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We compare the relative efficacy of virtual reality therapy exposure (VRET) versus in vivo therapy exposure among individuals suffering from phobias. A systematic search was completed up to 03 April 2020, using the following databases: ACM Digital Library, ResearchGate, IEEE, Science Direct, MIT PressJournals, Center for Direct Scientific Communication (CCSD) and Mary Ann Liebert Publishers. Five authors searched the databases using the following terms: Virtual Reality, Phobia, Mental health, Computing, Therapy, HMD, CAVE, Virtual ambient, in virtuo, Avoidance, Exposure, VRET, in vivo, Anxiety, Agoraphobia, Social Phobia, Stimuli, Cognitive-behaviour. All studies that evaluate the effect of in virtuo exposure towards phobia rehabilitation were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 30 articles were selected. Data extracted included the number of samples, amount of sessions, study variables that may affect the final outcome, therapy technology. The data provided was synthesized using a meta-analysis based on the results. The results demonstrated a positive outcome of Virtual Reality Exposure Treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. The findings suggest that for some specific phobias treatment, Virtual Reality Exposure Treatment does not reach the in vivo exposure level of immersion and presence. Further research is needed to perform studies with higher-dimension samples, since many papers report a low sample size and that is probably why many of them have inconclusive results.

Electrodermal activity (EDA) is a physiological signal that can be measured non-intrusively and associated with the sympathetic nervous system, hence being widely used nowadays. Although multiple sensor designs have been proposed over the years, practical hardware limitations still persist, due to differences in the electrode materials used to interface with the body, sweat gland density at the recording sites, and variability in the overall electrical properties of the skin in-between users. This is particularly challenging when low resolution Analog-to-Digital Converters (ADC) are used, which, due to the proliferation of open source and low-cost hardware platforms, are currently widespread. In this article we present a design and experimental evaluation of a new circuit for EDA measurement with adaptive gain control, allowing the dynamic adaptation of the measurement range. The proposed circuit has shown comparable results to those obtained with a reference sensor, obtaining a mean correlation coefficient of 0.967, and proved to have superior performance in cases where the reference sensor would saturate.

Epilepsy is a neurological disorder, where there is a cluster of brain cells that behave in a hyperexcitable manner, the individual can promote injuries, trauma or, in more severe cases, sudden death. Electroencephalogram (EEG) is the most used way to detect epileptic seizures. Therefore, more simplified methods of analysis of the EEG can help in the diagnosis and treatment of these individuals more quickly. In this study, we extracted pertinent EEG characteristics to assess the epileptic seizure period. We use Perceptron Multilayer artificial neural networks to classify the period of the crisis, obtaining a more efficient diagnosis. The multilayer neural network obtained an accuracy of 98%. Thus, the strategy of extracting characteristics and the architecture of the assigned network were sufficient for a rapid and accurate diagnosis of epilepsy.

Combining Phonocardiography (PCG) and Electrocardiography (ECG) data has been recognized within the state-of-the-art as of added value for enhanced cardiovascular assessment. However, multiple aspects of ECG data acquisition in a stethoscope form factor remain unstudied, and existing devices typically enforce a substantial change into routine clinical auscultation procedures, with predictably low technology acceptance. As such, in this paper, we present a novel approach to ECG data acquisition throughout the five main cardiac auscultation points, and that intends to be incorporated in a commonly used electronic stethoscope. Therefore, it enables analysis and acquisition of both PCG and ECG signals in a single pass. We describe the development, experimental evaluation, and comparison of the ECG signals obtained using our proposed approach and a gold standard medical device, through metrics that allow the evaluation of morphological similarities. Results point to a high correlation between the two evaluated setups, thus supporting the idea of meaningfully collecting ECG data along medical auscultation points with the proposed form factor. Moreover, this work has led us to conclude that for the studied population, signals acquired on focuses F1, F2, and F3 are usually highly correlated with leads V1 and V2 of the standard ECG medical recording procedure.

Toxoplasma gondii is an apicomplexan parasite, the causative agent of toxoplasmosis, a common disease in the world. Toxoplasmosis could be severe, especially in immunocompromised patients. The current therapy is limited, where pyrimethamine and sulfadiazine are the best choices despite being associated with side effects and ineffective against the bradyzoites, the parasitic form present during the chronic phase of the infection. Thus, new therapies against both tachyzoites and bradyzoites from T. gondii are urgent. Herein, we present the anti-T. gondii effect of 1,10-phenanthroline and its N-phenyl-1,10-phenanthroline-2-amine derivatives. The chemical modification of 1,10-phenanthroline to new derivatives improved the anti-T. gondii activity 3.4 fold. The most active derivative presented ED50 in the nanomolar range, the smallest value found was for Ph8, 0.1 µM for 96 h of treatment. The host cell viability was maintained after the treatment with the compounds, which were found to be highly selective presenting large selectivity indexes. Treatment with derivatives for 96 h was able to eliminate the T. gondii infection irreversibly. The ultrastructural alterations caused after the treatment with the most effective derivative (Ph8) included signs of cell death, specifically revealed by the Tunel assay for detection of DNA fragmentation. The Phen derivatives were also able to control the growth of the in vitro-derived bradyzoite forms of T. gondii EGS strain, causing its lysis and death. These findings promote the 1,10-phenanthroline derivatives as potential lead compounds for the development of a treatment for acute and chronic phases of toxoplasmosis.

