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Purpose The development of assistive technologies that support people in social interactions has attracted increased attention in HCI. This paper presents a systematic review of studies of Socially Assistive Systems targeted at older adults and people with disabilities. The purpose is threefold: (1) Characterizing related assistive systems with a special focus on the system design, primarily including HCI technologies used and user-involvement approach taken; (2) Examining their ways of system evaluation; (3) Reflecting on insights for future design research. Methods A systematic literature search was conducted using the keywords “social interactions” and “assistive technologies” within the following databases: Scopus, Web of Science, ACM, Science Direct, PubMed, and IEEE Xplore. Results Sixty-five papers met the inclusion criteria and were further analyzed. Our results showed that there were 11 types of HCI technologies that supported social interactions for target users. The most common was cognitive and meaning understanding technologies, often applied with wearable devices for compensating users’ sensory loss; 33.85% of studies involved end-users and stakeholders in the design phase; Four types of evaluation methods were identified. The majority of studies adopted laboratory experiments to measure user-system interaction and system validation. Proxy users were used in system evaluation, especially in initial experiments; 42.46% of evaluations were conducted in field settings, primarily including the participants’ own homes and institutions. Conclusion We contribute an overview of Socially Assistive Systems that support social interactions for older adults and people with disabilities, as well as illustrate emerging technologies and research opportunities for future work.

Approximately 1.1. billion people worldwide live with some form of disability, and assistive technology has the potential to increase their overall quality of life. However, the end users' perspective and needs are often not sufficiently considered during the development of this technology, leading to frustration and nonuse of existing devices. Since its first competition in 2016, CYBATHLON has aimed to drive innovation in the field of assistive technology by motivating teams to involve end users more actively in the development process and to tailor novel devices to their actual daily-life needs. Competition tasks therefore represent unsolved daily-life challenges for people with disabilities and serve the purpose of benchmarking the latest developments from research laboratories and companies from around the world. This review describes each of the competition disciplines, their contributions to assistive technology, and remaining challenges in the user-centered development of this technology., Annual Review of Control, Robotics, and Autonomous Systems, 6, ISSN:2573-5144

Dementia is related to disturbances in the sleep-wake pattern, behavioural and psychological symptoms of dementia (BPSD). These phenomena are the main reason for institutionalization. Assistive light technology is relevant to study, as mitigation of BPSD may allow for the improvement of quality of life for both people with dementia and their caregivers. Studies of dynamic light exposure in home-dwelling populations are scarce. In this single-case experimental design study, we evaluated the effects of exposure to dynamic light on the sleep-wake pattern and symptoms of depression, agitation, and anxiety in 11 home-dwelling people with dementia. A four-phase light-exposure therapy oscillating between the control and intervention waves was offered. Objective and questionnaire data were analysed and discussed. The results show that the used dynamic light system did not significantly affect the sleep variables. The severity of BPSD fluctuated in the expected pattern, reducing in intensity with increased light exposure. This pattern was significant for depression and agitation. This longitudinal study included an exploration of a low-cost assistive light intervention within a hard-to-study home-dwelling dementia population. The lessons learned are discussed and recommendations are made for future studies, as this design seems suitable for studying lifestyle interventions to support home-dwelling people with dementia.

読み書きに困難さを示す児童生徒への支援として支援技術（Assistive Technology: AT）を利用した事例報告は数多くある。一方で、学校単位で実施される入学時テストや中間考査・期末考査などの定期考査（以下、試験）におけるAT の導入から活用についてまとめた報告は見られない。そこで、本研究では、公立中学校特別支援学級（自閉症・情緒障害）に在籍する生徒の読み書きの機能代替及び補助を目的とした試験のAT デバイス活用について、PDCA サイクルの枠組みから探索的に課題を明らかにし改善を図った取り組みについて報告する。合計４回の継続した実践から、中学校内で自立した実施環境設定、教師の教育的評価とAT の利用に関する意識、受験者の受験時のAT 活用スキルの３つの視点で検討をすることの必要性が推察された。各視点に立って検討することで、今後、多くの学校で試験時のAT 活用が適切に行われることを目指している。, There are many case reports on the support use of Assistive Technology Devices for children with disabilities reading and writing. On the other hand, there are no reports on the introduction and use of AT Devices in examinations such as school entrance examination and mid-term / end-of-term tests, which are conducted at school level. Therefore, the purpose of this study is to report on our project to make use of AT as an alternative support for reading and writing during exams at a public junior high school, where we used exploratory approach within the PDCA cycle to find challenging issues around introduction of AT Devices in exams and to solve them. It was inferred that, in order to examine ongoing practice, it was necessary to consider the following three perspectives: the setting of an independent implementation environment within the implementing school; the educational evaluation and awareness of AT use among teachers; and AT use skills of examinees at the time of the examinations. By examining the requirements from each of these perspectives, we aim to help ensure that AT is appropriately used in school tests at many schools in the future., 本研究は、JSPS 科学研究費補助金基盤研究B（課題番号: 21H0088800）（研究代表: 氏間和仁）の助成を受けた。

Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients1–4. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness5–11, and existing wearable cardiac devices can only capture signals on the skin12–16. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.

Objective: This rapid review aims to identify the types of technologies used by people with dementia and their supporters during the COVID-19 pandemic, and the issues which influenced technology adoption within their usual care routines. Methods: PubMed, PsychInfo, Scopus, and Cochrane COVID reviews were searched to identify peer-review studies published since 2020. A total of 18 studies were included and synthesised thematically. Results: Of these, most were conducted in the community (n=15) with people with dementia only (n=11) and involved qualitative methods (n=11). The majority (n=12) focused on digital off-the-shelf and low-cost solutions, such as free video conferencing platforms, to access care, socialise or take part in interventions. Whilst often well-accepted and associated with positive outcomes (such as improved social connectedness), lack of digital literacy or support to use technologies, limited access to appropriate technology, individuals’ physical, cognitive, or sensory difficulties, were highlighted and likely to threaten the adoption of these solutions. The quality of the evidence was mixed, neither very robust nor easily generalisable which may be attributed to the challenges of conducting research during the pandemic or the need to rapidly adapt to a new reality. Conclusion: While COVID-19 has fast-tracked the adoption of technology, its use is likely to continue beyond the pandemic. We need to ensure this technology can leverage dementia support and care and that people with dementia are enabled and empowered to use it.

