbeat in all considered configurations.

IoT Wearable Sensors and Devices in Elderly Care: A Literature Review

The increasing ageing global population is causing an upsurge in ailments related to old age, primarily dementia and Alzheimer’s disease, frailty, Parkinson’s, and cardiovascular disease, but also a general need for general eldercare as well as active and healthy ageing. In turn, there is a need for constant monitoring and assistance, intervention, and support, causing a considerable financial and human burden on individuals and their caregivers. Interconnected sensing technology, such as IoT wearables and devices, present a promising solution for objective, reliable, and remote monitoring, assessment, and support through ambient assisted living. This paper presents a review of such solutions including both earlier review studies and individual case studies, rapidly evolving in the last decade. In doing so, it examines and categorizes them according to common aspects of interest such as health focus, from specific ailments to general eldercare; IoT technologies, from wearables to smart home sensors; aims, from assessment to fall detection and indoor positioning to intervention; and experimental evaluation participants duration and outcome measures, from acceptability to accuracy. Statistics drawn from this categorization aim to outline the current state-of-the-art, as well as trends and effective practices for the future of effective, accessible, and acceptable eldercare with technology.

UWB/BLE Tracking System for Elderly People Monitoring

Localization systems are the source of data that allows to evaluate elderly person's behaviour, to draw conclusions concerning his or her health status and wellbeing, and to detect emergency situations. The article contains a description of a system intended for elderly people tracking. Two novel solutions have been implemented in the system: a hybrid localization algorithm and a method for wireless anchor nodes synchronization. The algorithm fuses results of time difference of arrival and received signal strength measurements in ultrawideband (UWB) and Bluetooth Low Energy (BLE) radio interfaces, respectively. The system allows to change the intensity of UWB packets transmission to adapt localization accuracy and energy usage to current needs and applications. In order to simplify the system installation, communication between elements of the system infrastructure instead of wire interfaces is performed over wireless ones. The new wireless synchronization method proposed in the article consists in retransmission of UWB synchronization packets by selected anchor nodes. It allows for extension of the system coverage, which is limited by the short range of UWB transmission. The proposed solution was experimentally verified. The synchronization method was tested in a laboratory, and the whole system's performance was investigated in a typical flat. Exemplary results of the tests performed with older adult participation in their own homes are also included.

Automated anatomical labelling atlas 3

Following a first version AAL of the automated anatomical labeling atlas (Tzourio-Mazoyer et al., 2002), a second version (AAL2) (Rolls et al., 2015) was developed that provided an alternative parcellation of the orbitofrontal cortex following the description provided by Chiavaras, Petrides, and colleagues. We now provide a third version, AAL3, which adds a number of brain areas not previously defined, but of interest in many neuroimaging investigations. The 26 new areas in the third version are subdivision of the anterior cingulate cortex into subgenual, pregenual and supracallosal parts; subdivision of the thalamus into 15 parts; the nucleus accumbens, substantia nigra, ventral tegmental area, red nucleus, locus coeruleus, and raphe nuclei. The new atlas is available as a toolbox for SPM, and can be used with MRIcron.

Spatio-Temporal Features in Action Recognition Using 3D Skeletal Joints

Robust action recognition methods lie at the cornerstone of Ambient Assisted Living (AAL) systems employing optical devices. Using 3D skeleton joints extracted from depth images taken with time-of-flight (ToF) cameras has been a popular solution for accomplishing these tasks. Though seemingly scarce in terms of information availability compared to its RGB or depth image counterparts, the skeletal representation has proven to be effective in the task of action recognition. This paper explores different interpretations of both the spatial and the temporal dimensions of a sequence of frames describing an action. We show that rather intuitive approaches, often borrowed from other computer vision tasks, can improve accuracy. We report results based on these modifications and propose an architecture that uses temporal convolutions with results comparable to the state of the art.

Towards Smart Adaptive Care Toilets

Standard toilets in Western countries often do not meet the needs of elderly and disabled people with physical limitations. While the existing concept of barrier-free toilets and the emerging "changing places" concept offer more space and support, the fixed height of the toilet seat still imposes a major problem during all phases of toilet use and can limit the users' autonomy by requiring personal assistance. Thus, in the EU project iToilet an innovative ICT-based modular height adjustable toilet system was designed to support the autonomy, dignity and safety of older people living at home by digital technology enhancements adapting the toilet to their needs and preferences. The main requirements were: double foldable handrails, height and tilt adjustment, emergency detection and call, and ease of use. The ICT component in this approach serves a double purpose of enhancing usability of the base assistive technology while at the same time providing safety for independent use. A field test of a prototype system in real environments of a day care center and a rehabilitation clinic has been successfully finished. The application of the iToilet concept also in semi-public settings is currently studied in the Toilet4me project.