Background and Objective: The reliability of low-cost mobile systems for recording Electrocardiographic (ECG) data is mostly unknown, posing questions regarding the quality of the recorded data and the validity of the extracted physiological parameters. The present study compared the BITalino toolkit with an established medical-grade ECG system (BrainAmp-ExG). Methods: Participants underwent simultaneous ECG recordings with the two instruments while watching pleasant and unpleasant pictures of the “International Affective Picture System” (IAPS). Common ECG parameters were extracted and compared between the two systems. The Intraclass Correlation Coefficients (ICCs) and the Bland–Altman Limits of Agreement (LoA) method served as criteria for measurement agreement. Results: All but one parameter showed an excellent agreement (&gt, 80%) between both devices in the ICC analysis. No criteria for Bland–Altman LoA and bias were found in the literature regarding ECG parameters. Conclusion: The results of the ICC and Bland–Altman methods demonstrate that the BITalino system can be considered as an equivalent recording device for stationary ECG recordings in psychophysiological experiments.

Epilepsy is a neurological disease that affects about 50 million people worldwide. It is a disorder of the central nervous system, characterized by recurrent seizures that can have a massive impact in the physical and mental health of the people who suffer from it, as well as their loved ones. Long-term monitoring of epilepsy in uncontrolled environments is key to provide accurate characterization of the disease, and to create tools that improve the patients' lives. Although some wearable devices (particularly with motion and cardiac-based sensors) are quickly gaining ground as everyday use monitoring devices, in the scope of epilepsy, electroencephalography (EEG) remains the gold-standard. Therefore, it is of utmost importance to include this modality in ambulatory settings, leveraging its extensive presence in literature and available databases. Nevertheless, in long-term recordings, having information about the onset of the seizure is of utmost importance for effective analysis of the collected data. Hence, this work explores the use of a single-channel, nonintrusive, EEG configuration in automatic seizure detection, with the purpose of event annotation in long-term recordings. This is a key element to the creation of multimodal datasets that can be used in seizure detection and, eventually, prediction, as well as towards comprehensive multimodal epilepsy monitoring techniques. A seizure-specific Support Vector Machines (SVM) classifier was designed for labeling eight different types of seizure, using a limited-channel configuration (Fp1-Fp2). Our work uses the TUH EEG Seizure Corpus, for which encouraging results were achieved for tonic-clonic and myoclonic seizures, with sensitivities of 98.9% and 98.2%, as well as precisions of 100% and 99.8%, respectively.

Tuberculosis (TB) remains a major health problem within the Community of Portuguese Language Speaking Countries (CPLP). Despite the marked variation in TB incidence across its member-states and continued human migratory flux between countries, a considerable gap in the knowledge on the Mycobacterium tuberculosis population structure and strain circulation between the countries still exists. To address this, we have assembled and analysed the largest CPLP M. tuberculosis molecular and drug susceptibility dataset, comprised by a total of 1447 clinical isolates, including 423 multidrug-resistant isolates, from five CPLP countries. The data herein presented reinforces Latin American and Mediterranean (LAM) strains as the hallmark of M. tuberculosis populational structure in the CPLP coupled with country-specific differential prevalence of minor clades. Moreover, using high-resolution typing by 24-loci MIRU-VNTR, six cross-border genetic clusters were detected, thus supporting recent clonal expansion across the Lusophone space. To make this data available to the scientific community and public health authorities we developed CPLP-TB (available at http://cplp-tb.ff.ulisboa.pt), an online database coupled with web-based tools for exploratory data analysis. As a public health tool, it is expected to contribute to improved knowledge on the M. tuberculosis population structure and strain circulation within the CPLP, thus supporting the risk assessment of strain-specific trends., Highlights • The Community of Portuguese Speaking Countries (CPLP) occupies a vast geographical area. • Three CPLP countries are shortlisted in the WHO's list of Top 30 high-burden countries. • Common Mycobacterium tuberculosis population structure denote historical strain flow. • Cross-border clusters suggest recent intercontinental tuberculosis transmission. • CPLP-TB: a novel strain database and framework for collaborative studies and strain tracing.

Multiple wearable devices for cardiovascular self-monitoring have been proposed over the years, with growing evidence showing their effectiveness in the detection of pathologies that would otherwise be unnoticed through standard routine exams. In particular, Electrocardiography (ECG) has been an important tool for such purpose. However, wearables have known limitations, chief among which are the need for a voluntary action so that the ECG trace can be taken, battery lifetime, and abandonment. To effectively address these, novel solutions are needed, which has recently paved the way for “invisible” (aka “off-the-person”) sensing approaches. In this article we describe the design and experimental evaluation of a system for invisible ECG monitoring at home. For this purpose, a new sensor design was proposed, novel materials have been explored, and a proof-of-concept data collection system was created in the form of a toilet seat, enabling ECG measurements as an extension of the regular use of sanitary facilities, without requiring body-worn devices. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard equipment, involving 10 healthy subjects. For the acquisition of the ECG signals on the toilet seat, polymeric electrodes with different textures were produced and tested. According to the results obtained, some of the textures did not allow the acquisition of signals in all users. However, a pyramidal texture showed the best results in relation to heart rate and ECG waveform morphology. For a texture that has shown 0% signal loss, the mean heart rate difference between the reference and experimental device was − 1.778 ± 4.654 Beats per minute (BPM); in terms of ECG waveform, the best cases present a Pearson correlation coefficient above 0.99.