A brain-computer interface (BCI) is a type of technology that establishes a communication channel between a user and certain devices in the environment via the brain signals of the user. The UMA-BCI Speller tool allows for easy configuration of a BCI, permitting it to be manipulated without the need for much technical knowledge. However, adapting a BCI system so that it can communicate with devices is a challenging task. A simpler technology that is increasingly used to enable communication with devices in the environment is based on voice commands. The aim of the present work is therefore to create a system to facilitate communication between a BCI and devices in the environment using voice commands. Twelve healthy participants and three amyotrophic lateral sclerosis (ALS) patients were asked to control a BCI home automation system. The devices to be controlled were a television, an air conditioner, a smart light bulb, a smart plug, and the WhatsApp and Spotify apps. Performance measures were recorded, and subjective measures were collected based on the System usability scale, NASA-TLX and ad hoc questionnaires. The results of this study validate the proposed system as a suitable option to facilitate communication between a BCI and commercial devices that have been previously adapted to operate based on voice commands. This work is part of the SICCAU project (RTI2018-100912-BI00), which has been jointly funded by the Spanish Ministry of Science, Innovation and Universities (MCIU), the Spanish State Investigation Agency (AEI) and the European Regional Development Fund (ERDF). Moreover, the authors would like to thank all participants for their cooperation. Funding for open access charge: Universidad de Málaga / CBUA.

Resumo Introdução O conhecimento sobre tecnologia assistiva relaciona-se aos aspectos do domínio da terapia ocupacional, assim, interroga-se se tal conhecimento tem sido abordado nos cursos de graduação. Objetivos Identificar os cursos de graduação em terapia ocupacional no estado de São Paulo que ofertam discipinas referentes à tecnologia assistiva, identificar as disciplinas, suas respectivas cargas horárias e o conteúdo presente em cada uma delas. Método A amostra foi composta por oito universidades, cinco públicas e três privadas. A busca foi feita nas matrizes curriculares, planos de ensino de disciplinas específicas e não específicas, objetivos e conteúdos disponibilizados on-line ou solicitados ao coordenador de curso. Realizou-se análise descritiva dos dados. Resultados Constatou-se a oferta do conteúdo de tecnologia assistiva nas universidades investigadas, com diferença entre a carga horária e o conteúdo ofertado. A análise por área de aplicação da tecnologia assistiva evidenciou que o conteúdo sobre órteses é oferecido em 100% dos cursos analisados, seguido de produtos assistivos para o desempenho de atividades cotidianas e de prótese, ambos conteúdos encontrados em 75% dos cursos; equipamentos para mobilidade; acessibilidade e desenho universal em 62,5%; comunicação alternativa em 50% dos cursos. Conclusão Os resultados apontam a relevância de uma maior homogeneidade de conteúdo entre as universidades investigadas e sugerem que este estudo tem potencial para fomentar discussões sobre a formação do terapauta ocupacional na área da tecnologia assistiva, uma vez que os resultados advêm da análise dos cursos de graduação localizados no estado que possui o maior número de cursos de terapia ocupacional no Brasil. Abstract Introduction Knowledge about assistive technology is related to aspects of the field of occupational therapy, thus, it is questioned whether such knowledge has been addressed in undergraduate courses. Objectives To identify the undergraduate courses in occupational therapy in the state of São Paulo that offer disciplines related to assistive technology, identify the disciplines, their respective workloads and the content present in each of them. Method The sample consisted of eight universities, five public and three private. The search was made in the curricular matrices, teaching plans of specific and non-specific disciplines, objectives and contents available online or requested from the course coordinator. Descriptive data analysis was performed. Results It was found that assistive technology content was offered in the investigated universities, with a difference between the workload and the content offered. The analysis by assistive technology application area showed that the content on orthoses is offered in 100% of the analyzed courses, followed by assistive products for the performance of daily activities and prostheses, both contents found in 75% of the courses; mobility equipment; accessibility and universal design in 62.5%; alternative communication in 50% of the courses. Conclusion The results point to the relevance of greater homogeneity of content between the investigated universities and suggest that this study has the potential to foster discussions about the formation of occupational therapists in the assistive technology area, since the results come from the analysis of undergraduate courses located in the state which has the largest number of occupational therapy courses in Brazil.

According to the World Health Organisation, falling is a major health problem with potentially fatal implications. Each year, thousands of people die as a result of falls, with seniors making up 80% of these fatalities. The automatic detection of falls may reduce the severity of the consequences. Our study focuses on developing a vision-based fall detection system. Our work proposes a new feature descriptor that results in a new fall detection framework. The body geometry of the subject is analyzed and patterns that help to distinguish falls from non-fall activities are identified in our proposed method. An AlphaPose network is employed to identify 17 keypoints on the human skeleton. Thirteen keypoints are used in our study, and we compute two additional keypoints. These 15 keypoints are divided into five segments, each of which consists of a group of three non-collinear points. These five segments represent the left hand, right hand, left leg, right leg and craniocaudal section. A novel feature descriptor is generated by extracting the distances from the segmented parts, angles within the segmented parts and the angle of inclination for every segmented part. As a result, we may extract three features from each segment, giving us 15 features per frame that preserve spatial information. To capture temporal dynamics, the extracted spatial features are arranged in the temporal sequence. As a result, the feature descriptor in the proposed approach preserves the spatio-temporal dynamics. Thus, a feature descriptor of size [m×15] is formed where m is the number of frames. To recognize fall patterns, machine learning approaches such as decision trees, random forests, and gradient boost are applied to the feature descriptor. Our system was evaluated on the UPfall dataset, which is a benchmark dataset. It has shown very good performance compared to the state-of-the-art approaches.

Fueled by the recent proliferation of energy-efficient and energy-autonomous or self-powered nanotechnology-based wearable smart systems, human motion intention prediction (MIP) plays a critical role in a wide range of applications, such as rehabili- tation and assistive robotics, to enable more natural, biologically inspired, and seamless integrated motion assistance task execution, including for elders and physically impaired patients. With the increasing complexity of human-machine interactions and the need for personalized assistance, there is a growing demand for real-time and accurate MIP sys- tems. This review aims to provide a comprehensive understanding of the interdisciplinary field of MIP, under the logic of its physiological foundations, by discussing state-of-the- art sensing technologies, including brain-computer interfaces (BCI), electromyography (EMG), and motion sensors, alongside the relevant data processing techniques and decod- ing algorithms. We emphasize the importance of fostering collaboration among scholars from different domains to capture the intricate dependencies between the set of stimuli and responses of the central nervous system and the activation of the complex set of muscles and joints that produce human motion. By offering insights into the recent advancements and future prospects of the field, this review seeks to stimulate further research and innova- tion in the rapidly evolving area of human motion intention prediction, for a future where technologies understand and respond to complex human intentions patterns, anticipating their needs.

The intelligent wearable travel aid device has been developed for blind person usage for traveling purposes. The intelligent wearable travel aid device will be used along with the long cane that is usually used to detect any obstructions around the blind person. However, the problem on power supply to supply the electrical energy for the intelligent wearable travel aid device to work properly always been occurred. In order to fit the energy harvesting device on the intelligent wearable travel aid device, the comparison of the solar panel and photodiode is done. The performance evaluation to compare theenergy harvesting method on the developed intelligent wearable travel aid device for blind person has been conductedbased on the experiment result. The photodiode is proposed in this study due to small size and easy to arrange on top of developed wearable travel aid device compared to the solar panel which big size but commonly used as energy harvesting device. Consequently, the experimental result of the intelligent wearable travel aid device in terms of voltage, current and light intensity for the improved version with different type of configuration is proven respectively.