Characterization of Vibrio cholerae neuraminidase as an immunomodulator for novel formulation of oral allergy immunotherapy

To improve current mucosal allergen immunotherapy Vibrio cholerae neuraminidase (NA) was evaluated as a novel epithelial targeting molecule for functionalization of allergen-loaded, poly(D,L-lactide-co-glycolide) (PLGA) microparticles (MPs) and compared to the previously described epithelial targeting lectins wheat germ agglutinin (WGA) and Aleuria aurantia lectin (AAL). All targeters revealed binding to Caco-2 cells, but only NA had high binding specificity to α-L fucose and monosialoganglioside-1. An increased transepithelial uptake was found for NA-MPs in a M-cell co-culture model. NA and NA-MPs induced high levels of IFN-γ and IL10 in naive mouse splenocytes and CCL20 expression in Caco-2. Repeated oral gavage of NA-MPs resulted in a modulated, allergen-specific immune response. In conclusion, NA has enhanced M-cell specificity compared to the other targeters. NA functionalized MPs induce a Th1 and T-regulatory driven immune response and avoid allergy effector cell activation. Therefore, it is a promising novel, orally applied formula for allergy therapy.

HDOMO: Smart Sensor Integration for an Active and Independent Longevity of the Elderly

The aim of this paper is to present the main results of HDOMO, an Ambient Assisted Living (AAL) project that involved 16 Small and Medium Enterprises (SMEs) and 2 research institutes. The objective of the project was to create an autonomous and automated domestic environment, primarily for elderly people and people with physical and motor disabilities. A known and familiar environment should help users in their daily activities and it should act as a virtual caregiver by calling, if necessary, relief efforts. Substantially, the aim of the project is to simplify the life of people in need of support, while keeping them autonomous in their private environment. From a technical point of view, the project provides the use of different Smart Objects (SOs), able to communicate among each other, in a cloud base infrastructure, and with the assisted users and their caregivers, in a perspective of interoperability and standardization of devices, usability and effectiveness of alarm systems. In the state of the art there are projects that achieve only a few of the elements listed. The HDOMO project aims to achieve all of them in one single project effectively. The experimental trials performed in a real scenario demonstrated the accuracy and efficiency of the system in extracting and processing data in real time to promptly acting, and in providing timely response to the needs of the user by integrating and confirming main alarms with different interoperable smart sensors. The article proposes a new technique to improve the accuracy of the system in detecting alarms using a multi-SO approach with information fusion between different devices, proving that this architecture can provide robust and reliable results on real environments.

UWB Monitoring System for AAL Applications

Independent living of elderly persons in their homes requires support that can be provided with modern assistive technologies. Monitoring of elderly persons behaviour delivers valuable information that can be used for diagnosis and detection of health problems as well as triggering alerts in emergency situations. The paper includes a description of the ultra wideband system developed within Networked InfrasTructure for Innovative home Care Solutions (NITICS) Active and Assisted Living (AAL) project. The system can be used as a component of AAL platforms. It delivers data on users localization and has a fall detector functionality. The system also provides access to raw measurement results from Microelectromechanical Systems (MEMS) sensors embedded in the device worn by the monitored person. These data can be used in solutions intended for elderly person’s behaviour investigation. The system was investigated under laboratory conditions as well as in home environment. The detailed system description and results of performed tests are included in the article.

On the Prototyping of an ICT-Enhanced Toilet System for Assisting Older Persons Living Independently and Safely at Home

Standard toilets often do not meet the needs of a significant number of older persons and persons with disabilities. The EU funded iToilet project aims at design and development of a new type of ICT enhanced modular toilet system which shall be able to support autonomy, dignity and safety of older persons living at home. Methodologically the project started with gathering user requirements by means of questionnaires, interviews and focus group discussion involving a total of 74 persons, thereof 41 subjects with movement disorders (primary users), 21 caregivers (secondary users) and 12 healthcare managers (tertiary users). Most important wishes were bilateral removable handrails, height and tilt adjustment, emergency detection, simplicity. In parallel to the ongoing technical development participatory design activities have been carried out at user test sites in order to continuously involve users into the design process and to allow quick feedback with regards to early prototype parts. The project currently is working on the finalization of the first prototype ready to enter the lab trial stage in spring 2017. The experiences will be used for redesigning a prototype 2 which is planned to be tested in real life settings early 2018.

