Background: Serious video games have now been used and assessed in clinical protocols, with several studies reporting patient improvement and engagement with this type of therapy. Even though some literature reviews have approached this topic from a game perspective and presented a broad overview of the types of video games that have been used in this context, there is still a need to better understand how different game characteristics and development strategies might impact and relate to clinical outcomes. Objective: This review assessed the relationship between the characteristics of serious games (SGs) and their relationship with the clinical outcomes of studies that use this type of therapy in motor impairment rehabilitation of patients with stroke, multiple sclerosis, or cerebral palsy. The purpose was to take a closer look at video game design features described in the literature (game genre [GG], game nature [GN], and game development strategy [GDS]) and assess how they may contribute toward improving health outcomes. Additionally, this review attempted to bring together medical and game development perspectives to facilitate communication between clinicians and game developers, therefore easing the process of choosing the video games to be used for physical rehabilitation. Methods: We analyzed the main features of SG design to obtain significant clinical outcomes when applied to physical rehabilitation of patients recovering from motor impairments resulting from stroke, multiple sclerosis, and cerebral palsy. We implemented a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) database-adjusted electronic search strategy for the PubMed, IEEE Xplore, and Cochrane databases. Results: We screened 623 related papers from 2010-2021 and identified 12 that presented results compatible with our inclusion criteria. A total of 512 participants with stroke (8 studies, 417 participants), cerebral palsy (1 study, 8 participants), and multiple sclerosis (2 studies, 46 participants) were included; 1 study targeting the elderly (41 participants) was also included. All studies assessed motor, sensory, and functional functions, while some also measured general health outcomes. Interventions with games were used for upper-limb motor rehabilitation. Of the 12 studies, 8 presented significant improvements in at least one clinical measurement, of which 6 presented games from the casual GG, 1 combined the casual, simulation, and exergaming GGs, and 2 combined the sports and simulation GGs. Conclusions: Of the possible combinations of game design features (GG, GN, and GDS) described, custom-made casual games that resort to the first-person perspective, do not feature a visible player character, are played in single-player mode, and use nonimmersive virtual reality attain the best results in terms of positive clinical outcomes. In addition, the use of custom-made games versus commercial off-the-shelf games tends to give better clinical results, although the latter are perceived as more motivating and engaging.

Exoskeletons for locomotion, support, or other uses are becoming more common. An increasing number of studies are demonstrating relevant results in rehabilitation. Here we describe the steps required to properly place and train patients in ExoAtlet ® powered exoskeletons (Moscow, Russia), for which there is currently limited information available. These steps combine actions related to the hardware, software, as well as safety, rehabilitation, and psycho-emotional state of the subject. Training starts with a general preparation of the environment, the equipment, and the patient. When the actual training program begins, the patient needs to gradually learn to perform the different actions that will be required to control the exoskeleton. Initially, training requires transferring weight between legs to guarantee adequate equilibrium control. Then, actions assisted by computer-controlled motors begin, namely: standing up, walking in place, moving small distances and sitting down. As the patient becomes comfortable with the exoskeleton and the cardiovascular system becomes adjusted to the upright position, training can then include walking over longer distances, inclined planes, opening doors, and climbing stairs.•Powered exoskeletons are becoming a common method in rehabilitation.•The use of ExoAtlet ® powered exoskeletons in clinical research requires manipulation of variables thought to promote rehabilitation, without compromising safety standards.•The phases of training are: transferring weight between legs, walk in place, and walk over longer distances.

Brain–computer interfaces (BCIs) that integrate virtual reality with tactile feedback are increasingly relevant for neurorehabilitation in spinal cord injury (SCI). In our previous case study employing a BCI-based virtual reality neurorehabilitation protocol, a patient with complete T4 SCI experienced reduced pain and emergence of non-spastic lower limb movements after 10 sessions. However, it is still unclear whether these effects can be sustained, enhanced, and replicated, as well as the neural mechanisms that underlie them. The present report outlines the outcomes of extending the previous protocol with 24 more sessions (14 months, in total). Clinical, behavioral, and neurophysiological data were analyzed. The protocol maintained or reduced pain levels, increased self-reported quality of life, and was frequently associated with the appearance of non-spastic lower limb movements when the patient was engaged and not experiencing stressful events. Neural activity analysis revealed that changes in pain were encoded in the theta frequency band by the left frontal electrode F3. Examination of the lower limbs revealed alternating movements resembling a gait pattern. These results suggest that sustained use of this BCI protocol leads to enhanced quality of life, reduced and stable pain levels, and may result in the emergence of rhythmic patterns of lower limb muscle activity reminiscent of gait.

This review aims to explore the literature to assess the potential of artificial intelligence (AI) in environmental monitoring for predicting microbiome dynamics. Recognizing the significance of comprehending microorganism diversity, composition, and ecologically sustainable impact, the review emphasizes the importance of studying how microbiomes respond to environmental changes to better grasp ecosystem dynamics. This bibliographic search examines how AI (Machine Learning and Deep Learning) approaches are employed to predict changes in microbial diversity and community composition in response to environmental and climate variables, as well as how shifts in the microbiome can, in turn, influence the environment. Our research identified a final sample of 50 papers that highlighted a prevailing concern for aquatic and terrestrial environments, particularly regarding soil health, productivity, and water contamination, and the use of specific microbial markers for detection rather than shotgun metagenomics. The integration of AI in environmental microbiome monitoring directly supports key sustainability goals through optimized resource management, enhanced bioremediation approaches, and early detection of ecosystem disturbances. This study investigates the challenges associated with interpreting the outputs of these algorithms and emphasizes the need for a deeper understanding of microbial physiology and ecological contexts. The study highlights the advantages and disadvantages of different AI methods for predicting environmental microbiomes through a critical review of relevant research publications. Furthermore, it outlines future directions, including exploring uncharted territories and enhancing model interpretability.

The neurophysiological basis of width discrimination has been extensively studied in rodents and has shown that active and passive tactile discrimination engage fundamentally different neural networks. Although previous studies have analyzed active and passive tactile processing in humans, little is known about the neurophysiological basis of width discrimination in humans. Here we present a width discrimination task for humans that reproduces the main features of the width discrimination task previously developed for rodents. The task required subjects to actively or passively sample two movable bars forming a "narrow" or "wide" aperture. Subjects were then required to press one of two buttons to indicate if the bar width was "narrow" or "wide". Behavioral testing showed that subjects were capable of discriminating between wide or narrow apertures up to distances of 0.1 cm. Electroencephalography (EEG) recordings further suggested distinct topographic maps for active and passive versions of the task during the period associated with the aperture discrimination. These results indicate that the Human Differential Width Discrimination Task is a valuable tool to describe the behavioral characteristics and neurophysiological basis of tactile processing.•Active and passive width discrimination has been extensively studied in rodents but not in humans.•Human subjects were capable of discriminating aperture widths of 0.1 cm.•Electroencephalography recordings showed that active and passive versions of the task were associated with different topographic maps.