This study investigates the contribution of Assistive Technology (AT) in the teaching and learning process of students with disabilities, considering the perspective of mediation proposed by Vygotsky's theory. Historically, people with disabilities have been marginalized and excluded from society. However, with the advent of inclusive laws and public policies, these individuals now have rights and duties equal to those of any other person. In this context, the school plays a fundamental role as an environment conducive to the equitable development of these students. To achieve the proposed objective, concepts of technology in general and educational technology were explored. The methodology adopted in this study consists of a bibliographical research based on the writings of Vygotsky (1988, 1991, 2006) and other relevant authors on the subject. The analysis of Vygotsky's studies on the process of development, teaching and learning of individuals with disabilities, combined with the contributions of other researchers, allowed children with disabilities to learn in the same way as their peers, although they presented individual specificities. The study also showed that the social environment in which these students are inserted plays a fundamental role in their development. Learning occurs through compensation and stimuli, and it is the mediator's responsibility to provide the necessary conditions for the subject to overcome the barriers faced. In this sense, Assistive Technology emerges as a tool that can be used to enhance the teaching and learning process. By providing resources and personalized support, AT enables these students to develop skills, overcome obstacles and reach their full potential, thus allowing for effective and equitable inclusion in school and society.

Teaching mathematics to blind people is a challenge of modern educational methods. This article presents a method of preparing the adapted material and its usage in the learning process of mathematics by blind people, as well as the results of evaluating the proposed approach. The presented results were obtained based on a mathematical analysis course conducted in two classes—with and without using the developed method. The developed method uses the conceptualization of knowledge as a graph. The learning process is supported by feedback processes that consider the mechanisms of knowledge and error vectors, on which a personalized adaptation of the learning path is made for each particular student. The evaluation process has shown a statistically significant improvement in learning results achieved by blind students. The average final test score in the group working with the platform during learning increased by 14%. In addition, there was an increase in cooperation between blind students who had the opportunity to take on the role of a teacher, which was observed in 27% of the participants. Our results indicate the effectiveness of the developed approach and motivate us to evaluate the method in a broader group of students. The engagement of students indirectly indicates overcoming the barriers known from the state of the art: uncertainty, poor motivation, and difficulties in consolidating the acquired skills.

This study addresses the challenges faced by individuals with upper limb disadvantages in operating power wheelchair joysticks by utilizing the extended Function–Behavior–Structure (FBS) model to identify design requirements for an alternative wheelchair control system. A gaze-controlled wheelchair system is proposed based on design requirements from the extended FBS model and prioritized using the MosCow method. This innovative system relies on the user’s natural gaze and comprises three levels: perception, decision making, and execution. The perception layer senses and acquires information from the environment, including user eye movements and driving context. The decision-making layer processes this information to determine the user’s intended direction, while the execution layer controls the wheelchair’s movement accordingly. The system’s effectiveness was validated through indoor field testing, with an average driving drift of less than 20 cm for participates. Additionally, the user experience scale revealed overall positive user experiences and perceptions of the system’s usability, ease of use, and satisfaction.

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users’ perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers.

For this study, an online survey was conducted to discover the preferences of older adults when they used sensors in their households, rather than the preferences of the researchers who developed them. The sample size was 400 Japanese community-dwelling people aged 65 years and older. The numbers of samples for men and women, household composition (single-person/couple-only household), and younger senior (younger than 74 years old) and older senior (older than 75 years old) were equally assigned. The survey results showed that “informational security” and “constancy of life” were considered more important than other factors when installing sensors. Furthermore, looking at the results regarding the type of sensors that face resistance, we found that both cameras and microphones were evaluated as facing slightly strong resistance, while doors/windows, temperature/humidity, CO2/gas/smoke, and water flow were evaluated as not facing such strong resistance. The elderly who are likely to need sensors in the future also have various attributes, and the introduction of ambient sensors in elderly households may be further advanced by recommending applications that are easy to introduce based on the attributes of the target population, rather than discussing all of them in general.

International audience; This paper presents a generic power wheelchair dynamic model. As a first contribution, this paper proposes to use a generic model composed of a geometric model and a lumped model in order to be compliant with a wide range of existing commercially available wheelchairs. In this model, a set of essential parameters are enough to accurately replicate the dynamic behavior of a wheelchair. As a second contribution, this paper presents an identification method of a n-wheel type power wheelchair. The presented model is restricted to the sagittal plane only, which is sufficient to study the reliability of the identification and validation methods. Moreover, a Motion Cueing Algorithm based on the proposed model controls a simulator mechanical platform. The generic model has been then validated through a user study with 18 able-bodied participants evaluating the self-motion perception with our multisensory power wheelchair driving simulator. Results show that the simplified model is sufficient to provide accurate sensations to the user with respect to their experience while driving a power wheelchair.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Background: Social alarms are considered an appropriate technology to ensure the safety and independence of older adults, but limited research has been conducted on their actual use. We, therefore, explored the access, experiences, and use of social alarms among home-bound people with dementia and their informal caregivers (dyads). Methods: From May 2019 to October 2021, the LIVE@Home.Path mixed-method intervention trial collected data from semi-quantitative questionnaires and qualitative interviews conducted among home-dwelling people with dementia and their informal caregivers in Norway. The study focused on data from the final assessment at 24 months. Results: A total of 278 dyads were included, and 82 participants reached the final assessment. The mean age of the patients was 83 years; 74.6% were female; 50% lived alone; and 58% had their child as a caregiver. A total of 62.2% of subjects had access to a social alarm. Caregivers were more likely to answer that the device was not in use (23.6%) compared to patients (14%). Qualitative data revealed that approximately 50% of the patients were not aware of having such an alarm. Regression analyses assessed that access to a social alarm was associated with increasing age (86–97 years, p = 0.005) and living alone (p

This article brings reflections on how Assistive Technology resources contribute to the training of students with disabilities, and it is understood that a discussion on the subject is necessary. In this sense, this research outlined the following objective of analyzing the contributions of assistive technologies in the training process of people with disabilities. The methodology is qualitative, descriptive and bibliographic in nature, since it aims to point out knowledge published in the literature on Assistive Technologies (AT) that contributed to the development and training of people with disabilities. It is observed that we are experiencing a context of great advances and profound transformations, where Assistive Technologies emerge as an important instrument that creates new possibilities of autonomy for students with disabilities. Assistive technology emerges as an inclusive practice, which can contribute significantly to the training of these students and to their inclusion in the school environment. They are also necessary in this theme to continue the discussions, as well as the supply of technological resources necessary to be used according to the specificities of the students in the sense of not only making them available, but also stimulating supervision in order to guarantee the their use to contribute to their teaching-learning process.This article brings reflections on how Assistive Technology resources contribute to the training of students with disabilities, and it is understood that a discussion on the subject is necessary. In this sense, this research outlined the following objective of analyzing the contributions of assistive technologies in the training process of people with disabilities. The methodology is qualitative, descriptive and bibliographic in nature, since it aims to point out knowledge published in the literature on Assistive Technologies (AT) that contributed to the development and training of people with disabilities. It is observed that we are experiencing a context of great advances and profound transformations, where Assistive Technologies emerge as an important instrument that creates new possibilities of autonomy for students with disabilities. Assistive technology emerges as an inclusive practice, which can contribute significantly to the training of these students and to their inclusion in the school environment. They are also necessary in this theme to continue the discussions, as well as the supply of technological resources necessary to be used according to the specificities of the students in the sense of not only making them available, but also stimulating supervision in order to guarantee the their use to contribute to their teaching-learning process.

