Demand for wheelchairs is increasing with growing numbers of aged and disabled persons. Manual wheelchairs are the most commonly used assistive device for mobility because they are convenient to transport. Manual wheelchairs have several advantages but are not easy to use for the elderly or those who lack muscular strength. Therefore, handrim-activated power-assist wheelchairs (HAPAW) that can aid driving power with a motor by detecting user driving intentions through the handrim are being researched. This research will be on HAPAW that judge user driving intentions by using non-contact torque sensors. To deliver the desired motion, which is sensed from handrim rotation relative to a fixed controller, a new driving wheel mechanism is designed by applying a non-contact torque sensor, and corresponding torques are simulated. Torques are measured by a driving wheel prototype and compared with simulation results. The HAPAW prototype was developed using the wheels and a driving control algorithm that uses left and right input torques and time differences are used to check if the non-contact torque sensor can distinguish users’ driving intentions. Through this procedure, it was confirmed that the proposed sensor can be used effectively in HAPAW. Research and development of new products are continuously being performed on handrim-activated power-assist wheelchairs (HAPAW), which were first commercialized in the 1990s ,3,4,5. RHAPAW has the advantages of manual wheelchairs, such as lightness and convenient storage and transportation, along with the advantages of electric-powered wheelchairs such as drivability on steep paths or over long distances. The elderly and disabled have difficulty in moving freely by themselves over bumps or tilted surfaces with conventional manual wheelchairs ,7. To adHAPAW measures users’ driving intentions applied to the left and right rotating handrims, and it is important to effectively deliver the measured signals to the controller located in the body frame that does not rotate. JWII  uses a special circular connector to transfer signals from the rotating handrims to the fixed controller . e-MotioThe torque applied to the left and right handrims of HAPAW is uneven owing to physical features or disability, which makes the driving wheel output of HAPAW unstable; this causes degradation of wheelchair driving performance. Control methods to properly match user characteristics and road conditions are required because straight and rotating driving are the most basic driving performances. The mutual reference method, which refers left and right assist torques to the opposite propulsion torque, is used to solve this problem ,14,15. IA driving wheel that uses a non-contact torque sensor was designed and prototyped in this study to achieve users’ driving intentions. A driving wheel mechanism with an embedded non-contact torque sensor was designed, and the torque value applied to the handrim by external forces was simulated. After manufacturing a driving wheel prototype, torque measurement tests were conducted and it was confirmed that torques are similar to simulation values. A balancing algorithm that enhances straight and rotation driving performance by using input torques and their time differences  was usedA sensor that measures the force applied to the handrim is essential in HAPAW. The wires for sensor power and signal transmission become entangled because the handrim rotates with the wheel. This increases the price when special devices are used or when the structure needed to solve this problem becomes too complex. The non-contact torque sensor applied in the HAPAW driving wheel shown in As shown in To investigate the user input torque in the assisting wheel, the torque values measured by the designed wheel mechanism were simulated. Here, −2 kg·m2. Inertia moment Here, The handrim is rotated about the point The bar started to move when the handrim moved above 1°, as shown in A push–pull gauge  was used to calculate the spring constant by rotating the handrim in 1° increments from zero to 8°, and the external force was measured while the handrim was maintained in a certain position. Angular acceleration becomes 0 when the handrim stops, as Equation (4) shows above.As a result of the test, the spring constant Various studies are being performed for HAPAW control ,17, and β is the balance ratio, τs is the temporal similarity between the left and right input torques, and the range is expressed in values between 0 and 1. γ is the ratio of the two torques, and has a value between −1.0 and 1.0. The balanced torques Tbr and Tbl in To check if the torque sensor and driving wheel manufactured in this study are proper for applications in HAPAW, left and right input torques and time difference were used for the control method that adjusts the balance ratio so that it is suitable for driving straight and rotation . Figure β ≤ 1 and [β in Equation (7) reaches 0.5, making it easy to drive straight. On the other hand, if β approaches 1, the opposite input torque is not reflected, making rotation easy.These satisfy 0.5 ≤  ≤ 1 and  dirr andβ that uses this function. β, which fluctuates according to TSF results, and the predefined inflection points a, b, c, and d show the fluctuation range of β. A time difference between left and right input torques smaller than Δt1 in β, and a modification is conducted to enhance straight-driving performance even if input torques with large left and right differences occur. In this study, when inflection points p1 and p2 approach a and c, respectively, β is set to be 0.5 even if the left and right torque proportion falls to 50%.On the other hand, the driving intention of the user can be judged to be closer to rotation than driving straight if the time difference between the left and right propulsion torques is larger than Δt2. At this time, the controller brings inflection points p1 and p2 close to points b and d, respectively, to enhance direction change performance as shown in The sensitivity of the balance controller for detecting the driving intentions of a user is determined by the values of Δt1 and Δt2. With increasing Δt1 and Δt2, straight sensitivity is increased as increasing time for referencing the left and right torques. With decreasing Δt1 and Δt2, rotation sensitivity is increased because of the torque applied independently to the wheel. The average driving speed of manual wheelchair users in daily life is approximately 0.79 m/s , and it β. As shown in τs is first set to have a maximum value of 1.0 and decreases as time passes until the input signal on the opposite side is detected. When the input torque on the opposite side is detected, the τs value at this time indicates the temporal similarity, and that value is maintained until input torques on both sides disappear. It is used as a coefficient that controls β for generation of the assist torque.A HAPAW prototype was developed for driving tests to verify the usefulness of the proposed torque sensor, and the related specifications are shown in The experiment of dropping actual weights of 2–5 kg was conducted with the manufactured driving wheel to compare with the simulated torques. Three trials of dropping each weight were performed, and the angle of the handrim was measured by the voltage of the Hall IC. The sampling rate of the Hall IC was 1 kHz and the measured Hall IC voltage values were converted into handrim angle values. As shown in In HAPAW, sensors that can detect handrim movement have been used in various methods to detect the driving intentions of users. A commercially available HAPAW assists drivability without receiving driving intention input from handrims . This ty±8° is too wide a range of motion (ROM) for handrims. The ROM of handrims in another commercial HAPAW is approximately ±2~3°, which is much smaller than in our prototype. The driving wheel prototype used in this study was manufactured for research, and a wide angle was applied to obtain sufficient data from flexible handrim movement. However, future research is planned that will use a very small range. The dead zone that occurs when the handrim spoke and the bar are separated is a region that includes a great amount of information related to the driving intentions of users, and it is necessary to minimize this clearance. Noise occurs when the dead zone is decreased owing to vibration or impact applied on the handrim, and it is expected that this can be sufficiently eliminated by software components such as low-pass filters.The amplitude of the sensor signal decreases when the ROM of the handrim decreases. The sensor moving angle of the designed driving wheel is larger than the handrim moving angle because of the hinge structure of the bar, and the sensor moving angle can be adjusted depending on the hinge location. Therefore, the sensor signal size can be maximized by adjusting the hinge location even if the ROM is reduced. In this case, the linearity of the sensor signal deteriorates compared to The springs for the handrims used in the prototype discussed here apply commercial products that have known spring characteristics. Modification of the spring constant and suitability of the spring for mass production are required for commercialization of this research. The prototype was developed to minimize mechanical friction and loss; assembly is not easy, and vibration occurs when releasing the handrims. Application of a structure with a spring of proper stiffness that can reduce handrim vibration is required for commercialization.The handrim angle shows non-linearity in the 1°–2° and 7°–8° intervals as the magnet attached on the end of the bar rotates as shown in The battery can be considered as the core component related to driving distance and total weight of a HAPAW. Existing HAPAW mainly use lithium ion batteries or lithium iron phosphate batteries, which are light and have outstanding discharge performance. Lithium batteries have outstanding performance but high price, which is the main factor increasing wheelchair cost. The performance and price of the motor must also be considered significant as well as the battery. One of the most important factors of wheelchair cost determination is the level of health insurance supported by the government, and core components, such as motors and batteries, must be selected considering this fact.PAWs detect the driving intentions of users and can assist mobility, which is very useful for the elderly and disabled, who lack strength. It is important in HAPAW to obtain the driving intention signal of a user from the rotating handrim and to deliver this easily and accurately to the fixed controller. A fixed Hall IC detecting the magnet on a rotating part was used in this study to design a wheel mechanism and sensor that detect handrim movement easily and simply and to manufacture a prototype. The torque measured from the designed driving wheel was simulated, and a prototype was manufactured for verification. The driving wheel prototype balances uneven input signals based on the user driving intention to generate stable assist torques, and results confirmed the feasibility of using it in HAPAW. Performance of the manufactured prototype must be improved because an intuitive interface for users is important in PAW. To this end, more elaborate torque sensors must be researched, and tests and research on durability and impact stability are planned in preparation for commercialization. In addition, additional research and investigation on the rotation of a wheelchair on flatlands and driving on slopes is required to be performed.


