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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Lessening stress and anxiety-related behaviors by means of AI-driven drones for aromatherapy</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Giacomo Capizzi</string-name>
          <email>gcapizzi@dieei.unict.it</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Christian Napoli</string-name>
          <email>napoli@dmi.unict.it</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Samuele Russo</string-name>
          <email>samuelerussoct@gmail.com</email>
          <xref ref-type="aff" rid="aff3">3</xref>
          <xref ref-type="aff" rid="aff4">4</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Marcin Wozniak</string-name>
          <email>marcin.wozniak@polsl.pl</email>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Computer, Control, and Management Engineering Sapienza University of Rome</institution>
          ,
          <addr-line>Via Ariosto 25, 00185 Roma RM</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Department of Electrical, Electronics and Informatics Engineering University of Catania</institution>
          ,
          <addr-line>Viale Andrea Doria 6, 95125 Catania CT</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>Institute of Mathematics, Silesian University of Technology Kaszubska 23</institution>
          ,
          <addr-line>Gliwice 44-100</addr-line>
          ,
          <country country="PL">Poland</country>
        </aff>
        <aff id="aff3">
          <label>3</label>
          <institution>Postgraduate student, specialization school in Psychotherapy C.T.R.</institution>
          ,
          <addr-line>Via Galermo 105, 95123 Catania CT</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
        <aff id="aff4">
          <label>4</label>
          <institution>University of Catania</institution>
          ,
          <addr-line>Piazza Universita 2, 95124 Catania CT</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Stress and anxiety are part of the human mental process which is often unavoidably yield by circumstances and situations such as waiting for a ight at the airport gate, hanging around before an exam, or while in an hospital waiting room. In this work we devise a decision system for a robotic aroma di usion device designed to lessen stress and anxiety-related behaviors. The robot is intended as designed for deployments in closed environments that resembles the aspect and structure of a waiting room with di erent chairs where people sit and wait. The robot can be remotely driven by means of an arti cial intelligence based on Radial Basis Function Neural Networks classi ers. The latter is responsible to recognize when stress or anxiety levels are arising so that the di usion of speci c aromas could relax the bystanders. We make use of thermal images to infer the level of stress by means of an ad hoc feature extraction approach. The system is prone to future improvements such as the re nement of the classi cation process also by means of accurate psychometric studies that could be based on standardized tests or derivatives.</p>
      </abstract>
      <kwd-group>
        <kwd>Arti cial Intelligence Neural Networks Robotics Feature Extraction Human Machine Interaction Social Psychology</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        In our society we are nowadays experiencing a constant increase in stress and
anxiety levels as never seen before. Since such a phenomenon is a typically
obCopyright © 2020 for this paper by its authors. Use permitted under Creative
Commons License Attribution 4.0 International (CC BY 4.0).
served within industrial and hyper-urbanized areas, common belief relates stress
and anxiety to an overwhelming amount of work and occupation. On the
contrary stress and anxiety are a twofold part of the human mental process which
is often related to boredom [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. In facts, while it has been proven many times
that occupied time feels shorter than unoccupied time [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ], the lack of a
practical involvement during a long waiting time and the related boredom are typical
precursors for well known mentalization processes that often end in
overthinking [
        <xref ref-type="bibr" rid="ref19">19</xref>
        ].
      </p>
      <p>
        While generally considered a detrimental habit, overthinking is often also an
unavoidably yield by circumstances and situations such as waiting for a ight at
the airport gate, hanging around before an exam, or while in an hospital waiting
room. It has been proven that the quality of the time spent in a waiting room
also a ect the perceived quality of the awaited service, especially in
healthcarerelated contests [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]. The latter are also often positively or negatively a ected by
the perceived quality of service that, in the second case, could also tamper with
the therapeutic e cacy of the treatments (e.g. for psychological counseling or
and psychotherapy [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]).