A bengala branca é uma ferramenta indispensável para os deficientes visuais, o que justifica a relevância de novos projetos para melhorar a sua qualidade. Entretanto, mesmo bengalas com recursos eletrônicos, ainda apresentam uma alta taxa de abandono. Nesse sentido, o objetivo principal é apresentar uma solução segura e acessível para a ponteira da bengala branca comum, empregando tecnologia mecânica omnidirecional com mínimo agarre ao solo. Foram testados novos materiais para melhorar as propriedades de resistência à abrasão, durabilidade e leveza, com custo acessível. Foi empregado uma abordagem qualitativa composta porBrainstorming, testes de campo, teste de vida útil acelerado em bancada e questionário de usabilidade do produto. Ao final da pesquisa foi apresentado uma nova ponteira com uma esfera omnidirecional ligeiramente maior que a comum, que supera com mais facilidade desníveis no solo e não cai em grandes de águas pluviais. A classificação acima de 84%, referente a um nível de usabilidade do produto considerado excelente, indica a aprovação da ponteira Omni-Tip. A principal característica da ponteira desenvolvida é o agarre ao solo quase nulo com alterações geométricas mínimas, o que traz melhorias significativas às bengalas convencionais, além de minimizar o potencial estigma da cegueira e o abandono de novas tecnologias, indicando assim a sua potencial aplicabilidade junto à comunidade de deficientes visuais.

Objectives: (1) To validate the measurement of foam-tip real-ear-to-coupler differences (wRECD) using an integrated pressure level (IPL) method and (2) to compare the reliability of this method to SPL-based measurement of the wRECD. Design SPL-based wRECD and the proposed IPL wRECD measurement were completed bilaterally. Test-retest reliability of IPL wRECD was determined with full re-insertion into the ear canal and compared to published SPL wRECD test-retest data. Study sample 22 adults with normal hearing and middle ear status were recruited. Results Differences between SPL-based wRECD and IPL wRECD measurements were within 1.51 dB on average below 5000 Hz. At and above 5000 Hz, IPL wRECD exceeded SPL wRECDs by 6.11 dB on average. The average test-retest difference for IPL wRECD across all assessed frequencies was 0.75 dB with the greatest improvements in reliability found below 750 Hz and above 3000 Hz. Conclusions IPL wRECD yielded improved estimates compared to SPL wRECD in high frequencies, where standing-wave interference is present. Independence from standing wave interference resulted in increased wRECD values above 4000 Hz using the IPL measurement paradigm. IPL wRECD is more reliable than SPL wRECD, does not require precise probe-microphone placement, and provides a wider valid wRECD bandwidth than SPL-based measurement.

Background The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized. Objective With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology. Methods A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review. Results Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies. Conclusions This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user– and real life–targeting research is needed to assess the acceptance of proposed solutions.

BackgroundCommon, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability among research and quality improvement efforts, to ensure findings are generalizable, and can be pooled to establish best practices.Research questionCan we establish operational definitions for key elements related to pediatric ventilator liberation using a combination of detailed literature review and consensus-based approaches?Study design and methodsA panel of 26 international experts in pediatric ventilator liberation, two methodologists, and two librarians conducted systematic reviews on eight topic areas related to pediatric ventilator liberation. Through a series of virtual meetings, we established draft definitions that were voted upon using an anonymous web-based process. Definitions were revised by incorporating extracted data gathered during the systematic review and discussed in another consensus meeting. A second round of voting was conducted to confirm the final definitions.ResultsIn eight topic areas identified by the experts, 16 preliminary definitions were established. Based on initial discussion and the first round of voting, modifications were suggested for 11 of the 16 definitions. There was significant variability in how these items were defined in the literature reviewed. The final round of voting achieved≥ 80%agreement for all 16 definitions in the following areas: what constitutes respiratory support (invasive mechanical ventilation and noninvasive respiratory support), liberation and failed attempts to liberate from invasive mechanical ventilation, liberation from respiratory support, duration of noninvasive respiratory support, total duration of invasive mechanical ventilation, spontaneous breathing trials, extubation readiness testing, 28 ventilator-free days, and planned vsrescue use of post-extubation noninvasive respiratory support.InterpretationWe propose that these consensus-based definitions for elements of pediatric ventilator liberation, informed by evidence, be used for future quality improvement initiatives and research studies to improve generalizability and facilitate comparison.

Background Guidelines for choice of prosthetic heart valve in people of reproductive age are not well established. Although biologic heart valves (BHVs) have risk of deterioration, mechanical heart valves (MHVs) require lifelong anticoagulation. This study aimed to characterize the association of prosthetic valve type with maternal and fetal outcomes in pregnant patients. Methods and Results Using the 2008 to 2019 National Inpatient Sample, we identified all adult patients hospitalized for delivery with prior heart valve implantation. Multivariable regressions were used to analyze the primary outcome, major adverse cardiovascular events, and secondary outcomes, including maternal and fetal complications, length of stay, and costs. Among 39 871 862 birth hospitalizations, 4152 had MHVs and 874 had BHVs. Age, comorbidities, and cesarean birth rates were similar between patients with MHVs and BHVs. The presence of a prosthetic valve was associated with over 22‐fold increase in likelihood of major adverse cardiovascular events (MHV: adjusted odds ratio, 22.1 [95% CI, 17.3–28.2]; BHV: adjusted odds ratio, 22.5 [95% CI, 13.9–36.5]) as well as increased duration of stay and hospitalization costs. However, patients with MHVs and BHVs had no significant difference in the odds of any maternal outcome, including major adverse cardiovascular events, hypertensive disease of pregnancy, and ante/postpartum hemorrhage. Similarly, fetal complications were more likely in patients with valve prostheses, including a 4‐fold increase in odds of stillbirth, but remained comparable between MHVs and BHVs. Conclusions Patients hospitalized for delivery with prior valve replacement carry substantial risk of adverse maternal and fetal events, regardless of valve type. Our findings reveal comparable outcomes between MHVs and BHVs.