It was examined whether the single embryo transfer policy makes the treatment period longer for couples to achieve their first live birth by assisted reproductive technology.This study retrospectively analyzed women who started assisted reproductive technology at younger than 40 years of age in the authors’ organization. The treatment periods for couples to achieve the first live birth by assisted reproductive technology, between the women who started assisted reproductive technology from 2004 to 2009 , in which the double embryo transfer was predominant, and the women who started assisted reproductive technology from 2010 to 2015 , in which the single embryo transfer was predominant, were compared.The age at the start of assisted reproductive technology, pregnancy rate per embryo transfer, and rate of women who achieved a live birth by assisted reproductive technology per number of women who tried assisted reproductive technology were all significantly higher in the single embryo transfer period group. Among the women who achieved a live birth by assisted reproductive technology, the incidence of multiple births and severe ovarian hyperstimulation syndrome, the treatment period, and medical care costs needed to achieve the first live birth were all significantly lower in the single embryo transfer period group.In the single embryo transfer period group, those women who were younger than 40 years of age achieved their first live birth by assisted reproductive technology more safely, quickly, and reasonably. As the number of women who were ≥40 years of age was small in the DET period group, only the women who started ART before 40 years of age were analyzed.2.2In the authors’ organization, controlled ovarian hyperstimulation (COH); that is, agonist or antagonist methods, is the first choice for the women with a normal ovarian reserve. Low stimulation; that is, clomiphene with or without low doses of recombinant follicle stimulation hormone, or natural cycles, is applied on a case‐by‐case basis.2.3Subfertile couples sometimes have an intermission in fertility treatments due to social, economic, or emotional reasons. In this study, the treatment period was counted if the treatment was performed as quickly as possible. The period of miscarriages and stillbirths was counted according to the number of gestational weeks.2.4The prices for ovulation induction, oocyte pick‐up, culture of the embryos, and ET have been increasing gradually during the examined 12 years in the authors’ organization. The costs in this study are calculated with the prices and taxes in September 2016. For reference, ¥1000 was $US9.74 on September 11, 2016.2.5t test were used. The difference was considered to be significant at P<.05.The data are shown as the mean±SD. The chi‐square test of independence and Welch's 3The age of the women and the number of treatment cycles are shown in Table The outcomes of the treatments are shown in Table Among the women who achieved a LB by ART, the mean number of the oocyte pick‐up (OPU) trials and ET trials, the treatment period, and medical care costs that were needed to achieve the first LB all were lower in the SET period group Table .4As described in the Introduction, in order to avoid multiple pregnancies and severe OHSS, SET and “all freeze” strategies have prevailed for the past 15 years in Japan. Consequently, ART has provided safer pregnancies for women and their children. As a result, it was questioned if the treatment period and medical care costs for couples to achieve their first LB by ART would have increased from the DET period to the SET period. In this study, however, it was shown that the treatment period and costs were lower in the SET period group than in the DET period group in the authors’ organization. It is supposed that this is related to the following factors: (i) the advances in blastocyst culture have decreased the loss of good embryos; (ii) the increase in the ratio of the blastocyst transfer to the whole ET has increased the pregnancy rate per ET; and (iii) the advances in vitrification technology have decreased the loss of good embryos.There have been a few reports on the cost‐effectiveness of SET, compared to DET.For declining birthrate measures, the Japanese Government provides a grant system to married couples when the wife is younger than 40 years of age and their combined annual income is <¥7 300 000: ¥300 000 for the first OPU and ET, ¥150 000 for the subsequent OPU and ET, and ¥75 000 for frozen–thawed ET, for a maximum of six times. It was shown that when women who were younger than 40 years of age underwent ART, with the first choice of COH, 63.8% of the women achieved a LB in the SET period group, and that among them, 98.4% of the women achieved their first LB within the third trial of OPU  could be useful for these cases; however, at present in Japan, PGS is permitted only for couples with recurrent miscarriages. The Working Group of the Japan Society of Obstetrics and Gynecology is now reviewing the application of PGS. At present, each fertility treatment institute should create guidelines for DET for the couples to achieve a LB as quickly as possible, with the best care taken to minimize multiple births.In conclusion, the two periods of DET and SET were compared retrospectively and showed that, in the SET period, the ratio of the women who achieved a LB increased and that the treatment period and medical care costs decreased in women who were younger than 40 years of age. In other words, ART has provided LBs more safely, more quickly, and more reasonably. It is speculated that this trend has been common during the past 15 years in Japan.Animal studies: This article does not contain any study with animal participants that was performed by any of the authors.Conflicts of interest: The authors declare no conflict of interest. Human rights statement and informed consent: All the followed procedures were in accordance with the ethical standards of the responsible committee of Kurashiki Central Hospital  and with the Helsinki Declaration of 1964 and its later amendments. Informed consent was obtained from all the patients who participated in the study.


Keeping identity for a long term after occlusion is still an open problem in the video tracking of zebrafish-like model animals, and accurate animal trajectories are the foundation of behaviour analysis. We utilize the highly accurate object recognition capability of a convolutional neural network (CNN) to distinguish fish of the same congener, even though these animals are indistinguishable to the human eye. We used data augmentation and an iterative CNN training method to optimize the accuracy for our classification task, achieving surprisingly accurate trajectories of zebrafish of different size and age zebrafish groups over different time spans. This work will make further behaviour analysis more reliable. Computer-aided tracking of multiple same-size zebrafish with maintained identity after occlusion is still an unresolved problem in ethologyAfter occlusion happens, three possible situations may occur. In the first situation, the identity of the fish is not maintained after occlusion, and a new identity is generated instead. In the second situation, identities are linked across occlusions based on the individual movement prediction mechanism such as Kalman filteret al.et al.A new type of learning mechanism, namely deep learning, especially the convolutional neural network (CNN)We have developed CNNTracker, a software application that tracks each fish in a group and maintains the correct identities for different fish numbers and time spans. As illustrated in http://www.idtracker.es/. The fourth data set D4  in scale-space, where x and y are the point’s coordinates and is the scale of the point. The Hessian matrix of this point is defined as:Suppose a pixel point is denoted as  at scale σ. The scale-space can be obtained by convolving the image with a Gaussian kernel function at different scales σ. The doH (Determinant of Hessian) of matrix H can be expressed as:where Lxx, Lxy and Lyy are the convolution of the second order Gaussian derivatives with the 2D image I at point  at scale σ. The blob points where Blob points not only exist in the fish body regions but also occur in the non-fish body region. These non-fish body points not in the fish body regions should be filtered out according to the specified scale range and the intensity range of the head point. With the head point as the centre, we obtain a square patch cantered on the fish head . We continue this process until there are no more candidate segments, then we select another unused trajectory segment as the base part of another trajectory, and repeat the above-mentioned process until the total number of trajectories is the same as the total number of fish in the video sequence. We then remove all the duplicate segment IDs in the trajectories because each segment only belongs to one identity.The initial training data is generated based on two facts: each segment only belongs to one identity and the total number of identities is known in advance. As illustrated in dF, as mentioned above. The binary version of the head feature maps in the segment in one collection are compared with the binary version of the head feature maps in the segments in another collection using dF. The segment ID pairs can be added to the above generated initial trajectories.Some segments may share the same frame number. As illustrated in The head feature maps stored in the segment in the trajectory along with the trajectory ID form the initial training dataset. The initial dataset may be very small, so we use data augmentation to increase the training data set by shifting the head point by ±1 pixels in the horizontal and vertical directions and generate new head feature map. This newly generated head feature map with the original identity is added to the initial training dataset.The training dataset is divided into two parts, the training part and test part. These two parts correspond to two different modes of the CNN: training and test. The head feature maps in the test part are used to measure the error rate of the CNN. In training mode, the CNN is repeatedly given fish head feature maps with the correct ID (label) so that it can learn to classify each fish. In test mode, the CNN’s performance is evaluated on a set of different fish head feature map with the learning mode offline.f(x) = max. It not only increases the nonlinear properties of the decision function and of the overall network without affecting the receptive fields of the convolution layer but also makes the training speed several times faster. Pooling performs non-linear down-sampling on the input image, splits the image into a set of non-overlapping regions and, for each such sub-region, outputs the maximum or average. The pooling layer provides a form of translation invariance. A dropout layer randomly sets the layer’s input elements to zero with a given probability, which was set to 0.2 in the proposed method. This corresponds to temporarily dropping a randomly chosen unit and connections from the network during training. The dropout layer might help prevent overfitting. The