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    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>The role of intelligent telepresence robots for continuously caring elderly people at home</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Gloria Beraldo</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Riccardo De Benedictis</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Rami Reddy Devaram</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Amedeo Cesta</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Gabriella Cortellessa</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Institute of Cognitive Sciences and Technologies, National Research Council</institution>
          ,
          <addr-line>ISTC-CNR</addr-line>
        </aff>
      </contrib-group>
      <abstract>
        <p>With the COVID-19, telepresence robots have re-gained a particular attention as tool to keep in contact with people remotely. Over the years, a lot of studies have demonstrated the eficacy of telepresence robots for communication with respect to other typologies of devices. However, most of the works have focused on the short-term interaction between the robot and the users. Herein, we put the efort to design telepresence robots for continuously caring elderly people in the domestic scenario. With this purpose, in this work, we integrate diferent AI-driven services, developed inside the SI-Robotics project, to enhance the capabilities of a commercial robotic platform and to provide ecological interaction over time.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Telepresence robots</kwd>
        <kwd>Remote home assistance</kwd>
        <kwd>Elderly people</kwd>
        <kwd>Robotics&amp;AI</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        Telepresence robots are mobile robotic platforms generally endowed with a display, microphone,
speakers, and camera, to enable people to virtually interact from a remote location. Over the
years, telepresence robots have been largely exploited in several applications from the remote
education [
        <xref ref-type="bibr" rid="ref1">1, 2</xref>
        ] to facilitate the museum visits [3, 4], from elderly people assistance [5, 6, 7] to
patients support during COVID-19 pandemic [8, 9]. Although telepresence robots have been
validated in multiple contexts as tool to keep in touch with people and reduce the isolation, the
efectiveness of their use in the long-term period is still an opening question. Indeed, as some
examples have demonstrated in the past, introducing robots in real-time scenario (e.g., at school
[10], at shopping mall [11, 12]) can bias the interaction as a consequence of the novelty of the
technology and the curiosity of people in the first days of experience. But, after realizing the
limited robot’s functionalities with respect to their expectation, people start neglecting robots,
by reducing their eficacy.
      </p>
      <p>Given these premises, inside the project called SI-Robotics (SocIal ROBOTics for active
and healthy ageing), we are currently investigating how to design and develop advanced and
customized human-robot interaction for continuously supporting elderly people at home.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Motivation</title>
      <p>Recently, studies have estimated an increment of old-age dependency ratio (number of people
age 65 or above compared to those age 15-64) from the current 28% to 50% by 2060. Traditionally,
ageing causes a physiological decrease of motor, sensory and cognitive abilities in people that
might impede them to be self-suficient and live alone at home (i.e., the place where the most
would prefer to stay). In other words, it has emerged the necessity of developing healthcare
services, for instance telepresence robots, for continuously assisting elderly people in the daily
activities [13, 14] and to monitor them in order to detect the occurrence of impairments and
dementia [15]. In the case of telepresence robotics, despite the advance of the robotic platform
in recent years [16], their use is still mainly relegated to the remote videoconferencing (e.g.,
call) [17, 18, 19, 20], having no or very limited autonomy [21] and attention to privacy [20].
Long-term usability and acceptability of these platforms, however, require a certain level of
autonomy of the robot, for instance to facilitate the teleoperation for the users that are not very
familiar with technology (e.g., family members of the assisted persons, as well as doctors and
nurses) as well as to implement proactive and user-centered services designed to keep elderly
people company and stimulate them from the cognitive and the physical side (e.g., when the
robot is not used for remote communication) [16, 22, 6]. The next sections will provide an
overview of the AI based services designed inside the SI-ROBOTICS project, considering the
dual role of the robot: (a) being a companion for the primary user (i.e., the elderly); (b) being
an intelligent intermediary for the secondary users (i.e., the remote users) to monitor and to