It is increasingly important to provide post-stroke patients with rapid access to patient-tailored assistive technologies to increase independence, mobility, and participation. Automating the selection of assistive devices based on artificial intelligence could speed up the process and improve accuracy. It would also relieve the burden on diagnosticians and therapists and speed up the introduction of new ranges by automating databases. This article compares selected machine learning classification methods in the area of post-stroke rehabilitation device selection. The article covers the specifics of the selection, the choice of classification methods, and the identification of the best one, as well as the experimental part, the description of the results, the comparison process, and directions for further research. The novelty lies both in the topic, as the choice of classification method has an impact on the accuracy of classification in the selection of medical materials, and in the manner of the comprehensive approach. The possible contribution is of great scientific and clinical relevance, but above all, it has economic and social importance, enabling post-stroke individuals to return more quickly to the community, learning, and work, and relieving the burden on the health care system.

Dementia is a chronic and progressive neurodegenerative illness, which can lead to significant difficulties in a person’s capacity to perform activities of daily living (ADLs) and engage in meaningful activities. There is an acute need, which digital health technologies can potentially fulfil, to provide proactive support for persons living with dementia (PLwD) and their caregivers. However, there is limited involvement of PLwD in the design of technology that could be used to support their personal plans for independent living at home. In this paper, we describe how we are employing a co-design methodology to support engagement in an assistive technology toolkit for managing ADLs for people living with the early stages of dementia.

Students with special needs should be empowered to use assistive technologies and services that suit their individual circumstances and environments to maximize their learning attainment. Fortunately, modern distributed computing paradigms, such as the Internet of Things (IoT), cloud computing, and mobile computing, provide ample opportunities to create and offer a multitude of digital assistive services and devices for people with disabilities. However, choosing the appropriate services from a pool of competing services while satisfying the unique requirements of disabled learners remains a challenging research endeavor. In this article, we propose an ensemble meta-learning model that ranks and selects the best IoT services while considering the diverse needs of disabled students within the educational context. We train and test our deep ensemble meta-learning model using two synthetically generated assistive services datasets. The first dataset incorporates 50,000 records representing the possible use of 12 learning activities, fulfilled by 60 distinct assistive services. The second dataset includes a range of 120,000 service ratings of seven quality features, including response, availability, successibility, latency, cost, quality of service, and accessibility. Our deep learning model uses an ensemble of multiple input learners fused using a meta-classification network shared by all the outputs representing individual assistive services. The model achieves significantly better results than traditional machine learning models (i.e., support vector machine and random forest) and a simple feed-forward neural network model without the ensemble technique. Furthermore, we extended our model to utilize the accessibility rating of services to suggest appropriate educational services for disabled learners. The empirical results show the acceptability of our assistive service recommender for learners with disabilities.

Assistive technology can help people with disabilities to use computers more effectively and can enable them to access the same information and resources as people without disabilities. To obtain more insight into the factors that can bring about the design of an Emulator of Mouse and Keyboard (EMKEY) to higher levels of user satisfaction, an experimental study was conducted in order to analyse its effectiveness and efficiency. The experimental study involved 27 participants (Mage = 20.81, SD = 1.14) who performed three experimental games under different conditions (using the mouse and using EMKEY with head movements and voice commands). According to the results, the use of EMKEY allowed for the successful performance of tasks such as matching stimuli (F(2,78) = 2.39, p = 0.10, η2 = 0.06). However, the execution times of a task were found to be higher when using the emulator to drag an object on the screen (t(52,1) = −18.45, p ≤ 0.001, d = 9.60). These results indicate the effectiveness of technological development for people with upper limb disabilities; however, there is room for improvement in terms of efficiency. The findings are discussed in relation to previous research and are based on future studies aimed at improving the operation of the EMKEY emulator.

Background: Ankle-foot orthoses (AFOs) are extensively used as a primary management method to assist ambulation of children with Cerebral Palsy (CP). However, there are certain barriers that hinder their prescription as well as their use as a mobility device in all kinds of daily-life activities. This exploratory research attempts to further understand the existing limitations of current AFOs to promote a better personalization of new design solutions. Methods: Stakeholders’ (professionals in CP and end-users with CP) perspectives on AFO technology were collected by two online surveys. Respondents evaluated the limitations of current assistive solutions and assessment methods, provided their expectations for a new AFO design, and analyzed the importance of different design features and metrics to enrich the gait performance of these patients in daily-life. Quantitative responses were rated and compared with respect to their perceived importance. Qualitative responses were classified into themes by using content analysis. Results: 130 survey responses from ten countries were analyzed, 94 from professionals and 36 from end-users with CP. The most highly rated design features by both stakeholder groups were the comfort and the ease of putting on and taking off the assistive device. In general, professionals preferred new features to enrich the independence of the patient by improving gait at functional levels. End-users also considered their social acceptance and participation. Health care professionals reported a lack of confidence concerning decision-making about AFO prescription. To some degree, this may be due to the reported inconsistent understanding of the type of assistance required for each pathological gait. Thus, they indicated that more information about patients’ day-to-day walking performance would be beneficial to assess patients’ capabilities. Conclusion: This study emphasizes the importance of developing new approaches to assess and treat CP gait in daily-life situations. The stakeholders’ needs and criteria reported here may serve as insights for the design of future assistive devices and for the follow-up monitoring of these patients., his work has been carried out partly with the financial support from the Ministerio de Ciencia e Innovación and the Agencia Estatal de Investigación of Spain (MCIN/AEI/10.13039/501100011033) under grant FJC2019-039551-I, European Union NextGenerationEU/PRTR; and partly with the financial support from the Dutch Research Council NWO, under the grant Veni-TTW-2020 with reference number 18079.

Purpose: To better understand the global role of occupational therapists and explore facilitators and barriers impacting user access to high quality, affordable wheeled and seated mobility device (WSMD) provision worldwide. Methods: Mixed-method approach utilizing quantitative findings and qualitative strengths, weaknesses, opportunities, and threats (SWOT) analysis of a global online survey. Results: A total of 696 occupational therapists from 61 countries completed the survey. Almost 49% had 10 or more years of experience with the provision of WSMDs. WSMD provision had positive, significant associations with attainment of certification (0.000), higher service funding (0.000), higher country income (0.001), standardized training (0.003), continuous professional development (0.004), higher experience (0.004), higher user satisfaction (0.032), custom-made device provision (0.038), higher staff capacity (0.040), and more time working with users (0.050); negative, significant associations were identified with high cost of WSMDs (0.006) and pre-made device provision (0.019). SWOT analysis identified high country income, funding, experience, training, certification from global partners, variety of roles and practice settings, and interdisciplinary teamwork as strengths and opportunities for professional growth, while low country income, lack of time/staff capacity/standardization/support services, and poor access to proper devices were indicated as weaknesses and threats. Conclusion: Occupational therapists are skilled healthcare professionals and provide a variety of WSMD services. Efforts to build collaborative partnerships, enhance access to occupational therapists and funding options, improve service and standards for WMSD service delivery, and promote professional development will help to overcome challenges and facilitate WSMD provision globally. Promoting practices based on best available evidence for WSMD provision worldwide should be prioritized.