architecture of the CNN used in this research study is shown in The CNN in the proposed method is composed of convolution, pooling, rectified linear unit (ReLU), and dropout layers. In the convolution layer, the weights of each convolution kernel are trained by the backpropagation algorithm. Each layer contains many convolution kernels, and each kernel is shared over the entire image with the same parameters. The convolution operators can extract different features from the input layer. The ReLU is a layer of neurons that use the non-saturating activation function num, the total number of fish. The number of neurons in Layer 6 is equal to num.For each layer of the network, the specific configurations of the network parameters are shown in We use MatCovNetThe trained CNN was then applied to the remaining segment collections. As mentioned above, each collection has the same number of segments as the total number of IDs. Each segment only belongs to one identity. The trained CNN used each head feature map stored in the segment to determine which ID it belongs to. We then counted the frequency of each ID in the segment and chose the ID that had a frequency of over 0.2 as the candidate ID of the trajectory segment. Because the initial training dataset is small, the performance of the initial version of the CNN is not stable, and it will cause multiple IDs to be assigned to the same segment.IDtrue, remove IDs containing IDtrue from the multi-ID assigned segments, then collect all segments that have one assigned ID. If the total number of segments with one assigned ID is just same as the number of fish in the video sequence, then these segments can be added to the initial training data set. After the remaining collections have been processed like this, an extended version of the training set will be generated. The extended training data set will be fed into the CNN for re-training. This process is applied to all the remaining collections until the number of collections added to the training dataset is more than half of the total number of collections, and a final trained version of CNN is obtained.To fix this problem, we need to extend the training set. As mentioned before, a collection has the same number of segments as the total IDs in the image sequence. We keep all segments with one identity assigned in a collection and record these identities as This CNN is then applied to the head feature maps contained in the trajectory segments not in the training dataset. Each head feature map is fed into the CNN, and CNN assigns a fish ID to this image. The segments then have a list of fish IDs; we then count the frequency of each ID in the segment and chose the ID that has a frequency of over 0.2 as the candidate ID of the trajectory segment. We then filter out short segments (containing less than 10 frames) assigned with three or more identities to ensure it will not disturb the next segment linkage step.After each trajectory segment is automatically assigned an ID via the CNN, the segment with an assigned ID containing the smallest frame number acts as the initial part of the trajectory. We then choose the end coordinates of the base segment as the base point and, select all segments with the same ID that begin within 1,000 frames and start within of 2,000 pixels as the candidate segments for the link with the base segment. Among these candidates, we next choose the segment with the smallest starting frame number as the new base segment and link this segment to the old base segment until there are no more segments available. When there are no more segments available, we choose another segment with a different ID as the initial part of another trajectory and run the above process again until all IDs have been processed.segerr in one trajectory and extract coordinate pi and frame number n at the end of the located segment. Starting from frame n to n + 1, we use the Farnebackw pixels of pi as the selection mask m. We use a ten-bin histogram to find which orientation range  of the optical flow in mask m is the major flow, where b is bin width. After the major orientation θ is obtained, with the head point as the centre and the positive direction of the X-axis as 0 degrees, we draw ray segments with orientation θ from pi with length w. With equidistant sampling w points on the ray segment, we obtain maximum magnitude ρ from the segment and move pi to a new position (px + ρcos(θ), py + ρsin(θ)). We then move to frame n + 1, and perform the above-mentioned process again until we reach the frame number of the start point of error segment segerr, and calculate distance disi between the coordinate perr and pi. We then perform the above-mentioned process on another trajectory with error segment seg and get another distance disi+1 between the coordinate perr and pi + 1 pi+1 until all trajectories containing error segments are processed. Then, segment seg in the trajectory with minimum distance dis, where is below a specified threshold, can be regarded as the correct assigned seg. We then delete other segments seg in other trajectories.Each trajectory segment can correspond to only one trajectory. If a trajectory segment occurs in multiple trajectories, an error has occurred and should be corrected. Errors can be easily identified by summing the number of occurrences of the trajectory segments over all trajectories. If this sum is greater than one, an error has occurred. The detected error segment may occur in more than two trajectories. We locate segments before error segment Ngapstart and end Ngapend frame number of the gap in this trajectory can easily be identified, and we then extract position pstart and pend from the trajectory from frames gapstart and gapend. Starting from frames Nstart to Nstart+1 and assigned p with pstart, we again use the Farneback method to calculate the optical flow of each pixel between two frames, we then select the magnitude of optical flow bigger than one pixel in the surrounding w pixels of p as the selection mask m. We use a ten-bin histogram to find out which orientation range  of optical flow in mask m is the major flow, where b is bin width. We then obtain the ratio r of orientation in mask m and record r in list lr. After major orientation θ is obtained, with the head point as the centre, and the positive direction of the X-axis as 0 degrees, we draw ray segments with orientation θ from pi pi with length w. With equidistant sampling of w points on the ray segment, we obtain the maximum magnitude ρ from the segment, move p to a new position (px + ρcos(θ), py + ρsin(θ)), and record p in list lp. We then move to frames n + 1 to n + 2 and repeat the above-mentioned process again until we reach frame number Nend. We then calculate the portion pr of the items in lr that are greater than 0.5. If the distance between p and pend is less than 20 pixels, we use list lp to fill the gap. Otherwise, if the distance between p and pend is greater than 300 pixels and pr is greater than 0.6, we remove the segment with start frame number Nend and mark this trajectory for further processing. If neither of the above cases is true, we linearly fill the gap from its beginning to its end. We then redo the above-mentioned gap filling process on the marked trajectories.After all trajectories have been generated, some trajectories may contain time series gaps (discontinuous frame numbers caused by occlusion). When one trajectory is selected, the start ξ, we regard the trajectory at that frame to contain an error. We then locate the segment which causes this error, delete it from the trajectory, and apply the above mentioned gap filling process to this trajectory to obtain the final error-free trajectory.We then calculate the displacement of each fish between frames. If the displacement is too high above a threshold The proposed system utilizes the fact that animals of the same congener can be identified individually1415Ideally, after applying CNN to the head feature maps contained in the segment, the segment should have only one ID. However, in practice, the segment may be assigned more than one ID. The reason is that some head feature maps may have other small flotage covering or clinging to the fish head  of Shanghai Research Center for Model Organisms  with approval ID 2010-0010, and all efforts were made to minimize suffering. This study was approved by the Institutional Animal Care and Use Committee (IACUC), and written informed consent was obtained.Danio rerio) in our experiment were obtained from a local pet store. The fish are all over six months. The fish were kept in an animal facility with a 14/10 light/dark cycle, in 5-L transparent containers connected to a fish rack system with circulating water at 26.5 ± 0.5 °C and 7–7.5 pH. The fish were placed in a 20 cm × 20 cm × 15 cm transparent acrylic tank (width × length × height) with a water level of 5 cm. The water was changed the day before the experiments began. The internal walls of the fish tank were covered with white paper to eliminate reflections that could affect the tracking system. The tank was horizontally placed above an LED array panel covered with a thin diffuse film. One high-speed camera  was mounted above the tank, with the imaging plane parallel to the water surface. The captured videos were first stored in DVR Express  while the experiment was in process, and was exported as 8-bit bitmaps on a PC after the experiment was complete.The zebrafish .Publisher's note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


It is important to be able to reliably and feasibly measure infant and toddler physical activity in order to determine adherence to current physical activity guidelines and effects on early life development, growth and health. This study aimed to describe the development of an infant wearable wrist-worn band for the measurement of physical activity; to determine the feasibility of the device data for observational measurement of physical activity and to determine the caregiver reported acceptability of the infant wearable wrist band.n = 152) were recruited, and mothers were asked for their child to wear the band with enclosed monitor at all times for 1 week (minimum 3 days). Feasibility was assessed by determining technical reliability of the data, as well as wear time and compliance according to requirements for observational measurement. Acceptability was assessed via questionnaire.After various iterations of prototypes and piloting thereof, a final wearable band was designed to fit an Axivity AX3 monitor. Mother and infant/toddler (aged 3–24 months) pairs . Therefore, 94% of participants were compliant, having three or more days of wear with at least 15 h of wear per day, thus providing enough valid data for observational measurement. The majority (60%) of mothers reported being “very happy” with the safety of the device, while only 8% were “a little worried”. A large majority (86%) of mothers stated that the band attracted attention from others, although this was mostly attributed to curiosity about the function of the band. Most (80%) of participants rated the comfort of the band as “comfortable”, and 10% rated it as “very comfortable”.The infant wearable band proved to be feasible and acceptable