In this paper we present three studies that demonstrate the applicability of spectroscopy methods and optical clearing treatments in pathology identification and monitoring. In the first study, by obtaining the absorption spectra of human healthy and pathological (adenocarcinoma) colorectal mucosa tissues, it was possible to identify a higher content of a pigment in the diseased tissues. This study also shows that machine learning methods can be used to reach the same differentiated results in vivo through diffuse reflectance spectroscopy. In the second study, the combination of collimated transmittance spectroscopy with optical clearing treatments allowed to obtain the diffusion coefficients of glucose in healthy and pathological colorectal mucosa as: Dglucose=5.8x10–7 cm2/s and Dglucose=4.4x10–7 cm2/s, respectively. This study also demonstrated that the diseased tissues contains about 5% more mobile water than the healthy tissues. The third study was performed to evaluate the protein dissociation mechanism of optical clearing. By treating both healthy and pathological colorectal mucosa tissues with 93%-glycerol, a protein dissociation rate of about 3 times higher was obtained for the pathological mucosa. All the discriminating parameters that result from these studies can be obtained in the in vivo situation through diffuse reflectance spectroscopy and further studies to evaluate their values in different stages of cancer progression are of great importance to develop disease monitoring protocols., The authors of the article knew well and communicated with Ekaterina Borisova for many years, especially Valery Tuchin and in recent years Luís Oliveira. We had many joint plans to organize conferences and joint research projects, but COVID-19 mercilessly interrupted our communication. We have lost a great scientist and a person with a huge soul, sociable, but at the same time modest and kind. We will always remember our warm meetings and fruitful work with Ekaterina. This research was supported by the Portuguese grant FCT-UIDB/04730/2020. VVT was supported by grant under the Decree of the Government of the Russian Federation No. 220 of 09 April 2010 (Agreement No. 075-15-2021-615 of 04 June 2021).

Being the second most common neurodegenerative disease, Parkinson's disease (PD) can be symptomatically treated, although, unfortunately, it cannot be cured yet. Moreover, diagnosing and assessing PD patients is a complex process, requiring continuous monitoring. In this vein, the design, development, and validation of innovative assessment tools may be helpful in the management of patients with PD, in particular. Based on intelligent ICT interventions, the i-PROGNOSIS project intends to mitigate PD's specific symptoms, such as neurological movement disorders of gait, balance, coordination, and posture, already characterized in the early phase of the disease. From this perspective, an innovative iPrognosis motor assessment tool is presented here, taking into consideration the Unified Parkinson Disease Rating Scale (UPDRS) Part III motor skills testing items, for evaluating the motor skills status. The efficiency of the proposed Assessment Tests to reflect the motor skills status, similarly to the UPDRS Part III items, was validated via 27 participants (18 males; mean age = 62 years, SD = 10.36 years; range, 43–79 years) with early (n = 10) and moderate (n = 17) PD who performed the Assessment Tests. Features from the latter were then correlated with the corresponding clinically assessed UPDRS Part III items, and statistically significant negative correlations (range, −0.364 to −0.802) were identified between the median values of the Assessment Tests and the UPDRS Part III items. In this vein, the iPrognosis Assessment Tests were integrated within the personalized interventions of the i-PROGNOSIS project, providing alternative means of assessing their effect on the PD patient's motor skills enhancement. The promising results presented here elaborate on the concept of using ICT-based assessment means to achieve comparable outcomes with the clinical standards in motor skills assessment.

The stethoscope is a major symbol of modern medicine. It is used for diagnosis of different conditions and enables physicians to listen to internal body sounds. Electrocardiography was only introduced in medicine in the beginning of the twentieth century. Today measuring heart's electrical activity is also fundamental cardiac diseases diagnosis. Although performed with independent devices, requiring physician and patient presence in the same physical space, in combination they enhance cardiovascular assessment. In this paper, a digital stethoscope encapsulation was designed, adding new functionality to this advanced medical device. Today wired and wireless communications enable different medical devices to share data and information, over long distances. Using low-cost hardware technologies, the encapsulation will add the ability to acquire and transmit via Bluetooth the Electrocardiographic activity, determined in the same cardiac focus and synchronised with the Phonocardiographic sound recordings. Several encapsulation concepts were developed and prototyped using 3D printing. They were easily fitted to the digital stethoscope and tested in a hospital environment for ergonomics, acoustic and electric signals acquisition. The best concept was chosen with the help of a physician's opinion and the final prototype performance was very satisfactory.

Maintaining a stable upright position and body orientation are fundamental tasks to perform everyday activities and ensure the quality of life. The ability to maintain these can be damaged by various pathologies/disfunctions, such as stroke and aging. Therefore, it is important to quantify how the postural control reacts to different situation and how is affected by different pathologies, which could bring a big contribution in a clinical context, by helping to diagnose pathologies that can bring postural impairments. An experimental protocol was developed that combines both electromyography and posturography. To help validate this protocol, 53 patients (43 healthy and 10 stroke patients) performed it twice within a two-week period. By comparing the results from the two runs, it was possible to assess that these were not statistical different, and thus prove that the protocol is viable tool to build a normative database.

BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

Background Remote ischemic conditioning (RIC) is a procedure applied in a limb for triggering endogenous protective pathways in distant organs, namely brain or heart. The underlying mechanisms of RIC are still not fully understood, and it is hypothesized they are mediated either by humoral factors, immune cells and/or the autonomic nervous system. Herein, heart rate variability (HRV) was used to evaluate the electrophysiological processes occurring in the heart during RIC and, in turn to assess the role of autonomic nervous system. Methods Healthy subjects were submitted to RIC protocol and electrocardiography (ECG) was used to evaluate HRV, by assessing the variability of time intervals between two consecutive heart beats. This is a pilot study based on the analysis of 18 ECG from healthy subjects submitted to RIC. HRV was characterized in three domains (time, frequency and non-linear features) that can be correlated with the autonomic nervous system function. Results RIC procedure increased significantly the non-linear parameter SD2, which is associated with long term HRV. This effect was observed in all subjects and in the senior (> 60 years-old) subset analysis. SD2 increase suggests an activation of both parasympathetic and sympathetic nervous system, namely via fast vagal response (parasympathetic) and the slow sympathetic response to the baroreceptors stimulation. Conclusions RIC procedure modulates both parasympathetic and sympathetic autonomic nervous system. Furthermore, this modulation is more pronounced in the senior subset of subjects. Therefore, the autonomic nervous system regulation could be one of the mechanisms for RIC therapeutic effectiveness.

In the current digital era, cardiovascular activity analysis is becoming ubiquitous with the increasing availability of embedded systems, and, in some cases, these systems are even endowed with the capabilities of detecting health risk factors identified through electrocardiographic (ECG) markers. Aligned with this trend, and inspired by the results from our pilot study, we focus this research on exploring the potential of a low-cost and open source device for heart rhythm analysis, with emphasis on Atrial Fibrillation (AF). AF is the most common cardiac arrhythmia, defined as a complex cardiac disease which is highly correlated to stroke and heart failure, and its prevalence is especially high in elderly population. Given the importance and impact of such cardiovascular disease, we performed ECG acquisitions in a hospital setting to evaluate the potential of this device to identify heart rhythms. These ECG acquisitions were performed in 10 patients, accomplished simultaneously with the low-cost device and the gold standard devices used in the clinical routine of the hospital. The data collected from the low-cost device was analysed by the cardiologist specialized in rhythmology, along with the conventional ECG exam analysis, whom suggested 100% accuracy of the low-cost device in differentiating a sinus rhythm from AF. The results also present great accuracy in the detection of atypical cardiac events through ECG analysis, as well as a good agreement for the corroboration of the numerical data from the devices used for this study, as the RR intervals and QTc intervals values suggest.

Background and Objective: Respiratory gating training is a common technique to increase patient proprioception, with the goal of (e.g.) minimizing the effects of organ motion during radiotherapy. In this work, we devise a system based on autoencoders for classification of regular, apnea and unconstrained breathing patterns (i.e. multiclass). Methods: Our approach is based on morphological analysis of the respiratory signals, using an autoencoder trained on regular breathing. The correlation between the input and output of the autoencoder is used to train and test several classifiers in order to select the best. Our approach is evaluated in a novel real-world respiratory gating biofeedback training dataset and on the Apnea-ECG reference dataset. Results: Accuracies of 95 ± 3.5% and 87 ± 6.6% were obtained for two different datasets, in the classification of breathing and apnea. These results suggest the viability of a generalised model to characterise the breathing patterns under study. Conclusions: Using autoencoders to learn respiratory gating training patterns allows a data-driven approach to feature extraction, by focusing only on the signal’s morphology. The proposed system is prone to be used in real-time and could potentially be transferred to other domains.

BACKGROUND Cutaneous leishmaniasis (CL) is a world-wide health problem which currently lacks effective, affordable and easy to use therapy. Recently, the meglumine antimoniate (MA) intralesional infiltration was included among the acceptable therapies for New World leishmaniasis. While this approach is attractive, there is currently little evidence to support its use in Americas. OBJECTIVES The aim of this study was to provide information about effectiveness and safety of a standardised MA intralesional infiltration technique for the treatment of CL. METHODS It is a single-arm phase II clinical trial conducted at a Brazilian referral centre. CL cases with parasitological confirmation presenting a maximum of three CL-compatible skin lesions were treated with weekly MA intralesional infiltration by using a validated technique, up to a maximum of eight infiltrations. RESULTS A total of 53 patients (62 lesions) were included. Overall, patients received a median of seven infiltrations (IQR25-75% 5-8) over a median treatment period of 43 days (IQR25-75% 28-52 days). The definitive cure rate at D180 was 87% (95% CI:77-96%). The majority of adverse events were local, with mild or moderate intensity. Bacterial secondary infection of the lesion site was observed in 13% of the treated patients, beside two intensity-three adverse events (hypersensitivity reactions).

To evaluate the feasibility, clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) in the management of patients with germ cell tumors (GCT) and residual post-chemotherapy mass.We report our experience of 25 patients treated with L-RPLND between 2008 and 2015. All 25 patients were diagnosed with GCT by primary pathological evaluation of the specimens after orchiectomy. All patients received cisplatin-based chemotherapy. The technique consisted of L-RPLND excision of the residual mass using unilateral template dissection. We assessed perioperative data and histological findings.Surgery was successfully completed in 24 (96%) patients, 1 patient required an open surgery due to intense adhesions of the mass to the inferior vena cava. Mean operation time was 213 minutes. Mean blood loss was 260 mL. Postoperative complications were upper limb osteomuscular pain in 2 patients and chylous ascites in 1 patient. Mean postoperative hospital stay was 2 days. The median residual mass diameter was 3.3 cm (range 1.1-6.6 cm). Histopathological findings were necrotic tissue in 9 patients, teratoma in 9 patients, viable tumor in 6 patients, and Castleman disease in 1 patient. The median follow-up was 30 months. Normal antegrade ejaculation was preserved in all patients.Laparoscopic postchemotherapy RPLND is a feasible, safe, and highly oncologically efficient procedure, which has the benefits of minimally invasive surgery.