BackgroundDeep brain stimulation (DBS) of the globus pallidus interna (GPi) is an effective therapy for select patients with primary dystonia. DBS programming for dystonia is often challenging due to variable time to symptomatic improvement or stimulation induced side effects (SISE) such as capsular or optic tract activation which can prolong device optimization.ObjectiveTo characterize the safety and tolerability of active recharge biphasic DBS (bDBS) in primary dystonia and to compare it to conventional clinical DBS (clinDBS).MethodsTen subjects with primary dystonia and GPi DBS underwent a single center, double blind, nonrandomized crossover study comparing clinDBS versus bDBS. The testing occurred over two-days. bDBS and clinDBS were administered on separate days and each was activated for 6h. Rating scales were collected by video recording and scored by four blinded movement disorders trained neurologists.ResultsThe bDBS paradigm was safe and well-tolerated in all ten subjects. There were no persistent SISE reported. The mean change in the Unified Dystonia Rating Scale after 4h of stimulation was greater in bDBS when compared to clinDBS (-6.5 vs 0.3, p&nbsp

Background Assessment of fluid status in neonatal dialysis has largely focused on traditional tools including clinical assessment, serial weights, and blood pressure (BP) measurements. However, in infants on kidney replacement therapy, the assessment of fluid overload is problematic due to errors in weight assessment, subtlety of physical exam findings, and inaccuracy of non-invasive BP measurements. Case summary In this presentation of a neonate with bilateral renal agenesis requiring kidney replacement therapy, the treating team assessed a number of variables in determining the ultrafiltration prescription for dialysis across 2 modalities (hemodialysis and continuous kidney replacement therapy). Complications Fluid overload, cardiomegaly, and worsened respiratory status occurred when attempting to assess the neonate’s fluid status by traditional markers (weights, blood pressures, physical exam findings). B-type natriuretic peptide (BNP) was obtained and was noted to correlate with the degree of fluid overload. Key management points Compared to traditional tools for assessment of fluid status in pediatric dialysis, BNP assisted the medical team in optimizing the volume status of the subject and determining optimal daily ultrafiltration goals. Due to the rapid release in response to myocardial stretch and the lack of kidney clearance of the peptide, BNP may represent an objective, timely, and reliable index of volume status in the pediatric dialysis patient.

The commitment to increase the inclusion of students with disabilities has ensured that the concept of Assistive Technology (AT) has become increasingly widespread in education. The main objective of this paper focuses on conducting a systematic review of studies regarding the impact of Assistive Technology for the inclusion of students with disabilities. In order to achieve the above, a review of relevant empirical studies published between 2009 and 2020 in four databases (Web of Science (WoS), Scopus, ERIC and PsycINFO) was carried out. The sample consists of 31 articles that met the inclusion criteria of this review, out of a total of 216 identified. Findings of this study include that the use of Assistive Technologies is successful in increasing the inclusion and accessibility of students with disabilities, although barriers such as teacher education, lack of information or accessibility are found., Spanish Government DIFOTICYD EDU2016 75,232-P, Springer Nature

The study aimed to identify the degree of possessing the assistive technological competencies of the teachers of the talented students in the schools of the capital, Amman, and to achieve the objectives of the study, the descriptive and analytical approach was followed. The study population consisted of teachers of talented students, who numbered (80) teachers, a deliberate sample was chosen from these teachers and the sample of teachers of talented students consisted of (62) teachers in Amman schools. In order to achieve the objectives of the study, the two authors developed a questionnaire to reveal the degree of possession of the assistive technological competencies of the teachers of the talented students in Amman schools. The results of the study indicated that the degree of possession of assistive technological competencies of the teachers of the talented students in the schools of the capital Amman was high, and the results also revealed that there were no statistically significant differences attributed to the gender variable, and the absence of statistically significant differences attributed to the academic qualification variable, as well as the absence of statistically significant differences attributed to the variable of years of experience.

Over the past two decades, biodegradable metals (BMs) have emerged as promising materials to fabricate temporary biomedical devices, with the purpose of avoiding potential side effects of permanent implants. In this review, we first surveyed the current status of BMs in neuroscience, and briefly summarized the representative stents for treating vascular stenosis. Then, inspired by the convincing clinical evidence on the in vivo safety of Mg alloys as cardiovascular stents, we analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for treating ischemic stroke. For these novel applications, some key factors should also be considered in designing BM brain stents, including the anatomic features of the cerebral vasculature, hemodynamic influences, neuro-cytocompatibility and selection of alloying elements. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents., Graphical abstract Mg-based alloys have been used in neuroscience as filaments within nerve conduits to accelerate nerve regeneration, nerve electrode and devices for neural recording and monitoring, and stents for carotid artery stenosis and aneurysm treatment. Inspired by the convincing clinical evidence on the in vivo safety of Mg alloys as cardiovascular stents, we analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for ischemic stroke treatment.Image 1, Highlights • The current status of the application of biodegradable metals (BM) in neuroscience was presented. • We analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for ischemic stroke treatment. • Key factors in designing BM brain stents were discussed. • This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents.

The study was geared towards the usability of assistive technologies for learners with hearing impairment. Descriptive research of the Survey design was adopted. The sample comprised of one hundred and ten hearing impaired students of Federal College of Education (Special) Oyo. An adopted checklist and a structured questionnaire were utilized in collecting data while simple percentages, mean standard deviation, and t-test was used to analyze the data collected. The results of the study indicated that assistive technologies in FCE (SP) Oyo are generally available and functional; the use of assistive technologies among the learners with hearing impairment in FCE (SP) Oyo is high. Also, the result indicated that learners with hearing impairment in FCE (SP) Oyo have a positive attitude towards the use of assistive technologies. There was no significant difference between male and female learners with hearing impairment in the use of assistive technologies in FCE (SP) Oyo. It was recommended among others that learners with hearing impairment should be encouraged to adopt the ultimate use of assistive technologies.

Assistive Technology (AT) is a technology used by individuals with disabilities to perform functions that might otherwise be difficult or impossible. ATs are integrated into teaching and learning procedures to overcome the challenges faced by students with disabilities in educational institutions. The population of this study consisted of all the special students in Ilorin, Kwara State School for special needs. A random sampling technique was employed to select 100 students who constitute the sample size of this study. The findings of the study showed that deaf, blind, physical disability, learning disability, and language disorder are being catered for in the school, assistive technologies are available for all the special students in the school, majority of the students used the assistive technologies for learning, there is a significant difference in the level of utilization of assistive technologies for learning among the special students based on gender, and there is a significant difference in the level of utilization of assistive technologies for learning among special students based on age. This study concluded that basic disabilities are being catered for in the sample special school with appropriate assistive technologies, and the technologies are found to be adequately available for the students. The study, therefore, recommended that the ministry of education should put in place, seminars, workshops, conferences, and training for special education teachers.