according to the criteria tested, and compliance wearing the band was good. We have therefore provided a replicable, comfortable and acceptable wearable band for the measurement of infant and toddler physical activity.The online version of this article (10.1186/s40814-018-0256-x) contains supplementary material, which is available to authorized users. Physical activity is known to have beneficial effects on health through the life course . There iLiterature in the field of the first 1000 days of life is ever growing, and evidence has mounted showing that many later life diseases and health complications have their origins in the early life periods  . HoweverMost studies conducted since 2009 measuring physical activity in the first 2 years of life have used some form of accelerometer  . In infaSome studies have attempted to address this problem by designing their own bands for securing accelerometers for infant use , 12–14. Poor acceptability in conjunction with data that may not be feasible for use are issues that could deter researchers from conducting physical activity assessments in this population, or may result in poor data quality that is not comparable to other studies. Therefore, the aims of this study are to (1) report on the development of an infant wearable wrist band for the measurement of physical activity, (2) determine the feasibility of the infant wearable wrist band for the observational measurement of physical activity and (3) determine parent/caregiver reported acceptability of the infant wearable wrist band for objective assessment of physical activity.The following criteria will be used to determine feasibility and acceptability: (1) the majority of participants (> 80%) should wear the band for at least three, but up to seven, days consecutively; (2) the majority of data produced (> 80%) should be technically reliable; (3) the band should fit an Axivity AX3 accelerometer; (4) the band should be worn for the required number of days by the majority (> 80%) of infants and toddlers between the ages of 3–24 months; and (5) the majority of mothers (> 80%) should rate the acceptability of the device as high according to the design specifications—comfort (very comfortable or comfortable), safety (very happy or happy), the buttoning mechanism (easy to unbutton), and drying capability (very quickly or quickly).The design brief was to develop a reusable wrist-worn band for the Axivity AX3 device (logging accelerometer) that was suitable for continuous wear by infant/toddlers aged 3–24 months. Wrist-worn placement was chosen as the most appropriate for infants and toddlers of various ages and developmental stages alike, based on review of the literature . Initialn = 3) and Soweto, South Africa (n = 6). Qualitative feedback from parents related primarily to the security of the bands (parents commented on a range of press stud configuration for fixing bands), and inflexibility of a cotton material used in early designs. The final design .Feedback from parents was solicited for prototype designs when piloted on a small number of infants in Cambridge, UK  were recruited at different time points  during the first 2 years of life. Mothers and infants were drawn from one of a number of ongoing infant studies at the MRC/Wits Developmental Pathways for Health Research Unit, recruited from the Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. Once included in one of the ongoing studies, mothers were invited to participate in this feasibility study, together with their infants. If the infant had any major diagnosed developmental or physical abnormalities that would preclude them from wearing the device or partaking in normal routine physical activities, they were excluded from the study. All mothers signed informed consent and were free to leave the study at any time. Ethical approval was obtained from the Human Research Ethics Committee of the University of the Witwatersrand (M150632).Mother and infant pairs  worn within the infant wearable band on their left wrist. The monitor is a small raw triaxial accelerometer, weighing 11 g and is waterproof so that it can be worn continuously. Monitors were initialised to collect data at 100 Hz with a dynamic range of + − 8 g. Mothers were asked that their infant wear the band and enclosed monitor at all times for 1 week, and to not remove the band if possible. Mothers completed a logbook recording whether the band was removed at any point and for what reason. After the week period, mothers returned the bands to the research unit and the data were downloaded from the monitors.In order to test the feasibility of the infant wrist band for the observational measurement of infant physical activity, device data were downloaded from the monitors using open source OmGui software . The number of monitors correctly initialised and downloaded with complete data was recorded and summarised as an assessment of technical reliability. The raw triaxial acceleration data was auto-calibrated to gravity using methods described elsewhere . Vector Acceptability of the infant wearable band according to the infant’s mother was assessed via questionnaire either immediately upon return of the band or shortly thereafter telephonically. The complete list of questions and potential responses are provided as Additional file p = 0.40).All data are presented as mean(SD). Of the 152 mother-infant pairs recruited for the study, 146 infant participants provided valid accelerometer data and were included in the feasibility assessment. The mean age of the mothers was 29(6) years, ranging from 19 to 44 years. Just over half (52%) of the infants were males, and there was no difference in distribution of gender by age (n = 147) were correctly downloaded and provided data. One correctly downloaded file was later lost due to human error. Infants with missing data were significantly older than infants with useable data (p = 0.02)—this was due to all the infants who lost their devices being between 18 and 24 months of age. There were no differences according to mother’s age or infant sex.Technical reliability of the Axivity AX3 monitors was good, with 151 of 152 devices correctly initialised. One monitor was not properly initialised because the battery was not adequately charged before use, and this data was consequently excluded. Four devices were lost by participants and were thus not returned for downloading. All of the monitors that were returned %. Wear time ranged from 2 to 7 days, with a mean of 6.4(0.7) days. After excluding days which did not have at least 15 h of wear time, three participants (2%) had less than three valid days of data remaining. Therefore, of the participants who had accelerometer data, 98% were compliant, having three or more days of wear with at least 15 h of wear per day, thus providing enough valid data for observational analysis. When considering the whole sample of infants (including those who lost their devices or had missing data), 94% were compliant and provided enough valid data for observational analysis.n = 15) were the following: we were unable to make contact with them (n = 11) or because they had lost the bands and were thus unable to answer the questions (n = 4). There were no differences in mother’s age, infant age or infant sex between participants included in the acceptability assessment compared to those not included (data not shown). Percentages reported here are thus representative of those who responded and exclude the 10% who were not able to respond.Of the 152 mother-infant pairs recruited, 137 (90%) mothers completed an acceptability questionnaire and were included in the acceptability assessment. Reasons for not completing the questionnaire (Most participants (98%) preferred a black or blue band, and the non-preferred colours were white (49%) and green (38%) see Fig. . Of thosParticipants were asked to comment on the fabric used to make the band, and various qualities of the fabric, and responses are shown in Table Most (60%) of the mothers reported being “very happy” with the safety of the device, and a further 27% were “happy”, while 8% were “a little worried” and only one mother 1%) was “very worried” (no further information given). Comments regarding the buttoning mechanism of the device are reported in Table % was “ven = 4) presumed the band was a watch; “People asked for the time”. Mostly, mothers reported that “People were just curious”. Mothers were also asked to report how their baby reacted to the band and responses are shown in Table A large majority (86%) of mothers stated that the band attracted attention from others. In 74% of cases, people wanted to know what the band was or why it was being worn by the infant. Some people (The majority (90%) of participants rated the comfort of the band as “comfortable”, or “very comfortable”. Few (4%) rated the band as “fine”, and the remaining 6% rated the band as “uncomfortable” or “very uncomfortable”. One participant (mother of infant aged 12 months) who rated the band as uncomfortable stated that: “The rubber band (worn by adults) would be better for children”. When asked about the baby’s reaction to the band she stated that: “(my) baby wanted to take the band off, (the) device was itching”, yet the band was not actually removed and this infant achieved 5 days wear time. No other comments were provided for participants who were less satisfied with the comfort of the band.The aims of this study were to report on the development of an infant wearable band and to examine the feasibility  and acceptability of this band for the observational measurement of physical activity using accelerometers in infants. To our knowledge, this is the first study of its kind in infants and provides an invaluable resource for researchers who are planning on measuring physical activity at this critical life stage. We have described the process of development of the band and have published full material and component specifications and design patterns; thus allowing for replicability and for modifications to be made if necessary. Overall, the infant band was found to be feasible and acceptable in the Soweto context, with only a few issues noted for future development. Wear time and compliance was very high, as was technical reliability of the data, with only a few (mainly human) errors noted.The infant wearable band was considered to be feasible and acceptable in this context based on a priori criteria stated in the introduction: (1) the majority of participants (> 95%) wore the band for at least three, but up to seven, days consecutively; (2) the majority of data produced was technically reliable ; (3) the band was able to fit an Axivity AX3 accelerometer; (4) the band was worn for the required number of days by the majority of infants and toddlers of various ages ; and (5) the majority of mothers (80–95%) rated the acceptability of the device as high according to the design specifications—comfort (90%), safety (87%), buttoning mechanism (95%) and drying capability (80%).n = 6) were due to missing data or devices—indicating that the majority of non-compliance was actually due to loss of devices. It is also important to note that all of the lost devices were from toddlers aged 18 to 