© 2015 The Author(s). Published by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Research on psycho-oncology increased across literature during the last decades, pointing to links between biological, psychosocial and behavioural factors in cancer beginning and progression. This study aimed to characterize a sample of recently breast-cancer-diagnosed women, compared to a control group, regarding their stress reactivity at a psychological and autonomic levels, anger regulation and attachment styles. Eighty-seven females (52 breast cancer patients and 33 controls) respectively from Portuguese public hospitals and general population were recruited. They were assessed through psychometric measures (distress, attachment styles and anger regulation) and psychophysiological parameters of reactivity were collected. The breast cancer patients studied seem to be less anxious in their attachment patterns compared to healthy people, but they report significant distress while facing a threatening situation. This clinical group also shows lower psychophysiological reactivity, both at the baseline and confronted with different emotional eliciting stimuli. Self-directed anger was associated with the presence of anxious attachment schemes and strictly linked to the appraised distress. A predictive model suggests the impact of this pattern of anger management and an anxious attachment style in the emotional disturbance reported by these patients. Findings suggest that insecure attachment schemes, dysfunctional anger regulation strategies and a lack of psychophysiological activation may be discussed as relevant factors that modulate emotional distress associated with the diagnosis of breast cancer., The research was granted by BIAL Foundation (Grant with the Reference no. 119/10)

Low-cost hardware platforms for biomedical engineering are becoming increasingly available, which empower the research community in the development of new projects in a wide range of areas related with physiological data acquisition. Building upon previous work by our group, this work compares the quality of the data acquired by means of two different versions of the multimodal physiological computing platform BITalino, with a device that can be considered a reference. We acquired data from 5 sensors, namely Accelerometry (ACC), Electrocardiography (ECG), Electroencephalography (EEG), Electrodermal Activity (EDA) and Electromyography (EMG). Experimental evaluation shows that ACC, ECG and EDA data are highly correlated with the reference in what concerns the raw waveforms. When compared by means of their commonly used features, EEG and EMG data are also quite similar across the different devices.

An original self-contained enzymatic microreactor − detector in a thin layer flow-through configuration has been developed for the screening of tyrosinase inhibitors. The microreactor- detector consisted of a gold disk for tyrosinase immobilization adjacent to a glassy carbon disk as working electrode (GCE). Using l -tyrosine as substrate, the enzymatic product formed (dopaquinone) was detected amperometrically at the GCE. Experimental parameters most affecting the l -tyrosine response were optimized with a central composite design. Measurements were performed in phosphate buffer pH 6.0 with an applied potential of +50 mV vs Ag/AgCl and a flow rate of 100 μL/min. The determined Km app was 1.9 ± 0.1 mM. The setup permitted the determination of the efficiency and the duration of inhibition of twelve compounds known as tyrosinase inhibitors namely kojic acid, gallic acid, azelaic acid, benzoic acid, l -ascorbic acid, hydroquinone, glabridine, resveratrol, quercetin dihydrate, captopril, l -cysteine and l -glutathione reduced. l -Ascorbic acid and kojic acid were found to be the most potent inhibitors for the two studied criteria with IC 50 of 32 μM and 156 μM, respectively.

Autism Spectrum Disorders (ASD) are a triad of disturbances affecting the areas of communication, social interaction and behavior, and each subject has very different cognitive and functional characteristics. Especially at young ages and in educational contexts, these limitations can be deeply disabling if appropriate intervention methodologies are not used. Computer aided tools play a major role in the development of adequate educational responses, however, current approaches either focus more on the delivery of rich multimedia content, and less on the customization capabilities, or vice versa, and are unable to explore the individual differences that are specific to each subject with ASD. This work presents a novel approach focused on improving the outcomes of children with ASD, with a special emphasis on communication skills, by exploring the potential of user-tuned content customization to enable children to interact and share opinions and experiences, through a rich multimedia environment. Our approach was evaluated through a set of transversal and longitudinal studies involving real-world users. In the overall, experimental results have shown that our proposed approach leads to improved outcomes and higher engagement of the children in the educational process.

Background: Postoperative delirium (POD) is a frequent post-surgical complication that is associated with increased mortality and poor patient outcomes. POD is a complex disorder with multiple risk factors such as pre-existing patient comorbidities and perioperative complications. The aim of this study was to evaluate the incidence of POD and to identify risk factors for the development of POD in a post-anesthesia care unit (PACU). Methods: We enrolled 97 adult patients admitted to a PACU over a five-day period (start date September 6, 2010). Patient demographics and intraoperative and postoperative data were collected. Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist. Descriptive analyses of variables were used to summarize data, and the Mann–Whitney U test was used to compare continuous variables; the chi-square or Fisher's exact test was used for comparisons. Univariate analysis was performed using simple binary logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). The significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons and variables were deemed significant if p≤0.0025. Results: Six percent of patients developed POD. These patients were older and more likely to have higher American Society of Anesthesiologists (ASA) physical status (83 vs. 22% with ASA III/IV, p=0.004) as well as a higher frequency of congestive heart failure (50 vs. 3%, p=0.003) and a higher Revised Cardiac Risk Index (RCRI) score (33 vs. 6% with RCRI ≥2, p=0.039). The duration of anesthesia for patients with POD was also longer and they received a greater volume of crystalloids, colloids, and erythrocytes during surgery. Congestive heart disease was an independent risk factor for POD (OR 29.3, 95% CI 4.1–210.6; p