This study was conducted to investigate whether information and communication technology (ICT) devices are used differently for students with developmental disabilities in elementary schools, depending on the type of disability (learning disabilities, attention deficit hyperactivity disorder, and autism spectrum disorder) and class (regular classes, resource rooms, and classes for special needs education). A questionnaire survey was administered to elementary school teachers to identify the extent of use of different ICT devices for students with developmental disabilities in their schools by type of disability and class. Results did not show differences in the extent of ICT device use by type of disability, although relative ICT scarcity in resource rooms was found. For supporting students with developmental disabilities, a need exists for more effective use of ICT devices depending on different types of developmental disability and class.

Objectives This study aims to understand the acceptability of social robots and the adaptation of the Hybrid-Face Robot for dementia care in India. Methods We conducted a focus group discussion and in-depth interviews with persons with dementia (PwD), their caregivers, professionals in the field of dementia , and technical experts in robotics to collect qualitative data. Results This study explored the following themes: Acceptability of Robots in Dementia Care in India, Adaptation of Hybrid-Face Robot and Future of Robots in Dementia Care. Caregivers and PwD were open to the idea of social robot use in dementia care; caregivers perceived it to help with the challenges of caregiving and positively viewed a future with robots. Discussion This study is the first of its kind to explore the use of social robots in dementia care in India by highlighting user needs and requirements that determine acceptability and guiding adaptation.

Objective Explore trajectories of functional recovery that occur during the first two years after spinal cord injury (SCI). Design Observational cohort study. Setting Eight SCI Model System sites. Participants 479 adults with SCI completed four Spinal Cord Injury-Functional Index (SCI-FI) item banks within 4 months of injury and again at 2 weeks, 3, 6, 12, and 24 months following baseline assessment. Intervention None. Main Outcome Measures SCI-FI Basic Mobility/Capacity (C), Fine Motor Function/C, Self-Care/C, and Wheelchair Mobility/Assistive Technology (AT) item banks. Results Growth mixture modeling was used to identify groups with similar trajectory patterns. For the Basic Mobility/C and Wheelchair Mobility/AT domains, models specifying 2 trajectory groups were selected. For both domains, a majority class exhibited average functional levels and gradual improvement, primarily in the first six months. A smaller group of individuals made gradual improvements but had greater initial functional limitations. The Self Care/C domain exhibited a similar pattern; however, a third, small class emerged that exhibited substantial improvement in the first six months. Finally, for individuals with tetraplegia, trajectories of Fine Motor Function/C scores followed two patterns, with individuals reporting generally low initial scores and then making either modest or large improvements. In individual growth curve models, injury/demographic factors predicted initial functional levels but less so with regard to rates of recovery. Conclusions Trajectories of functional recovery followed a small number of change patterns, though variation around these patterns emerged. During the first two years after initial hospitalization, SCI-FI scores showed modest improvements; however, substantial improvements were noted for a small number of individuals with severe limitations in fine motor and self-care function. Future studies should further explore the personal, medical, and environmental characteristics that influence functional trajectories during these first two years and beyond.

Assistive technologies have the potential for supporting people with memory complaints in their daily life. User-centered interaction design research helps developers to create systems that are suitable for users. The aim of this work is to describe the methodology and the results of the usability test for the first Memento prototype involving users.In each country, 5 subjects with different levels of cognitive reserve and technical proficiency were enrolled in Italy, Austria and Spain, respectively (15 subjects; 6 M; 9 F, age 72.8 ± 10.8 years, MMSE score 25.6 ± 1.6). Observation methods, performance metrics and the System Usability Scale were used to collect data.The results are presented in terms of design, technical problems, target-group-related challenges and usability perception from the participant perspective. Suggestions for improvement were pointed out by the users. Considering the usability scores interpretation, the first prototype was classified as "OK" and "Good" by users.The results of the Lab Trials provide important information on usability and the users' needs in order to improve the Memento prototype and to create a final system to be evaluated during the Field Trials phase of the project.Implication for rehabilitationThe MEMENTO project mission is to improve the quality of life of people in the early and middle stages of dementia, by supporting the management of daily activities that are usually affected by the loss of memory and cognition. The Lab Trial phase is essential to have feedback on the usability of the Memento prototype to allow a better understanding of users' needs and expectations.

In this paper, we have proposed an assistive technology solution to visually impaired that helps them to move from one place to another without depending on others, by leveraging Internet of Thing (IoT), Machine Learning and Embedded Technologies. In the literature different assistive solutions have been proposed to assist the visually impaired people. i) Assistance from stick helps them to sense the object and also helps them to carry out various activities such as walking, negotiating a crowd and so on, but at the same time they won’t know the object that is in front of them. ii) Robots help them to navigate from one place to another, but at the same time it is highly expensive. iii) Assistance from visually fit people is not a viable solution. The proposed solution employs Google Tensor Flow Machine Learning Framework for the classification of the real-world objects. Therefore, the proposed system can rise the cognizance of the explored environment, it interacts with its user by means of audio messages and at the same time it is a cost-effective solution.

International audience; Complete tetraplegia can deprive a person of hand function. Assistive technologies may improve autonomy but needs for ergonomic interfaces for the user to pilot these devices still persist. Despite the paralysis of their arms, people with tetraplegia may retain residual shoulder movements. In this work we explored these movements as a mean to control assistive devices. Methods: We captured shoulder movement with a single inertial sensor and, by training a support vector machine based classifier, we decode such information into user intent. Results: The setup and training process take only a few minutes and so the classifiers can be user specific. We tested the algorithm with 10 able body and 2 spinal cord injury participants. The average classification accuracy was 80% and 84%, respectively. Conclusion: The proposed algorithm is easy to set up, its operation is fully automated, and achieved results are on par with state-of-the-art systems. Significance: Assistive devices for persons without hand function present limitations in their user interfaces. Our work present a novel method to overcome some of these limitations by classifying user movement and decoding it into user intent, all with simple setup and training and no need for manual tuning. We demonstrate its feasibility with experiments with end users, including persons with complete tetraplegia without hand function.

Amyotrophic lateral sclerosis, also known as ALS, is a progressive nervous system disorder that affects nerve cells in the brain and spinal cord, resulting in the loss of muscle control. For individuals with ALS, where mobility is limited to the movement of the eyes, the use of eye-tracking-based applications can be applied to achieve some basic tasks with certain digital interfaces. This paper presents a review of existing eye-tracking software and hardware through which eye-tracking their application is sketched as an assistive technology to cope with ALS. Eye-tracking also provides a suitable alternative as control of game elements. Furthermore, artificial intelligence has been utilized to improve eye-tracking technology with significant improvement in calibration and accuracy. Gaps in literature are highlighted in the study to offer a direction for future research.