Assistive Solutions in Practice: Experiences from AAL Pilot Regions in Austria

Since 2012 six AAL pilot regions were launched in Austria. The main goal of these pilot regions is to evaluate the impact of AAL technologies in daily use considering the entire value chain. Additionally, go-to market strategies for assistive technologies based on an involvement of all relevant stakeholders are developed. Within this paper an overview of the specific objectives, approaches and the status of all Austrian AAL pilot regions is given. Taking into account the different experiences of the different pilot regions, specific challenges in establishing, implementing and sustaining pilot region projects are discussed and lessons-learned are presented. Results show that a careful planning of all project phases taking into account available resources is crucial for the successful implementation of an AAL pilot region. In particular, this applies to all activities related to the active involvement of end-users.

Fucosylation is associated with the malignant transformation of intraductal papillary mucinous neoplasms: a lectin microarray-based study

PURPOSE

Intraductal papillary mucinous neoplasm (IPMN) is an intraductal mucin-producing pancreatic neoplasm with the potential for malignant transformation. Changes in glycans expressed on the cell surface and glycotransferases play important roles in malignant transformation. We conducted this study to analyze glycan alterations in IPMNs by using a lectin microarray and to identify the factors associated with altered glycans and their relationships with malignant transformation.

METHODS

Using a lectin microarray, we evaluated glycan expression in 22 samples of IPMN with carcinoma, obtained from curative resections performed in our department. We also used immunohistochemistry to investigate fucosyltransferase 8 (Fut 8) protein expression, which is associated with glycan alterations in IPMNs.

RESULTS

The lectin microarray demonstrated that only two lectins, Aleuria aurantia lectin (AAL) and Aspergillus oryzae L-fucose-specific lectin (AOL), which bind to fucose, exhibited significant sequential increases from normal pancreatic duct to adenoma and carcinoma. Similarly, Fut 8 protein expression, which is associated with AAL and AOL, sequentially and significantly increased from the normal pancreatic duct to adenoma and carcinoma.

CONCLUSIONS

Lectin microarray analysis suggested that fucosylation is associated with the malignant transformation of IPMNs.

AAL exacerbates pro-inflammatory response in macrophages by regulating Mincle/Syk/Card9 signaling along with the Nlrp3 inflammasome assembly

Previously, we demonstrated that Agrocybe aegerita lectin (AAL), a galectin isolated from edible mushroom Agrocybe aegerita, exerts potent anti-tumor activity, while the mechanisms by which AAL suppresses tumor growth are yet to be elucidated. Here, we conducted studies with focus for its impact on the cecal ligation and puncture (CLP)-induced innate immune response. Administration of AAL significantly exacerbated the severity of CLP-induced septic shock as manifested the increased lethality. AAL promoted inflammatory cytokine production by preferentially regulating macrophage activation and recruitment. Mechanistic studies revealed that AAL likely targets macrophages through receptor Mincle to activate Syk/Card9 signaling, which then couples to the Nlrp3 inflammasome assembly. It was further noted that AAL markedly promotes H3K4 di- and trimethylation, by which it enhances Hmgb1 expression. Specifically, AAL induced macrophages secretion of copious amount of Hmgb1 as manifested the Hmgb1 cytoplasmic translocation along with the detection of extracellular Hmgb1. AAL also stimulated a significant increase for nuclear Hmgb1, which then formed a complex with RelA, and thereby enhancing NF-κB transcriptional activity. Together, our data suggest that AAL may possess important pharmaceutical properties in the regulation of innate immune response.

Establishment of a novel lectin-antibody ELISA system to determine core-fucosylated haptoglobin

BACKGROUND

Fucosylated haptoglobin (Fuc-Hpt) is a novel cancer biomarker that increases in various pathological conditions. We previously established a Fuc-Hpt lectin-antibody assay using Aleuria aurantia lectin (AAL), and applied this to diagnose several diseases, including various cancers. AAL recognizes both α1-3/1-4 and α1-6 fucosylation on N/O-linked glycans. These fucosylation types differ in biological function, and in regulation by different fucosyltransferases. Recently, we identified a novel lectin, Pholiota squarrosa lectin (PhoSL), which specifically recognizes α1-6 fucosylation (core-fucosylation).

METHODS

We developed a lectin-antibody ELISA kit using PhoSL to determine core-Fuc-Hpt levels in sera from colorectal or pancreatic cancer patients.

RESULTS

Serum levels of AAL-reactive Hpt are higher in pancreatic cancer patients, whereas those of PhoSL-reactive Hpt are higher in colorectal cancer patients. Mass spectrometry analyses of Hpt fucosylation levels were consistent with lectin-antibody ELISA results. Hpt-transfected colorectal cancer cell lines produced significant amounts of core-Fuc-Hpt, suggesting that colorectal cancer tissues produce core-Fuc-Hpt.

CONCLUSIONS

These differences in Fuc-Hpt patterns might depend on cancer cells and the surrounding cells, which produce Hpt.