The measurement of bio-signals is an important tool not only to assess the physical fitness, but also to prevent and/or to anticipate clinical episodes. In this paper a prototype to collect biosignals in water environments is described. This prototype collects three different signals such as accelerometry, electrocardiography, and electromyography, and was developed based on a modified off-the-shelf BITalino, to allow its use in water related bio-signal research. Several challenges are raised related with acquisition, transmission, and analysis of data, namely on defying environments such as swimming. The proposed model revealed it accuracy and suitability when applied on the swimming context.

Autism spectrum disorders (ASDs) are a triad of disturbances affecting the areas of communication, social inter- action and behavior. In educational contexts, these limitations can be deeply disabling unless appropriate intervention methodologies are promoted. Children with ASDs usually have very strict interests, which may cause a lack of interest in standard ICT tools overtime. Our paper presents a new way to overcome these issues, by enabling children to have the opportunity to enjoy a rich multimedia platform. This approach allows tutors and peers to prepare a unique setup for the child's needs, giving the possibility to fully customize the layout and contents. Special attention was given to the promotion of communicative and social competences of children with ASDs, enabling them to interact with one another through messages, share opinions, and experiences. Preliminary results show that children feel motivated using the tool, and number of interactions between peers increase. In this paper we will describe the platform and how it can be customized, and finally, introduce the evaluation methodology to be used.

Atmospheric aerosols of four aerodynamic size ranges were collected using high volume cascade impactors in an extremely busy roadway tunnel in Lisbon (Portugal). Dust deposited on the tunnel walls and guardrails was also collected. Average particle mass concentrations in the tunnel atmosphere were more than 30times higher than in the outside urban background air, revealing its origins almost exclusively from fresh vehicle emissions. Most of the aerosol mass was concentrated in submicrometer fractions (65%), and polycyclic aromatic hydrocarbons (PAH) were even more concentrated in the finer particles with an average of 84% of total PAH present in sizes smaller than 0.49μm. The most abundant PAH were methylated phenanthrenes, fluoranthene and pyrene. About 46% of the total PAH mass was attributed to lower molecular weight compounds (two and three rings), suggesting a strong influence of diesel vehicle emissions on the production of local particulate PAH. The application of diagnostic ratios confirmed the relevance of this source of PAH in the tunnel ambient air. Deposited dust presented PAH profiles similar to the coarser aerosol size range, in agreement with the predominant origin of coarser aerosol particles from soil dust resuspension and vehicle wear products. published

Physiological Computing augments the information bandwidth between a computer and its user by continuous, real-time monitoring of the user’s physiological traits and responses. This is especially interesting in a context of emotional assessment during human-computer interaction. The electroencephalogram (EEG) signal, acquired on the scalp, has been extensively used to understand cognitive function, and in particular emotion. However, this type of signal has several drawbacks, being susceptible to noise and requiring the use of impractical head-mounted apparatuses. For these reasons, the electrocardiogram (ECG) has been proposed as an alternative source to assess emotion, which is continuously available, and related with the psychophysiological state of the subject. In this paper we analyze morphological features of the ECG signal acquired from subjects performing an attention-demanding task. The analysis is based on various unsupervised learning techniques, which are validated against evidence found in a previous study by our team, where EEG signals collected for the same task exhibit distinct patterns as the subjects progress in the task.

Previous work by our group introduced a novel concept and sensor design for “off-the-person” ECG, for which evidence on how it compares against standard clinical-grade equipment has been largely missing. Our objectives with this work are to characterise the off-the-person approach in light of the current ECG systems landscape, and assess how the signals acquired using this simplified setup compare with clinical-grade recordings. Empirical tests have been performed with real-world data collected from a population of 38 control subjects, to analyze the correlation between both approaches. Results show off-the-person data to be correlated with clinical-grade data, demonstrating the viability of this approach to potentially extend preventive medicine practices by enabling the integration of ECG monitoring into multiple dimensions of people’s everyday lives. PTDC/EEI-SII/2312/2012; SFRH/BD/65248/2009;SFRH/PROTEC/49512/2009 info:eu-repo/semantics/publishedVersion

Biofeedback from physical rehabilitation exercises has proved to lead to faster recovery, better outcomes, and increased patient motivation. In addition, it allows the physical rehabilitation processes carried out at the clinic to be complemented with exercises performed at home. However, currently existing approaches rely mostly on audio and visual reinforcement cues, usually presented to the user on a computer screen or a mobile phone interface. Some users, such as elderly people, can experience difficulties to use and understand these interfaces, leading to non-compliance with the rehabilitation exercises. To overcome this barrier, latest biosignal technologies can be used to enhance the efficacy of the biofeedback, decreasing the complexity of the user interface. In this paper we propose and validate a context-aware framework for the use of animatronic biofeedback, as a way of potentially increasing the compliance of elderly users with physical rehabilitation exercises performed at home. In the scope of our work, animatronic biofeedback entails the use of pre-programmed actions on a robot that are triggered in response to certain changes detected in the users biomechanical or electrophysiological signals. We use electromyographic and accelerometer signals, collected in real time, to monitor the performance of the user while executing the exercises, and a mobile robot to provide animatronic reinforcement cues associated with their correct or incorrect execution. A context-aware application running on a smartphone aggregates the sensor data and controls the animatronic feedback. The acceptability of the animatronic biofeedback has been tested on a set of volunteer elderly users, and results suggest that the participants found the animatronic feedback engaging and of added value.