      </p>
      <p>
        Many techniques has been developed to relieve anxiety and lessen stress,
among such techniques several of them focuses on the psychological impact of
the surrounding environment and its perception. Aromatherapy has been proven
to be an e ective remedy for stress and anxiety-related behaviors due to the
apparent interaction between sense of smell and pituitary gland's physiology [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ].
In particular several aroma has been show to signi cantly lower the blood's
levels of cortisol [
        <xref ref-type="bibr" rid="ref20">20</xref>
        ]. Therefore aroma inhalation could be a very e ective stress
management method in several contests ranging from medical care centers to
school and studyrooms [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ]. However, while more basic research is needed to
fully understand the mechanisms underlying the e ects of aromatherapy [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ],
the clinical trials seems to suggest that aromatherapy may decrease sympathetic
nervous system activity and increase parasympathetic nervous system [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ].
Finally, aromatherapy-enhanced mindfulness state has been studied in order to
develop new therapeutic intervention against stress and anxiety in hospitalized
people [
        <xref ref-type="bibr" rid="ref16 ref17">16, 17</xref>
        ].
      </p>
      <p>
        In this work we devised a robotic aroma di usion device for deployments
in waiting rooms, airports, hallways and similar environments. Such a robot as
been designed to be remotely driven by means of an arti cial intelligence that
is responsible to recognize when the stress or anxiety levels are arising and the
di usion of speci c aromas could relax the bystanders. The devised robot could
easily blend with other similar device which are nowadays di used for di erent
use ranging from cleaning to healthcare applications [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. The overall system
architecture and design are described in the following.
2
      </p>
    </sec>
    <sec id="sec-2">
      <title>The developed system</title>
      <p>Our approach provides aromatherapy in closed environments that resembles the
aspect and design of a waiting room with several chairs where people sit and
THERMAL
IMAGE</p>
      <p>FEATURES</p>
      <p>VECTOR
t
∑
∑
∑
∑</p>
      <p>TIMFEEA-DTEULRAEYSED</p>
      <p>VECTOR</p>
      <p>HIDDEN LAYERS
INPUT
LAYER</p>
      <p>PATTERN
LAYER</p>
      <p>SUM
LAYER</p>
      <p>
        OUTPUT
LAYER
wait. It follows that we can imagine people's locations as xed points in space
and suppose that each person will remain on the same position during all his
staying. In this kind of setting we use a thermal camera to acquire images during
time. Such images are at the basis of our classi cation task to decide whether or
not aromatherapy is needed. If we can dispose of several cameras that produce
frames, then those frames can be geometrically segmented and normalized in
order to depict only one person at the time. It has been shown the existence
of strong correlations between stress and thermal e ects on several body parts
(e.g. see [
        <xref ref-type="bibr" rid="ref11 ref14">11, 14</xref>
        ]). The feature extraction and classi cation system (see Fig. 1) is
explained in the following.
Each thermal image frame, regarding the k-th person at a discrete time step ,
can be represented as an N M matrix Ak( ) of pixels pikj ( ) where i and j
represents the row and column indexes respectively. To each matrix Ak( ) we
can associate a features vector ak( ) of components aik( ) de ned as
aik( ) =
      </p>
      <p>M
X pikj ( )
j=1
8 k; i;
From each feature vector, we can compute the variation at each time step as
ik( ) = aik( ) aik( 1). Starting from such variations we can de ne a 4N 1
time-delayed features vector xk( ) as a concatenation of 4 time steps so that:
xk( ) =
k
i (
3)j ik(
2)j ik(
1)j ik( )
8 k; i;
4
The vector xk( ) can be used as input u for a classi cation system since it stores
values proportional to an horizontal orthogonal projection of the time-dependent
variations of temperature in the k-th person body. In facts, due to the body
symmetry, and the top-bottom mechanism of the physiological actions on blood
(1)
(2)
pressure and supply from the sympathetic and parasympathetic nervous system,
we are interested to the distribution of temperature along the vertical axis. In
order to classify these features we can use a radial basis function neural network
(RBFNN).