24 months, which implies that younger infants with less autonomy were almost 100% compliant. Older toddlers who were able to walk, and were possibly interacting more frequently with other children and with diverse environments, were thus more likely to lose their devices. This suggests that strategies should be developed for better compliance in older age groups. Although some mothers of older toddlers (12–24 months) were concerned about the safety of the buttoning mechanism, the majority of the mothers were happy with the safety of the device itself, and none reported their child being able to take the band off or unbutton the band . This is an improvement over the cloth band constructed by Mack and Kleinhenz in 1974 who reported that out of the five infants tested two devices fell off and had to be replaced [In the current study, all but 9 participants (95%) wore the band for three or more days for 15 or more hours per day, with the majority (90%) actually wearing the band for 5–7 days with 99% wear time per day. This is significantly better than the 63% of infants in the Van Cauwenberghe et al. study who provided at least 3 days of data with valid wear time according to less stringent criteria (32% wear time required per day excluding naps compared to 63% wear time required per day in the current study) using waist-worn ActiGraphs [replaced .The wearable bands in the current study were generally found to be acceptable in terms of colour, fabric, perceptions, comfort and perceived safety. Some concerns arose around the quality of the fabric, which could potentially give rise to decreased perceived safety of the band if mothers were worried that poor quality may result in the monitor slipping out and becoming a choking hazard. As a result, we have improved the stitching through the use of a professional garment manufacturer. Furthermore, we have concluded that the infant bands would only be used once (one per participant) and disposed of after use, rather than reusing bands between participants (which was done in this feasibility study due to the limited number of bands that could be produced). Two responses in the present study were worth noting. One mother stated that the band made her baby “itchy”, and that the baby wanted to take it off. Since the child (12 months) was unlikely to have voiced this exact reaction, the word “itchy” could be a misrepresentation of the child playing with the band for another reason. However, it is possible that the child was experiencing a dermatological reaction to the band, and in future, mothers should be warned to remove the band if any reaction occurs. A second concerning response was that a family member believed that the band made the child sick, and the band was subsequently removed. Since it is unlikely that a fabric band could cause such an effect, this response is not concerning from a safety point of view, but rather from an acceptability point of view. The Soweto community is made up of a diverse spread of cultures, and many traditional beliefs and norms exist. Furthermore, parenting is often governed by older family members who reside within the home, and traditional views are often enforced –23. ThisLimitations of the current study include the inability to assess acceptability of the devices in 10% of the participants. Furthermore, the loss of some devices limits the conclusions that can be drawn around wear time and compliance in these infants. We were also not able to determine how devices were lost due to an inability to follow these mothers up, and it is therefore unclear whether these losses have implications for the feasibility of the wrist band. Lastly, we did not quantify how many mothers refused to participate in this study upon recruitment or assess the reasons for declining, thus potentially confounding the results around the acceptability of the wrist band.In conclusion, the infant wearable band was feasible for the 24-h observational measurement of infant physical activity over an extended period (7 days), and was largely accepted by mothers in Soweto. Compliance was very high, and most data was reliable and usable. We were able to ascertain potential concerns with the wrist band, and are able to make modifications to future production accordingly. The infant wrist-worn wearable band housing an appropriate accelerometer is thus recommended for future observational measurement of infant and toddler physical activity, in order to provide comparable, objective data, while maintaining safety and acceptability standards as communicated by mothers.Additional file 1:Acceptability Questionnaire. (PDF 67 kb)


The Health of the Nation Outcomes Scale (HoNOS) is recommended for use by the English National Service Framework for Mental Health and by the working group on outcome indicators for severe mental illnesses to the Department of Health. It was developed to measure the health and social functioning of people with severe mental illness. Since the development of the HoNOS many have debated its latent structure. This paper examines the latent structure of the HoNOS using current factor analysis techniques.HoNOS data for 12,910 patients with ICD10 diagnoses F20 to F29 at a UK National Health Service Mental Health Trust were analysed using exploratory, confirmatory and bifactor analysis for categorical data. The fit of models was assessed using relative and absolute fit indices.Exploratory followed by confirmatory factor analysis identified a four factor solution which fit the data better than existing models. The corresponding bifactor factor solution identified three robust factors and one weak factor after accounting for a general factor. The factor loadings on the general factor were not appreciably different when compared to a unidimensional factor solution indicating the existence of a common trait.Existing models proposed in the literature did not fit well in our data. Factor analysis identified a new four factor solution. These factors showed clinical relevance according to published literature. The bifactor model demonstrated that there is not much loss of information when the HoNOS is used as a unidimensional construct. Further studies should explore this structure in larger samples and in alternative sample populations. A bifactor approach may have implications for how the HoNOS is used in practice, since there is ongoing debate on whether HoNOS item scores should be aggregated for interpretation. The Health of the Nation Outcomes Scale (HoNOS) was developed to measure the health and social functioning of people with severe mental illness . It is aSince its development many have debated the latent structure of the HoNOS , 5–17 anThis paper examines the factor structure of the HoNOS using item factor analysis . The aim is to determine whether the HoNOS has a multidimensional structure as outlined originally by its developers, whether alternative factor structures proposed in the literature may be more appropriate or, if necessary, to derive a new, more suitable factor structure.For this study the data consisted of patients with an International Classification of Disease (ICD-10) diagnosis F20 to F29 . An F20 Common factor analysis for metrical data is often used in ordinal data . HoweverFactor analysis for categorical data  via the weighted least squares estimator (WLSMV)  was implEFA assesses the underlying structure of a set of variables with no a priori expectation on how the variables form factors. The model identifies the number of underlying latent variables  and how each item loads onto these factors. Under this model framework, all items have some loading to each latent factor. A Geomin rotation  was usedParallel analysis using polychoric correlations  was usedIn CFA the factorial structure is pre-defined, that is the number of factors and how the items are assigned to each factor are imposed to the model by the user. CFA was applied here to test the fit of the factor structures which have been previously proposed in the literature, as well as those driven by the current EFA results. CFA models with and without cross-loading items are explored.Methodologically, EFA and CFA models cannot be employed in the same data. For that reason, the sample was randomly divided into two samples; the first sub-sample (Sample 1) was used in EFA and the second one (Sample 2) in CFA.Bifactor modelling offers an appealing solution to conflicting evidence of unidimensionality and multidimensionality in outcome measures. It can inform us whether there is enough evidence for outcome measures to be used as a multidimensional structure, a unidimensional measure or both . This isIn the bifactor model all indicators are modelled to load on a single general latent factor. But item covariance can also be caused by competing specific factors which are uncorrelated with each other and with the general factor. Typically, each item can load on the general factor and only one specific factor  and eachThis is a restricted bifactor model which assumes that there are no cross-loadings. In the presence of cross-loadings (as is the case here), Reise et al.  suggestsAssess whether an outcome measure can be used as a unidimensional scale. If the factor loadings on the general factor in a bifactor solution remains comparable to the loadings in a unidimensional solution, then this indicates that no major loss in information is present when the scale is used as unidimensional.Assess whether the multidimensional factors are justified. If the factor loadings on the general factor are higher than the ones on the specific factor and, the factor loading on specific factors of the bifactor model are diminished compared to the multidimensional factor structure then this indicates a weak factor. In this case the specific factor has little influence after controlling for the general factor.Reise et al.  proposedReise’s approach was used here to further assess the dimensionality of the HoNOS.2: values close to 2 indicate close fit; [Measures of both absolute and relative fit were used, namely the relative chi-square , the Roose fit; ), the Coose fit; ), and those fit; ). Data aose fit; . For EFAose fit;  with priose fit; .H) was used to estimate the reliability of the general factor and, omega subscale (ωS) used to estimate the reliability of the specific factors by controlling for the general factor.In CFA models Cronbach’s alpha is presented for each factor as is customary. Cronbach’s alpha (α) determines the reliability of each set of items in a factor. Cronbach’s alpha is a function of the number of items in a scale so fewer items will result in a smaller coefficient . For thet = −23.985, df = 12,908, p ≤ 0.001).Table  = 171.59, p ≤ 0.001). Bonferroni post hoc pairwise comparisons (adjusted for multiple comparisons) showed that on average “white” individuals were 4.9 years older than “black” or “other” ethnicity group . However, there was no significant difference between the “black” and “other” ethnicity groups (p ≥ 0.999).There were significant differences in the mean ages between ethnic groups .Among the models previously suggested in the literature, some utilise all 12 items  and others use a reduced number of indicators . Among those which contain