Scramblases are a family of single-pass plasma membrane proteins, identified by their purported ability to scramble phospholipids across the two layers of plasma membrane isolated from platelets and red blood cells. However, their true in vivo role has yet to be elucidated. We report the generation and isolation of null mutants of two Scramblases identified in Drosophila melanogaster. We demonstrate that flies lacking either or both of these Scramblases are not compromised in vivo in processes requiring scrambling of phospholipids. Instead, we show that D. melanogaster lacking both Scramblases have more vesicles and display enhanced recruitment from a reserve pool of vesicles and increased neurotransmitter secretion at the larval neuromuscular synapses. These defects are corrected by the introduction of a genomic copy of the Scramb 1 gene. The lack of phenotypes related to failure of scrambling and the neurophysiological analysis lead us to propose that Scramblases play a modulatory role in the process of neurotransmission.

Objective: The aim of this study was to investigate psychophysiological reactivity to daily-life stimuli in opiate dependents and associations with alexithymia. Methods: The sample (n=72) was composed of a heroin addicts group treated with methadone and a healthy group, studied in several variables. Participants completed the Portuguese versions of the Toronto Alexithymia Scale-20 items, the Hospital Anxiety and Depression Scale and the Mini-Mental State Examination. They were also exposed to images from The International Affective Pictures System (IAPS) and physiological parameters and ratings of valence and arousal were collected. Results: Opiate dependents showed more alexithymia than controls and higher autonomic reactivity to stimuli. Higher levels of alexithymia seems to moderate an inverse association between heart rate and cognitive appraisals of unpleasant stimuli in this sample. Conclusion: A dysregulated brain-peripheral integration increased by the long term-use of drugs and damage in prefrontal regions are discussed as potential etiological factors supporting the presence of emotional deficits in these populations.

Este estudo tem como objetivo determinar a experiência de cárie em crianças infectadas pelo HIV, correlacionada com a classificação clínica e imunológica (CDC³, 1994). Participaram da pesquisa 92 crianças (50 meninas e 42 meninos), com média de idade de 5,77 ± 3,31 anos (6 meses a 13 anos), com diagnóstico definitivo para o HIV, todos pacientes com atendimento ambulatorial. Foi realizado exame bucal para determinar os índices ceo/CPOD e os dados de história médica foram coletados dos prontuários médicos. Na dentição decídua de crianças mais jovens (até 5 anos), apesar de a prevalência de cárie ter apresentado valores maiores naquelas mais comprometidas clínica e imunologicamente, não houve diferença estatisticamente significante entre as diversas categorias de classificação. Nas crianças de maior idade, isto também foi observado, apesar de terem sido encontrados valores de CPOD maiores nas crianças mais doentes. This research aims to determine the relationship between the prevalence of caries and clinical and immunological classification in HIV-infected children. Ninety-two outpatients (42 male and 50 female subjects) with definitive diagnosis of HIV infection took part in this research. The patients were examined in order to determine the prevalence of caries (dmf and DMFT indexes), and medical data were collected from their medical records. The mean age of the subjects was 5.77 years. Although no statistical differences were found, young patients (up to 5 years old) had more caries when they were more clinically and immunologically compromised. The same fact was observed regarding older children.

Diarrhea, which is common after transplantation, may be due to infections and immunosuppressive therapy. Inflammatory bowel disease (IBD) de novo or as an exacerbation of pre-existent disease is a rare complication after kidney transplantation with pre-existing disease having a less aggressive clinical course than the de novo disease. Cytomegalovirus mismatch, prescription of tacrolimus instead of cyclosporine or mycophenolate mofetil rather than azathioprine as well as low-dose corticosteroid treatments have been linked to an increased incidence of IBD. This series of renal transplant recipients with de novo IBD showed a higher incidence and more aggressive course than that previously described, possibly related to increased use of tacrolimus with minimization of steroids.

Tuberculosis is a disease relatively frequent in renal transplant patients, presenting a wide variety of clinical manifestations, often involving various organs and potentially fatal. Gastrointestinal tuberculosis, although rare in the general population, is about 50 times more frequent in renal transplant patients. Intestinal tuberculosis has a very difficult investigational approach, requiring a high clinical suspicion for its diagnosis. Therapeutic options may be a problem in the context of an immunosuppressed patient, requiring adjustment of maintenance therapy. The authors report two cases of isolated gastro-intestinal tuberculosis in renal transplant recipients that illustrates the difficulty of making this diagnosis and a brief review of the literature on its clinical presentation, diagnosis, and therapeutic approach.

Patients affected with neurological disorders can experience severe speech and motor disturbances, sometimes with communication skills limited to yes/no reply. Our study presents the development of a new platform to provide flexible and efficient computer control. Wireless sensors are placed on the body, so that the user can take advantage of any residual movement to generate control signals. These control signals can be used to access an augmentative and alternative communication (AAC) software or any virtual keyboard. Experimental results in three patients with few residual movements show that different sensors, placed in different body locations, can create novel communication channels, selectable according to each person’s neurological condition. By providing visualization of the body signal in real time, the user can raise awareness of residual movements, and learn to enhance its control. In progressive conditions, this biofeedback activity can assist the user and the therapist to anticipate the progression and search for alternatives.