interact with the person at home.</p>
    </sec>
    <sec id="sec-3">
      <title>3. The roles of the robot &amp; the design of AI-services</title>
      <p>To support the continuous interaction (e.g., during all the day), with respect to other works
[23, 24, 20], the robot can be used in the two modalities inside the same system: video
conferencing to enable the remote communication between the primary and secondary user; intelligent
and autonomous companion where the robot operates for assisting the elderly people at home
by implementing Communication &amp; Cognitive exercises, Physical exercises and Navigation
functionalities. A schematic representation of the system is shown in Fig. 1. The shift of the robot’s
role is determined by the Timeline-based planner &amp; executor that copes with the Local Task
Manager module and are responsible for the decision-making process. Indeed, if the one side,
robots are expected to implement reactive behaviors (e.g., look for the person when he/she
does not answer to the robot, avoid obstacles, modify the dialogue, etc.), on the other robots
have to operate inside predefined boundaries to be acceptable and to adapt to the necessities of
people. Therefore, the first is in charge of planning the personalised activities supporting elderly
people (e.g., GoingTo, LookForPerson, Cognitive Exercise, Physical Exercise, VideoConferencing,
Dialogue) [25], determining the temporal interval and the corresponding parameters (e.g., the
most suitable physical exercises from the specific physiological status). The latter re-adapts the
scheduled tasks evaluating the feasibility of performing them in the specific real-time situations
and calling the corresponding sub-services according to the relations in the Fig. 1. For instance,
before starting a session of cognitive and physical exercises, first, the Local Task Manager
requests the activation of camera and then verifies the presence of person close to the robot
as well before starting a Dialogue it requires the activation of the microphone (e.g., through
the robot interface). In this way, the system can consider constraints related to privacy, by
postponing and/or changing the programmed activity when the camera/microphone are not
enabled.</p>
      <p>Given the importance of creating a bond between the robot and the elderly person to be
acceptable, the system personalises the interaction not only by diferentiating the plan of the
daily activities, but also in terms of feedback provided (e.g., dialogue and content displayed
on the robot’s tablet). Indeed, we aim creating an emphatic interaction through the Emotion
recognition module that estimates the person’s emotional status [26](e.g., angry, contempt,
disgust, happy, natural, sad, surprise) and triggers diferent dialogues (e.g., when the person
is sad, the Dialogue service proposes sentences for the robot to make the person smile, when
he/she is angry to understand the reasons) and/or the change of the animation on the tablet.</p>
      <p>Finally, the architecture includes the Contextualized navigation module that manages
autonomous and semi-autonomous robot’s movements (e.g., when the user also provides direction
commands to the robot). This module is designed to facilitate the teleoperation by freeing the
human to control any detailed manoeuvres as in the manual modality, and by reaching some
navigation goals according to the robot’s perception (e.g., the position of the elderly provided
by the skeleton tracker and the surrounding obstacles) [27] and target positions where some
activities are expected to be performed (e.g., the predefined place where the session of physical
exercises should start).</p>
      <p>It is worth highlighting, as represented in Fig. 1, the system exploits the dialogue and the
robot’s perception to both provide feedback to the user and to acquire information on the user
himself/herself (e.g., cognitive and physical score (e.g., number of correct exercises performed),
geometric features of the environment, user’s preference). Thus, the several modules are not
independent among them, but, on the contrary, they exchange specific data (e.g., decoded
text, decoded emotions, decoded keypoints, obstacle detections) that can activate autonomous
behaviors (e.g., not a priori determined at the planner level), such as the implementation of
extra dialogues starting from the feedback achieved during the execution of the physical and
the cognitive exercises and the output of the navigation.</p>
    </sec>
    <sec id="sec-4">
      <title>4. The implementation on a commercial robot</title>
      <p>The AI-based services previously described have been modularly implemented inside the Robotic
Operating System (ROS)1, the standard de facto in robotics, where each module corresponds to
a ROS node. However, the transfer of the AI-based services to a commercial robot has required
the introduction of additional constraints in the design. First of all, a significant limitation is
associated with a few resources capabilities in terms of computing power and memory available.