all 12 items, the model M7 had the closest fit to the data, according to the goodness of fit indices  to from one factor. However, retaining only four items as in M9 may reduce the clinical usefulness of the HoNOS since other items  which evaluate behaviours and mental state are excluded. This is also the case for Lovaglio’s model , who inSince Trauer’s model  has a stIn addition, α coefficients were approximately 0.5 for the first three factors of the M3 model and 0.6 for the fourth factor showing good reliability across all factors compared to other models. The α coefficients for the first and second factors of Trauer’s model  were appThe bifactor BSEM methodology was used to test the dimensionality of the model with the best fit (M3). The factor loadings for the unidimensional, bifactor BSEM, and four factor solutions can be found in Table Second, we compared the loadings of the items to the specific factors of the bifactor BSEM  to the corresponding ones in the factors  of the four factor solution. Overall the factor loadings on the three specific factors  were high and comparable to the corresponding ones in F2, F3 and F4. Overall, these factors formed stable solutions with high factor loadings.) dropped appreciably. As outlined in the Methods section this indicates a weak factor with little influence after accounting for the general factor. The result of the Bifactor BSEM also shows that all factor loadings were significant apart from items 3, 6 and 8 in S1 of the bifactor BSEM model. This also corroborates the findings of three strong factors with high factor loadings on each factor and a weak factor with low factor loadings. Reliability indices  for the standard bifactor model are also presented in Table H and ωS values. After accounting for the general factor ωS on specific factor S1 of the bifactor model dropped considerably compared to S2-S4.Regarding the first factor (S1), when the general factor was added in the bifactor model the loadings on three of the items in S1  and the other items within this factor; item 3 , item 6 , and item 1 (overactive aggressive or disruptive behaviours). Coexisting mental health and drug and alcohol problems are common in clinical practice [non-accidental self-injury) and item 7 (problems with depression). Therefore, we consider the cross-loadings justified and in line with the latent constructs.There are two cross-loading items in our proposed four factor solution. Item 8 loaded on the first and second factor and item 10 loaded on the third and fourth factor. There are established relationships between item 8 practice  and drugpractice . In addipractice  and theractivities of daily living or ADLs), this fits well within both the third and fourth factor. Item 10 (ADLs) forms a plausible factor with item 4 (cognitive problems) and item 5 . Network and Stoppe [Regarding item 10  compared with the three remaining factors. All four factors showed clinical relevance according to published literature. Future studies should examine this structure and the bifactor approach in alternative subclasses of patients.This study contributes to the research which aims to establish how the HoNOS ratings should be used to evaluate outcomes. It has implications for whether the ratings should be aggregated in practice. Deriving an appropriate factor structure will help to improve the sensitivity of the HoNOS with respect to changes in subscale scores. It is important to establish a consistent reliable approach to using the HoNOS ratings to be able to identify significant changes and efficiently assess patients’ needs. This study was based on a sample of a patients with severe mental illness. Further studies could apply this approach to a different patient population or a wider patient group.


The present work has been conducted to define the sensory profile of these products through tasting by trained experts and consumers to study the acceptability, preference, and quality perception. The four sensorial profiles of the bars differed in the level of persistence, bitterness, aromaticity, acidity, astringency, and tastiness. In particular, the sour attribute could be traced to the presence of dried apple. Bars containing apple and chestnut flour obtained higher acceptance ratings, compared to those with extra virgin olive oil. The bar with chestnut flour was preferred by consumers who considered it to be sweeter due to the presence of natural sugars, which lowered the bitter sensation of cocoa. These results showed that the selection of the preferred bar by consumers was mainly based on the level of bitterness and, in particular, elderly consumers expressed a strong preference for the sweetest product. As far as we know, this is the first study comparing the results of a panel of expert tasters with that of consumers in the tasting of dark chocolate.A new set of cocoa bars named Toscolata Other traditional products are not so easy to be marketed because they do not meet market standards. For example, some fruits do not reach the desiderate size, color, and firmness or may have a very short season. Thus, it would be useful to find new strategies for their commercialization selecting new formulations, novel methods of transformation by which increase the economic value and the income of the producers.One confectionary products preferred by consumers is cocoa and its derivatives. They are consumed for pleasure, acting as a stimulant, relaxant, or potentially an antidepressant  or organoleptic features (chestnut flour).http://www.vestri.it) using the best mixture of cocoa beans produced directly by Vestri in their organic farm in Santo Domingo. All the production conditions  were set to maintain the highest organoleptic features of the original cocoa beans and ingredients. The composition of the bars is given in Table The samples were manufactured in the Vestri chocolate laboratory located in Arezzo . All of the samples to be assessed were taken out of the refrigerator 24 hr before each session. Each cocoa bar was cut into 6.5 g servings, placed on to plastic plates codified with three‐digit random numbers and served at room temperature (22°C) to the panelists without specifying the formulation. As recommended, water was used for cleansing the palate between samples.The sensory evaluation was conducted in two replicate sessions by a panel of the Grosseto Chamber of Commerce composed of 10 experienced judges. In the first session, the products containing “Mora,” “Nesta,” “Ruggine,” “Stayman,” and “Golden Delicious”  were evaluated to understand if there was any difference between local and international dried apples added to the cocoa. In the second session two apple bars were evaluated together with extra virgin olive oil (EVO) and chestnut flour (CHF). Attributes were expressed on a 9‐cm line scale and quantified by measuring the distance of the mark from the origin  where young, adults, and families interact directly with researchers.After the panel test, only four bars were submitted to the consumer test. The aim of this step was to determine the acceptability and level of preference of the new cocoa bars by a representative sample of the consumer population. The test was conducted for 3 days in different locations: Pisa, Siena, and Follonica. The consumers were recruited during the “European Researchers’ Night”  was applied to analyze the dataset to standardize the scale of evaluation. Principal component analysis (PCA) was applied to the dataset from the panel test to select the most discriminant attributes and to study differences among all of the samples. Principal component analysis was also applied to discriminate groups of consumers on the base of sociodemographic differences. A Pearson's chi‐square test was used to study the differences in the distribution of cocoa bar preference within the groups of consumers. All the statistics were performed by Systat 11 statistical program .33.1A total of 38 potential sensory terms were used for the preliminary description of cocoa prototypes Table . During 3.2Data from the two separated sessions, statistically elaborated by PCA, underlined the most discriminant attributes of the sensory profile of cocoa bars only containing dried apples. The total variance explained by the first two principal components was equal to 71% and the five attributes with the highest loadings were “sapidity” and “fruity” on the first component and “graininess,” “astringency,” and “persistence” on the second component  again using the sensorial sheet with all 16 attributes. The loading of each sensory property on the first two components as calculated by the Principal Component procedure is shown in Table 3.3The 182 consumers who participated in the test were well distributed within the classes of gender and age Table , and regNone of those interviewed disliked all the bars and only 16  expressed to dislike (very or extremely) of one of the bars. The number of “dislike” opinion were, respectively, 8 for EVO, 5 for the apple bars, and 3 for CHF with no statistical differences among the number of answers. The preference of the consumers .With regard to the distribution of preferences among groups of consumers, the only statistical difference was found to be “male over 61 years old” who preferred the cocoa bar with chestnut flour  found this bar very “tasty” and pleasant in its smoothness, complexity, and persistency. With regard to EVO, we have to underline that the extra virgin olive oil is not considered by the European Commission directive among the vegetable oils/fats permitted in the production of chocolate, even though extra virgin olive oil is considered to be highly beneficial to health compared to palm oil which is instead included in the list of legal ingredients for chocolate. Recently, the Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Agency (EFSA) evaluated the risks for human health related to the presence of 3‐ and 2‐monochloropropanediol (MCPD), and their fatty acid esters and glycidyl fatty acid esters in food. The EFSA reported that the esters of 3‐ and 2‐MCPD and glycidyl esters were highest in palm oil/fat, and that the level in some foods could cause health problem for young people. The EVO bar did not present any processing or conservation problem and has a peculiar organoleptic profile, different from other commercial products. Its action on human health is now under evaluation by our group. Since only 15% of the consumers declared that they buy cocoa for its effects on health, there is great potential for information strategies. The communication of scientific knowledge about these high‐quality products could be more greatly explored and exploited to increase market penetration and price.While similar research has been conducted for the assessment of apple quality by Gatti, Di Virgilio, Magli, and Predieri , this pa5The different ingredients used in the recipes directly influenced the acceptability of these novel bars to consumers. DAM, DAN, and CHF obtained higher acceptance ratings compared to EVO. This study demonstrated that novel food made with ingredients such as Tuscan autochthonous dried apples and PGI Monte Amiata chestnut flour had a high acceptance and preference by consumers.None declared.