2.2</p>
      <p>
        RBF-based classi er
For the purpose of stress level classi cation from thermal images, it is possible to
implement a dedicated system based on Radial Basis Function Neural Networks
(RBFNN). The said network has a topology similar to common four-layer Feed
Forward Neural Networks (FFNN), with a Radial Basis Function (RBF) used
for its rst hidden layer and a purely linear activation function on his its second
hidden layer. This kind of neural architecture can generate a model of the latent
features [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ] for which there is a non explicit correlation to an high level of
stress or anxiety. If we name the chosen RBF activation function, then the
new output of the rst hidden layer for the j-esime neurone will be
x(1) =
j
jju
      </p>
      <p>C(1) !
j jj
;
where u is the input vector, C(1) the RBF distribution centroid for the j-th
j
neuron, and is a distribution shape control parameter.</p>
      <p>
        The second hidden layer computes a weighted sums of values received from
the preceding neurons. This second hidden layer is called summation layer with
the output of the k-esime summation unit
x(k2) = X Wjkx(j1);
j
(3)
(4)
where Wjk represents the weight matrix elements. Such a weight matrix is
composed by a weight value for each connection from the j-esime pattern units to
the k-esime summation unit. The output layer ful ls the nonlinear mapping for
classi cation. In fact, the rst hidden layer of the RBPNN is responsible for
the fundamental task expected (see [
        <xref ref-type="bibr" rid="ref21">21</xref>
        ] for more details). The number of the
summation units in the second hidden layer is equal to the number of output
units, these should match the number of classes we are interested in to have the
inputs classi ed. In this application we make use of 3 classes to represent the
absence of stress as well as a mild or strong stress condition. It is then possible
to obtain psychological status evaluation sk( ) 2 f0; 1; 2g correlated to the level
of stress and corresponding to the classi cation of the RBFNN.
2.3
      </p>
      <p>Robotic device
In our scenario each person sit on a xed spot, therefore it is possible to assign a
geometrical location L(k) to each person k in the set of people K. It follows that
we can obtain a statistical distribution of the estimated level of stress both as
a global distribution S( ) for each person in the room, and as many as possible
local distributions Sl( ) so that</p>
      <p>S( ) =
1 jKj</p>
      <p>X sk( )
jKj k=1</p>
      <p>Sl( ) =</p>
      <p>X sk( )
1
j lj k2 l</p>
      <p>K = [</p>
      <p>l
l
(5)
where l is the set of people k that belongs to the l-th location. It follows
that, given two threshold m (to identify a mild stress level) and h (to identify
high stress levels) we can drive the robot to di use di erent aromas in di erent
locations l of the room when Sl( ) &gt; m or Sl( ) &gt; h.
3</p>
    </sec>
    <sec id="sec-3">
      <title>Conclusion</title>
      <p>
        The devised decision system, based on thermal imagery and Radial Basis
Function Nerual Networks, seems promising for the development of a robotic aroma
di usion devices to be deployed in closed environments that resembles the
aspect and design of a waiting room with several chairs where people sit and wait.
Since the robot can be remotely driven by means of an arti cial intelligence it
could release aromas in the air only when and when it is needed, therefore only
when the stress or anxiety levels are arising in the room or in a smaller portion
of it. The system is prone to future improvements such as the re nement of
the classi cation process also by means of accurate psychometric studies that
could be based on well known tests (e.g. MASLAC [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ], OSI [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ], MSP [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ]) or by
means of a mixture of them, and possibly supported by a cloud-based solution
for standardization and testing (e.g. [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ]).
      </p>
    </sec>
    <sec id="sec-4">
      <title>Acknowledgment References</title>
      <p>This work has been supported by \Piano della Ricerca 2016/2018 - linea di
intervento 2, University of Catania".</p>
    </sec>
  </body>
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