Musculoskeletal disorders are a globally significant health problem affecting millions. Physiotherapy, including prescribed exercises performed independently by patients in their homes, is a key treatment for many sufferers. However, many patients fail to complete home exercises, prolonging recovery periods or accelerating decline. Pervasive health technologies, capable of monitoring users in their homes, are ideally suited to address this problem. This paper describes user research with a group of three physiotherapists and eleven current physiotherapy patients to understand the problems and user needs underlying non-compliance with home exercise regimes. The research adopted a speed dating approach and culminated with six insights and design recommendations relating to the form and type of feedback that should be used in such systems, to how scheduling and therapist-patient communication systems should be designed and to the role of privacy.

Musculoskeletal disorders are a globally significant health problem affecting millions. Physiotherapy, including prescribed exercises performed independently by patients in their homes, is a key treatment for many sufferers. However, many fail to complete home exercises, prolonging recovery periods or accelerating decline. Pervasive health technologies, capable of monitoring users in their homes, are ideally suited to address this problem. This paper describes user research with a group of three physiotherapists and eleven current physiotherapy patients to understand the problems and user needs underlying non-compliance with home exercise regimes. The user research adopted a speed dating approach and culminated with recommendations relating to the design of feedback, scheduling systems and privacy.

Part 1: Long and Short Papers; International audience; Autism spectrum disorders (ASDs) are a triad of disturbances affecting the areas of communication, social interaction and behavior. In educational contexts, without appropriate intervention methodologies, these limitations can be deeply disabling. Our research promotes the communicative competence of children with ASDs It extends the current state-of-the-art in the field, both in terms of usability for the educators and functionality for the end-users. We performed a long-term study, and results suggest that the proposed approach is effective in promoting the development of new interaction patterns.

The paper presents a case study based on a system for the monitoring of daily functions in post-stroke rehabilitation patients. The system is capable of monitoring some daily life functions of the patient, by providing to the rehabilitation experts information about the correct or wrong activation of the monitored muscles during those specific functions. The monitoring system consists of a wearable wireless device, equipped with electrogoniometers and electromyography sensors, and by a signal processing software. Preliminary experiments have been conducted on post-stroke patients.

Transthyretin (TTR) amyloidosis, an autosomal-dominant disease, is characterized by peripheral and autonomic neuropathy--familial amyloidotic polyneuropathy (FAP). End-stage renal disease (ESRD) occurs at 10 years after the onset of neuropathy. Orthotopic liver transplantation (OLT) is the usual treatment of choice. We evaluated FAP patients, ATTR V30M, before and after OLT who started dialysis within 3 months after surgery. The 11 patients had an age at the onset of neuropathy of 31.9 ± 6.3 years with a mean evolution of disease to OLT of 4.54 ± 2.5 years. The glomerular filtration rate was60 mL/min in 2 patients, 2 displayed nephrotic range proteinuria, and 3 had microalbuminuria. Elective pacemaker implantation was necessary in 8 subjects. Post-OLT 3 patients developed proteinuria, 2 of whom showed increasing nephrotic syndrome. Dysautonomia worsened leading to bladder catheterization in 6. In patients with previous normal renal function and proteinuria3 g/d, the evolution of neuropathy to the first dialysis was 14.6 ± 4.2 years versus 7.5 ± 1.1 among the other subjects. Overall, dialysis was implemented at 7.4 ± 4.9 years after surgery. There was no liver graft dysfunction. The heart evaluation post-OLT showed the following: 3 patients with de novo dysrhythmias requiring pacemaker implantation and 3 with N-terminal pro-natriuretic peptide levels10,000 pg/mL. Death occurred in 4 subjects at an average of 26 months after initiation of dialysis. Concerning ESRD, there was no clear benefit of transplantation in the early stages. Patients with normal renal function and lower levels of proteinuria showed slower progression to ESRD, irrespective of their duration of neuropathy.

The need to develop systems electromyographic (EMG) in the aquatic environment, has led several researchers to refine these instruments to ensure the credibility of the data provided by EMG. The aim of this study is to characterize the behavior of two muscle muscles involved in the crawl technique (biceps brachii and triceps brachii) over a test of 200m crawl. 1 male swimmer trained was subjected to a test consisting of a maximum voluntary contraction (MVC) of the Biceps Brachii (BB) and Triceps Brachii (TB) for standardization. A protocol of 4 x 50m with an interval of 15 seconds at a swimming speed of pre-established, making each part to 95% of transit time for 200m crawl. EMG surface electrodes were used with a Wirelless bioPLUX.research. The EMG signal of the BB and TB muscles of the right arm was removed throughout the test and then synchronized with the video image, and selected 5 cycles of swimming on all identical pathways. There is a gradual decrease of its average muscle activity. The BB was about 43% and TB was 26%. The largest variation on it, in the case of BB, between the third and fourth route (21%), and in the case of TB, between the second and third route (14%). The muscles studied demonstrated changes in the duration of swim cycles, indicating that, there is a decrease in muscle activity, this supposed to be due to limitations in production capacity under swimmer and the characteristics of the art of swimming which are changing as increasing fatigue.