Psychosis effect on hippocampal reduction in schizophrenia

INTRODUCTION

In schizophrenia, disruption of the neurodevelopmental processes may lead to brain changes and subsequent clinical manifestations of the illness. Reports of the progressive nature of these morphological brain changes raise questions about their causes. The possible toxic effects of repeated stressful psychotic episodes may contribute to the disease progression.

OBJECTIVES

To analyze the influence of illness duration and previous psychotic episodes on hippocampal gray matter volume (GMV) in schizophrenia.

METHODS

We performed an analysis of hippocampal GMV correlations with illness duration, number of previous psychotic episodes, and age in 24 schizophrenia patients and 24 matched healthy controls.

RESULTS

We found a cluster of GMV voxels in the left hippocampal tail that negatively correlated with the number of previous psychotic episodes, independent from the effect of age. On the other hand we found no effect of illness duration independent of age on the hippocampal GMV. Finally, we found a cluster of significant group-by-age interaction in the left hippocampal head.

CONCLUSIONS

We found an additive adverse effect of psychotic episodes on hippocampal morphology in schizophrenia. Our findings support toxicity of psychosis concept, together with etiological heterogeneity of brain changes in schizophrenia.

Is there a cerebellar compensatory effort in first-episode, treatment-naive major depressive disorder at rest?

BACKGROUND

This study was undertaken to explore whether there is a cerebellar compensatory response in patients with first-episode, treatment-naive major depressive disorder (MDD). The cerebellar compensatory response is defined as a cerebellar hyperactivity which would be inversely correlated with both the activation of the functionally connected cerebral regions and the depression severity.

METHODS

Resting-state functional magnetic resonance imaging (fMRI) data of 24 patients with MDD and 24 healthy subjects were analyzed with the fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC) methods. The structural images were processed with the voxel-based morphometry (VBM) method.

RESULTS

Compared to healthy controls, depressed patients had significantly increased fALFF in the left Crus I and the left cerebellar lobule VI. FC analysis of these two seeded regions found that depressed patients had increased FC between the left Crus I and the right hippocampus, but had decreased FC between the left Crus I and the left inferior parietal lobule (IPL), and between the left cerebellar lobule VI and bilateral inferior temporal gyrus. No correlation was observed between the abnormal fALFF of the seeds and their connected regions and the depression severity or the executive function. The VBM results did not show significant reduction in gray or white matter volume in any above-mentioned region.

CONCLUSIONS

Our findings suggest that increased cerebellar activity at resting state may be a disease state phenomenon but not a compensatory response to the dysfunction of the default mode network (DMN) in MDD.

Configuring a context-aware middleware for Wireless Sensor Networks

In the Future Internet, applications based on Wireless Sensor Networks will have to support reconfiguration with minimum human intervention, depending on dynamic context changes in their environment. These situations create a need for building these applications as adaptive software and including techniques that allow the context acquisition and decisions about adaptation. However, contexts use to be made up of complex information acquired from heterogeneous devices and user characteristics, making them difficult to manage. So, instead of building context-aware applications from scratch, we propose to use FamiWare, a family of middleware for Ambient Intelligence specifically designed to be aware of contexts in sensor and smartphone devices. It provides both, several monitoring services to acquire contexts from devices and users, and a context-awareness service to analyze and detect context changes. However, the current version of FamiWare does not allow the automatic incorporation related to the management of new contexts into the FamiWare family. To overcome this shortcoming, in this work, we first present how to model the context using a metamodel to define the contexts that must to be taken into account in an instantiation of FamiWare for a certain Ambient Intelligence system. Then, to configure a new context-aware version of FamiWare and to generate code ready-to-install within heterogeneous devices, we define a mapping that automatically transforms metamodel elements defining contexts into elements of the FamiWare family, and we also use the FamiWare configuration process to customize the new context-aware variant. Finally, we evaluate the benefits of our process, and we analyze both that the new version of the middleware works as expected and that it manages the contexts in an efficient way.

Uranus: a middleware architecture for dependable AAL and vital signs monitoring applications

The design and realization of health monitoring applications has attracted the interest of large communities both from industry and academia. Several research challenges have been faced and issues tackled in order to realize effective applications for the management and monitoring of people with chronic diseases, people with disabilities, elderly people. However, there is a lack of efficient tools that enable rapid and possibly cheap realization of reliable health monitoring applications. The paper presents Uranus, a service oriented middleware architecture, which provides basic functions for the integration of different kinds of biomedical sensors. Uranus has also distinguishing characteristics like services for the run-time verification of the correctness of running applications and mechanisms for the recovery from failures. The paper concludes with two case studies as proof of concept.