To deal with this aspect, we have designed an emotion recognition algorithm that depends on
a thin deep architecture with only 3.9M number of parameters with respect to the 50-100M
necessary in the standard approaches, reaching the 87.71% of average accuracy [26]. Coherently,
we wrapper the MediaPipe Pose2 library inside a ROS package, for its capability of also running
in mobile phone without requiring GPU with respect to the traditional algorithms in robotics
such as OpenPose3 and SPENCER People Tracking4.</p>
      <p>Secondly, to respect the privacy and save resources on the robot, all the services are switched
of at the beginning per default except for the Timeline-based planner &amp; executor and Local Task
Manager and activate one by one when needed through ROS services.</p>
      <p>Given the central importance of the communication in the system, the dialogue module
(composed by the Speech-to-text and the Dialogue service) relies on the Google API5 and RASA6
library for learning automated and contextualized robot answers at each iteration. While the
navigation system exploits the ROS Navigation stack7 for computing the best trajectories for
the robot to reach the computed navigation goal [27].</p>
    </sec>
    <sec id="sec-5">
      <title>5. Pilot test and Conclusion</title>
      <p>We are testing the integration of the proposed AI-services on the commercial robot, Ohmni
robot, mounting two RGB cameras and a 2D lidar for robot’s perception and telepresence
purposes. The platform supports ROS via a Docker virtualization layer. In the ongoing pilot
tests, we are evaluating the synchronization of the information exchanged between the multiple
1https://www.ros.org/
2https://google.github.io/mediapipe/
3https://github.com/CMU-Perceptual-Computing-Lab/openpose
4https://github.com/spencer-project/spencer_people_tracking
5https://cloud.google.com/speech-to-text
6https://rasa.com/
7http://wiki.ros.org/navigation
modules and the feasibility of the proposed services in the domestic scenario (e.g., not structured
environment), representing still a challenge for roboticists (in Fig. 2).</p>
      <p>The results of the first tests spotlight some limitations of the current robotic platform not
only in terms of limited resources but also regard the battery life when all the services are
active simultaneously. Furthermore, the services related to the robot’s perceptions (such as
skeleton tracker, emotion recognition) can be influenced from the light conditions as well as
the performance of the speech to text is strongly conditioned from the noise in the environment
(however it has been testing with the typical domestic sounds such as radio, TV and home
appliances active).</p>
      <p>Future steps will include the validation of the system with the final potential users, by focusing
on diferent levels of robot’s autonomy correlated with the acceptance in terms of privacy.</p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>This work is supported by “SI-Robotics: SocIal ROBOTICS for active and healthy ageing” project
(Italian M.I.U.R., PON – Ricerca e Innovazione 2014- 2020 – G.A. ARS01 01120).
[2] P. Thompson, S. Chaivisit, Telepresence robots in the classroom, Journal of Educational</p>
      <p>Technology Systems (2021) 00472395211034778.
[3] G. Claudio, G. Luca, L. M. Luce, Interaction design for cultural heritage. a robotic cultural
game for visiting the museum’s inaccessible areas., The Design Journal 20 (2017) S3925–
S3934.
[4] E. Chang, Museums for everyone: Experiments and probabilities in telepresence robots,
in: Exploring Digital Technologies for Art-Based Special Education, Routledge, 2019, pp.
65–76.
[5] A. Cesta, G. Cortellessa, F. Fracasso, A. Orlandini, M. Turno, User needs and preferences on
AAL systems that support older adults and their carers, J. Ambient Intell. Smart Environ.
10 (2018) 49–70. URL: https://doi.org/10.3233/AIS-170471. doi:10.3233/AIS-170471.
[6] S. Laniel, D. Létourneau, F. Grondin, M. Labbé, F. Ferland, F. Michaud, Toward enhancing
the autonomy of a telepresence mobile robot for remote home care assistance, Paladyn,
Journal of Behavioral Robotics 12 (2021) 214–237.
[7] K. Winterstein, L. Keller, K. Hufstadt, N. H. Müller, Acceptance of social and telepresence
robot assistance in german households, in: International Conference on Human-Computer
Interaction, Springer, 2021, pp. 326–339.
[8] B. Isabet, M. Pino, M. Lewis, S. Benveniste, A.-S. Rigaud, Social telepresence robots: A
narrative review of experiments involving older adults before and during the covid-19
pandemic, International Journal of Environmental Research and Public Health 18 (2021)
3597.
[9] C. Esterwood, L. Robert, Robots and covid-19: Re-imagining human–robot collaborative
work in terms of reducing risks to essential workers, Available at SSRN 3767609 (2021).
[10] T. Kanda, R. Sato, N. Saiwaki, H. Ishiguro, A two-month field trial in an elementary school
for long-term human–robot interaction, IEEE Transactions on robotics 23 (2007) 962–971.
[11] T. Kanda, M. Shiomi, Z. Miyashita, H. Ishiguro, N. Hagita, A communication robot in a
shopping mall, IEEE Transactions on Robotics 26 (2010) 897–913.
[12] M. Niemelä, P. Heikkilä, H. Lammi, V. Oksman, A social robot in a shopping mall: studies
on acceptance and stakeholder expectations, in: Social Robots: Technological, Societal
and Ethical Aspects of Human-Robot Interaction, Springer, 2019, pp. 119–144.
[13] A. W. Group, et al., The 2018 ageing report underlying assumptions and projection
methodologies, Economy, finance and the euro publications (2018).
[14] G. Mois, J. M. Beer, The role of healthcare robotics in providing support to older adults: a
socio-ecological perspective, Current Geriatrics Reports (2020). URL: https://doi.org/10.