Ptilinorhynchus nuchalis) males build and maintain display courts by placing tens to hundreds of objects in a positive size–distance gradient. The visual angles created by the gradient create a forced perspective illusion that females can use to choose a mate. Although the quality of illusion is consistent within males, it varies among males, which may reflect differences in how individuals reconstruct their courts. We moved all objects off display courts to determine how males reconstructed the visual illusion. We found that all individuals rapidly created the positive size–distance gradient required for forced perspective within the first 10 objects placed. Males began court reconstruction by placing objects in the centre of the court and then placing objects further out, a technique commonly used when humans lay mosaics. The number of objects present after 72 h was not related to mating success or the quality of the illusion, indicating that male skill at arranging objects rather than absolute number of objects appears to be important. We conclude that differences arise in the quality of forced perspective illusions despite males using the same technique to reconstruct their courts.Many animals build structures to provide shelter, avoid predation, attract mates or house offspring, but the behaviour and potential cognitive processes involved during building are poorly understood. Great bowerbird ( SeemingPtilonorhynchus nuchalis) males build bowers comprising two parallel densely thatched stick walls and floor that create an avenue of up to 1 m long. Each end of the avenue opens up onto a display court, where a cleared area of ground is covered with tens to hundreds of grey and white objects such as stones, shells and bones  build and decorate structures called bowers that are used in mate choice . Great bnd bones . These oP. violaceus), females sample several males multiple times before choosing who to mate with each year [Males show consistent, individual differences in their gradients, which may reflect some aspect of male ability to learn and/or remember object arrangement . Objectsach year  and willach year . Being aObject availability may also be an important factor determining gradient characteristics: males given objects from another bower created gradients similar to the donor bower rather than their original gradient . HoweverIt is difficult to determine the extent of a cognitive component in gradient construction without first knowing how gradients are built, whether building behaviour varies among males, and whether variation in building behaviour is related to male quality. To address these questions, we moved the objects off one court of each bower of 14 male bowerbirds, and recorded how they reconstructed their gradients. Males could reconstruct their gradients in a number of ways: (i) by placing the smallest objects closest into the bower and then increasing object size as they moved further out from the bower avenue ; (ii) by randomly selecting and placing the correct sized objects in the appropriate court area in no particular order; (iii) by placing all objects back on the court and then rearranging them by size or (iv) by placing objects in the centre of the court and then working outwards, a technique commonly used by humans in building mosaics  figure . ReconstWe quantified how males reconstructed their gradients  by measuring the location and time of each object placed and the changes in gradient over time. We also determined whether the first ten objects placed recreated a positive size–distance gradient and compared how the reconstructed gradient compared with the original gradient.2.This study was carried out at Dreghorn Station in Queensland, Australia . At the start of the breeding season in September 2011, motion-activated, solar-powered cameras were set up at 14 male great bowerbird bowers as described previously [t-shaped dowel set was used to locate and mark the centre of the entrance to the avenue and the distance to the female's location in the central depression of the avenue during male displays (a). The overhead camera was also calibrated with the dowels (to account for differences among bowers in the distance of the camera from the court), so that video frames could be exported and court objects measured in the same way as the photographs.To quantify the quality of male courts during the breeding season, photographs of both courts were taken approximately every 8 days as described previously . Wooden displays a. The ovp-value with a precision of 0.005) of what the bird could make with the objects available on the court [Court measurements were made using photographs and exported video frames using Matlab . Court ghe court .Prior to manipulation, we photographed both courts at each bower. We then moved all of the objects (both coloured and uncoloured) off the primary display court and placed the objects 20 cm to one side of the edge of the court. After manipulation, each bower was left undisturbed for 72 h, and then another set of photographs of both bower courts was taken. The calibrated motion-activated cameras were on continuously during these times.To determine how males began reconstruction of their courts, for each bower we extracted time-stamped video frames every time a new object was placed onto the court for the first 10 objects placed. We also determined where males placed the first 10 objects in relation to the distance from the avenue entrance and distance from the avenue long axis. In order to compare bowers with different court sizes, we assessed object placement relative to the original court length and width. During placement of the first 10 objects, dappled shade on four bowers made the object boundaries difficult to distinguish and data from these four males were excluded from further analysis. This left us with first 10 object placement data for 10 bowers.We tested whether males reconstructed the original gradient values immediately by measuring how the gradient created by the first few objects compared with the original gradient. We did this for the fourth to tenth objects added to the court, when there were enough objects present to create a statistically reasonable size–distance gradient. Each time a new object was added to the court, we calculated the residual of each object from the original gradient residual, then calculated the root mean square (RMS) of these residuals; the s.d. of the residuals. If the birds had an inherent sense of perspective, we predicted that all objects placed would have similar RMS residuals to the original gradient, whereas trial-and-error placement would have more variable RMS residuals.We also carried out overall comparisons of geometric quality calculating the residuals of the gradient regressions and the residuals from the mean visual angle . The smaller the residuals from the regression, or the smaller the visual angle s.d., the higher the geometric quality. We calculated three different sets of residuals from both the gradients and s.d. angles. R1 is the set of residuals of original objects from the original  value. It is a measure of the quality of the original court geometry. R2 is the set of residuals of the first 10 objects from their own gradient or s.d. angles. It is a measure of how carefully the male placed the first 10 objects in relation to each other; small R2 indicates a high-quality gradient or low s.d. with only 10 objects. R3 is the set of residuals of the first 10 objects from the original  value. It is a measure of how well males recovered their original gradient when placing the first 10 objects; small R3 indicates a good fit with the original gradient. We then compared R1 with R2 and R3 separately for each bower and separately for visible width and depth measurements. Probabilities of these differences were calculated for each bower using 20 000 permutations of the individual object residuals between the two groups being compared. If males were selecting and placing objects at random with respect to size and position, then we would expect the R2–R1 and R3–R1 differences to be significantly larger than zero. If males were placing objects non-randomly and consistently, we expected these differences to be not significantly different from zero. We also investigated whether motivation to replace the gradient was linked with mating success (the number of copulations recorded within the bower avenue), by determining whether the number of objects present on the court was associated with mating success.n = 14). Two bowers were excluded from analysis: one where the individual was highly atypical and had only a handful of objects on the court and another where the dappled lighting conditions made it difficult to accurately measure court objects, leaving 12 bowers. Court statistics as described previously were calculated at 2 h intervals during daylight to determine how the size–distance gradient, visual angle s.d. and effect size changed over 3 days. These data were analysed using generalized additive mixed models (GAMM) in the R gamm4 package [To quantify how courts were reconstructed, we measured the court variables at 2 h intervals during daylight hours for 3 days after the courts were cleared . On the x-axis of the court , all males placed the first 10 objects in the half of the court closest to the avenue compared with the original court, and 70% were in the closest third of the court , seven of the 10 males placed their first 10 objects in the middle third of the court . Over the course of 72 h, males continued to place objects in the same pattern as seen in the placement of the first 10 objects—directly in the female's eyeline (court width), and in the first third of the court x-axis .All males began reconstruction of their court gradients within 4 h of removal, with the first object being placed at an average time of 45 ± 17 min after court clearance . In summary, within bowers the gradients and resulting visual angles of the courts with the first 10 objects were similar to the pre-removal statistics and had similar gradient qualities. The number of objects present on the court was not correlated with court quality after 72 h , or mating success .Males differed in how well they recovered their gradients and visual angle evenness when placing the first 10 objects . Most maWe then investigated how 72 h of reconstruction time and object number affected court measurements once variation across bowers was accounted for. The visible width gradient increased over time but the number of objects did not affect the slope, whereas the slope of visible depth was not affected by time or the number of objects used . Visual 4.y-axis and the half of the court closest to the bower entrance on the x-axis. The central court area is probably replaced first because it creates the backdrop for the male's courtship display that the female is guaranteed to see from her position in the bower [Males were motivated to replace their courts as they began reconstruction of their size–distance gradients within 45 min. They first replaced the section of the court that is most central in the female's field of view from within the bower—the middle of the court's he bower . Femaleshe bower , which aWe found that the depth and width components of the forced perspective illusion did not show a steady improvement during the time taken for the first 10 objects to be replaced. This suggests that there are complex relationships between the number and size distribution of objects, the time taken to place the objects and visual angles. This may reflect the shape of many objects on the court; any object that is not circular will show a simultaneous increase in visual depth and a decrease in visual width (or vice versa) when rotated . Males mTaeniopygia guttata) nest building [All males placed the first 10 objects in the same area of the court, indicating that they selected objects of a specific size to replace onto the court first and were not simply taking objects that were at the top of the pile; i.e. they actively searched for objects of the appropriate size to place in the centre area of the court. The ability to select appropriately sized objects for a task  is also seen in corvid tool use and zebra finch . Object familiarity, therefore, appears to be of limited importance during court construction, and we predict that variation in the environment and object availability would select for males to be flexible in terms of the objects used and their placement given the largest and smallest objects available.The speed of court and gradient repair indicates that males were motivated to replace the missing component of their courtship display. This is consistent with previous findings in this and other bowerbird species ,12,23. IMales did not appear to use trial and error when replacing their court objects. If males constructed gradients by trial and error, we would expect that the residuals of the first 10 objects should be much higher than the original geometry, and the locations to be random, but we found that the first 10 objects placed created court geometry that was the same as prior to removal. In fact, on average the quality of geometry created by the first 10 objects was slightly higher than the original, the opposite of what we expected from trial and error. This does not exclude the possibility that males used trial and error the first time they ever constructed the court geometry and then later recalled the general location of objects of certain sizes . Although previous work has shown that males do not place objects in exactly the same location as previously when the court is disturbed , a simplAlternatively, males may have an internal template that can also be refined through learning , eitherOenanthe leucura), for example, carry stones to their nest and females use the number of stones carried  to assess male quality [Torquigener sp.), the finer details of the construction are assessed [We expect that energetically or cognitively demanding building behaviour will be a feature of structures that are used in mate choice, as they can provide information about male quality to females . Male bl quality . Wheatea quality ,27. In tassessed ,8. The p


Metal objects in the body such as hip prostheses cause artifacts in CT images. When CT images degraded by artifacts are used for treatment planning of radiotherapy, the artifacts can yield inaccurate dose calculations and, for particle beams, erroneous penetration depths. A metal artifact reduction software (O‐MAR) installed on a Philips Brilliance Big Bore CT has been tested for applications in treatment planning of proton radiotherapy. Hip prostheses mounted in a water phantom were used as test objects. Images without metal objects were acquired and used as reference data for the analysis of artifact‐affected regions outside of the metal objects in both the O‐MAR corrected and the uncorrected images. Water equivalent thicknesses (WET) based on proton stopping power data were calculated to quantify differences in the calculated proton beam penetration for the different image sets. The WET to a selected point of interest between the hip prostheses was calculated for several beam directions of clinical relevance. The results show that the calculated differences in WET relative to the reference case were decreased when the O‐MAR algorithm was applied. WET differences up to 2.0 cm were seen in the uncorrected case while, for the O‐MAR corrected case, the maximum difference was decreased to 0.4 cm. The O‐MAR algorithm can significantly improve the accuracy in proton range calculations. However, there are some residual effects, and the use of proton beam directions along artifact streaks should only be used with caution and appropriate margins.PACS numbers: 87.55.D‐, 87.57.cp In radiotherapy it is standard routine to use X‐ray computed tomography (CT) to provide a basis for planning of the treatment. CT images are used for delineation of targets and organs at risk (OARs), and the Hounsfield units (HU) provide quantitative data for mapping to radiation transport data in dose calculations. A common problem in CT is the occurrence of image artifacts when metallic objects, such as dental fillings or orthopedic prostheses, are present in the patient. The artifacts usually appear as dark and bright streaking zones across the reconstructed image. With artifacts present in the scanned volume, the acquired HU values will map to erroneous interaction properties, which affects the results of the dose calculations and can seriously jeopardize the entire radiotherapy planning process.Li et al.The software O‐MAR was installed on a Philips Brilliance Big Bore CT  used at the radiotherapy clinic at the Uppsala University Hospital. CT images of a water phantom, in which metallic hip prostheses could be mounted, were acquired and analyzed. Copies of the images were O‐MAR corrected and compared with the original uncorrected images for the regions outside the metal objects. Images of the water‐filled phantom without the prostheses were used as reference data.A flow chart of the O‐MAR algorithm30 × 30 cm2 and was filled with water to a depth of approximately 23 cm. Two chromium‐cobalt hip prostheses with cups were placed 20 cm apart on a slab of PMMA resting on the bottom of the water phantom. Imaging was done with a helical CT protocol typically used for the pelvic area .An image of the phantom used in the evaluation is shown in Images were first captured with the prostheses present in the phantom, followed by acquiring reference images with the metal objects removed . Images with both one and two prostheses present were acquired. The supporting slab of PMMA was present in the phantom during all scans. Images corresponding to the central area of the femoral heads were chosen for the investigation because of its relevance for radiotherapy in the pelvic area.In the imaged phantom, a central position in between the prostheses was chosen. The WET values for proton beams directed to this point were then calculated for the original uncorrected image with prostheses, the O‐MAR corrected images, and the reference images scanned with water replacing the prostheses.m, of thickness, tm. The WET is in the thin target approximation given by:tw and tm are the thicknesses of water and the medium corresponding to an equivalent energy loss of the incident protons, ρw and ρm are the mass densities of water and the medium, and (S/ρ)w and (S/ρ)m are the mass stopping power values for water and the medium, respectively. Values for the relative stopping power ratio,CaCl2 dissolved in water. These measurements were used to determine the parameters Kph/KKN and Kcoh/KKN (following the nomenclature of the above references), yielding the values 2.86 × 10‐5 and 7.20 × 10‐4, respectively, through a fitting procedure. In a second step, the corresponding HU for the tissues mentioned above were calculated based on the chemical composition and density given by ICRP Report 23‐740 HU to 1370 HU. The relative stopping power values given by SchneiderHU = 0 not exactly equals the geometrical ray length in water, but instead gives the result for the tissue mapped at HU = 0 . This systematic error cancels while scanning and deriving the reference WET for the water phantom through exactly the same calculations procedure instead of using the geometrical distances directly. Furthermore, it allows for using PMMA as part of the phantom, yielding a similar systematic deviation also canceling between the test and the reference data.WET is defined as the thickness of water that causes a hypothetical straight line ray to lose the same amount of energy as the beam ray would lose in a medium, r0 to r is thus defined as:i run over all the N voxels intersected by the line from r0 to r, and Δsi is the ray length in the voxel at step i.The WET value from The WET was calculated in MATLAB  along lines to a point of interest, placed between the prostheses, from the edge of the water phantom. The locations of the points of interests are shown in (WETdiff = WETO‐MAR/Uncorr ‐ WETref) versus the reference image are shown for a posterior–anterior (PA) beam direction for the O‐MAR corrected image and the uncorrected image. In In The results show that the O‐MAR algorithm significantly improves the WET values in artifact‐affected CT images, and can thus improve the range accuracy in dose calculations by several millimeters. In In the case with two prostheses, the maximum WET difference as a function of angle was 2.0 cm for the uncorrected case and 0.4 cm for the O‐MAR corrected case. Imaging of the unilateral prosthesis phantom showed smaller deviations in WET relative to the reference, but the O‐MAR algorithm generally improved the accuracy.It is important to apply margins in proton treatment planning to account for range uncertainties. A common distal margin is about 4% of the range.As seen in Further evaluation of the O‐MAR application could be performed by using a more complex heterogeneous phantom. According to a white paper from Philips, the O‐MAR algorithm may incorrectly modify areas with metal in close proximity to air.In addition to implants made of chromium‐cobalt, which is the type of prostheses used in this phantom study, titanium and stainless steel are also used as material for hip prostheses. An additional parameter in the evaluation of a metal artifact reduction algorithm could therefore be different hip prostheses material. However, the chromium‐cobalt alloy has a higher attenuation coefficient than titanium and steelAnother technique used for reducing the impact of metal artifacts on the CT image‐based dose calculations, apart from a MAR algorithm, is to override the artifact‐affected areas by assigning it to be composed of water or a homogeneous tissue. The override technique is however both time‐consuming and subjective, factors which can be eliminated with automated approaches like O‐MAR corrections.In this evaluation, a single setting of the CT protocol was used. According to the white paper from Philips,This study confirms, based on WET calculations, that the O‐MAR algorithm has capacity to reduce uncertainties in proton dose calculations when metal artifacts are present in the CT images. The method of comparing WET values, as a way to evaluate the impact of metal artifacts in CT studies used for proton therapy treatment planning, is generic and could easily be generalized to other geometries.Supplementary MaterialClick here for additional data file.