1007/s13670-020-00314-w. doi:10.1007/s13670-020-00314-w.
[15] M. E. Pollack, Intelligent technology for an aging population: The use of AI to assist elders
with cognitive impairment, AI Magazine 26 (2005) 9.
[16] B. Isabet, M. Pino, M. Lewis, S. Benveniste, A.-S. Rigaud, Social Telepresence Robots: A
Narrative Review of Experiments Involving Older Adults before and during the COVID-19
Pandemic, International Journal of Environmental Research and Public Health 18 (2021).</p>
      <p>URL: https://www.mdpi.com/1660-4601/18/7/3597.
[17] F. Melendez-Fernandez, C. Galindo, J. Gonzalez-Jimenez, A web-based solution
for robotic telepresence, International Journal of Advanced Robotic Systems 14
(2017) 1729881417743738. URL: https://doi.org/10.1177/1729881417743738. doi:10.1177/
1729881417743738.
[18] A. Kristofersson, S. Coradeschi, A. Loutfi, A review of mobile robotic telepresence,</p>
      <p>Advances in human-computer interaction 2013 (2013) 1–17.
[19] K. M. Tsui, M. Desai, H. A. Yanco, C. Uhlik, Exploring use cases for telepresence robots, in:
2011 6th ACM/IEEE International Conference on Human-Robot Interaction (HRI), 2011,
pp. 11–18. doi:10.1145/1957656.1957664.
[20] M. Niemelä, L. Van Aerschot, A. Tammela, I. Aaltonen, H. Lammi, Towards ethical
guidelines of using telepresence robots in residential care, International Journal of Social
Robotics 13 (2021) 431–439.
[21] A. Orlandini, A. Kristofersson, L. Almquist, P. Björkman, A. Cesta, G. Cortellessa,
C. Galindo, J. Gonzalez-Jimenez, K. Gustafsson, A. Kiselev, A. Loutfi, F. Melendez, M.
Nilsson, L. O. Hedman, E. Odontidou, J.-R. Ruiz-Sarmiento, M. Scherlund, L. Tiberio, S. von
Rump, S. Coradeschi, ExCITE Project: A Review of Forty-Two Months of Robotic
Telepresence Technology Evolution, Presence 25 (2016) 204–221. doi:10.1162/PRES_a_00262.
[22] L. Riano, C. Burbridge, M. Mc Ginnity, A study of enhanced robot autonomy in telepresence,
in: Proceedings of Artificial Intelligence and Cognitive Systems, AICS ; Conference date:
31-08-2011, AICS, Ireland, 2011, pp. 271–283.
[23] T. Bakas, D. Sampsel, J. Israel, A. Chamnikar, B. Bodnarik, J. G. Clark, M. G. Ulrich,
D. Vanderelst, Using telehealth to optimize healthy independent living for older adults: A
feasibility study, Geriatric Nursing 39 (2018) 566–573.
[24] W. Moyle, C. Jones, B. Sung, Telepresence robots: Encouraging interactive communication
between family carers and people with dementia, Australasian journal on ageing 39 (2020)
e127–e133.
[25] R. De Benedictis, G. Beraldo, R. R. Devaram, A. Cesta, G. Cortellessa, Enhancing
telepresence robots with AI: Combining services to personalize and react, in: Proceedings of
AIxIA 2021 – Advances in Artificial Intelligence, 2021.
[26] R. R. Devaram, G. Beraldo, R. De Benedictis, M. Mongiovì, A. Cesta, LEMON: A lightweight
facial emotion recognition system for assistive robotics based on dilated residual
convolutional neural networks, Sensors 22 (2022) 3366.
[27] G. Beraldo, L. Tonin, A. Cesta, E. Menegatti, Brain-driven telepresence robots: A fusion of
user’s commands with robot’s intelligence, in: M. Baldoni, S. Bandini (Eds.), AIxIA 2020
– Advances in Artificial Intelligence, Springer International Publishing, Cham, 2021, pp.
235–248.</p>
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  </body>
  <back>
    <ref-list>
      <ref id="ref1">
        <mixed-citation>
          [1]
          <string-name>
            <given-names>V. A.</given-names>
            <surname>Newhart</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            <surname>Warschauer</surname>
          </string-name>
          , L. Sender,
          <article-title>Virtual inclusion via telepresence robots in the classroom: An exploratory case study</article-title>
          ,
          <source>The International Journal of Technologies in Learning 23</source>
          (
          <year>2016</year>
          )
          <fpage>9</fpage>
          -
          <lpage>25</lpage>
          .
        </mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>