Background Long standing, recalcitrant venous ulcers fail to heal despite standard compression therapy and wound care. Stenting of central veins has been reported to assist in venous ulcer healing. This study reports outcomes of deep venous stenting for central venous obstruction in patients with recalcitrant venous ulcers at a single comprehensive wound care center. Methods A single center retrospective analysis was conducted of patients with CEAP (Clinical, Etiology, Anatomy, and Pathophysiology) 6 disease that had undergone deep venous stenting in addition to wound care and compression therapy. Intra-operative details, wound healing, and stent patency rates were recorded. Stent patency and intra-operative details were compared between the healed and unhealed groups. Results Between 2010 and 2019, 15 patients met inclusion criteria (mean age: 63 years old, 12 males). Pre-operative mean wound area was 14.1 cm2 with mean wound duration of 30 months. 93% of patients healed the ulcers at mean healing time of 10.6 months. Wound recurrence rate was 57% with mean recurrence time of 14.8 months. Ten patients presented with an inferior vena cava (IVC) filter, 4 in the healed group and 6 in the unhealed group. The common iliac vein was stented in all patients. Extension into the IVC was required in 4, the common femoral vein in 11, and femoral vein in 2 patients. The average stent length was 190cm. During the follow-up period, primary patency rates in healed patients (mean follow-up time: 19.2 months) was 83% and 59% in the unhealed group (mean follow-up time: 36.6 months); secondary patency rates were 83% and 89%, respectively. Conclusions In patients with recalcitrant venous ulcers with central venous obstruction, deep venous stenting resulted in a high rate of healing. However, a prolonged 10-month healing time was observed and despite high stent patency, wound recurrence rate was high.

Despite the potential value of assistive technology to support people with dementia and their informal caregivers (=PlwD) to age in place, use of these innovations is still limited. To ensure that innovations better address specific needs of PlwD, it is important to actively involve them into the innovation process. A Living Lab (LL) is a user-centred research design in which multiple stakeholders, develop, test and validate innovative solutions in real-life environment together with end-users (i.e. PlwD). Although user involvement activities in LLs are seen as their main goal, little literature is available on how different stakeholders, including users, experience their collaboration in LLs. This case study (Playtime) investigates the experiences of various stakeholders, including PlwD, when developing a serious game in a LL. 18 semi-structured interviews were conducted with PlwD, healthcare professionals, developers and researchers about their experiences following the key-principles of a successful User Centred Design project. Results shows that the stakeholders of the Playtime LL are most positive with regard to the key-principles active user participation, continuous iteration of design solutions and multidisciplinary networks. Some lessons learned are selected to inspire other LLs when collaborating with PlwD in the development of assistive technology for dementia.

Musculoskeletal conditions, often requiring rehabilitation, affect one-third of the U.S. population annually. This paper presents rehabilitation assistive technology that includes body-worn motion sensors and a mobile application that extends the reach of a physical rehabilitation specialist beyond the clinic to ensure that home exercises are performed with the same precision as under clinical supervision. Assisted by a specialist in the clinic, the wearable sensors and user interface developed allow the capture of individualized exercises unique to the patient’s physical abilities. Beyond the clinical setting, the system can assist patients by providing real-time corrective feedback to repeat these exercises through a correct and complete arc of motion for the prescribed number of repetitions. An inertial measurement unit (IMU) is used on the body part to be exercised to capture its pose. In this paper, we present a kinematics data processing approach to defining custom exercises with flexibility in terms of where it is worn and the nature of the exercise, as well as real-time corrective feedback parameters. The system is tested on two exercises perfromed by a healthy individual to demonstrate the feasibility and accuracy of the approach. We demonstrate how it can improve exercise adherence by assisting users in reaching the full prescribed range of motion and stay on the ideal plane of motion and improve hold time. Preliminary results from an ongoing clinical trial are presented.

With the rising prevalence of autism diagnoses, it is essential for research to understand how to leverage technology to support the diverse nature of autistic traits. While traditional interventions focused on technology for medical cure and rehabilitation, recent research aims to understand how technology can accommodate each unique situation in an efficient and engaging way. Extended reality (XR) technology has been shown to be effective in improving attention in autistic users given that it is more engaging and motivating than other traditional mediums. Here, we conducted a systematic review of 59 research articles that explored the role of attention in XR interventions for autistic users. We systematically analyzed demographics, study design and findings, including autism screening and attention measurement methods. Furthermore, given methodological inconsistencies in the literature, we systematically synthesize methods and protocols including screening tools, physiological and behavioral cues of autism and XR tasks. While there is substantial evidence for the effectiveness of using XR in attention-based interventions for autism to support autistic traits, we have identified three principal research gaps that provide promising research directions to examine how autistic populations interact with XR. First, our findings highlight the disproportionate geographic locations of autism studies and underrepresentation of autistic adults, evidence of gender disparity, and presence of individuals diagnosed with co-occurring conditions across studies. Second, many studies used an assortment of standardized and novel tasks and self-report assessments with limited tested reliability. Lastly, the research lacks evidence of performance maintenance and transferability., [Accepted version] K. Wang, S. J. Julier and Y. Cho, "Attention-Based Applications in Extended Reality to Support Autistic Users: A Systematic Review," in IEEE Access, vol. 10, pp. 15574-15593, 2022, doi: 10.1109/ACCESS.2022.3147726

Ventricular assist devices have become a valuable tool in the treatment of heart failure in children. The use of ventricular assist devices has decreased mortality in children with end-stage heart failure awaiting transplant. It is not uncommon for children with end-stage heart failure associated with cardiomyopathy or congenital heart disease to have significant systemic semilunar and atrioventricular valve regurgitation, which can impact the efficiency and efficacy of hemodynamic support provided by a ventricular assist device. Therefore, implanting clinicians should carefully assess for valve abnormalities that may need repair and impact device selection and cannulation strategy to effectively support this diverse population. The purpose of this review is to provide an overview of this important and relevant topic and to discuss strategies for managing these patients.

Increased left ventricular (LV) mass (LVM) and LV hypertrophy (LVH) are risk markers for adverse cardiovascular events, and may indicate an underlying cardiomyopathy. Cardiac magnetic resonance (CMR) is the gold standard for LVM estimation, but is challenging to obtain at scale, which has limited the power of prior genetic analyses. In the current study, we performed a genome-wide association study (GWAS) of CMR-derived LVM indexed to body surface area (LVMI) estimated using a deep learning algorithm within nearly 50,000 participants from the UK Biobank. We identified 12 independent associations (1 known atTTNand 11 novel) meeting genome-wide significance, implicating several candidate genes previously associated with cardiac contractility and cardiomyopathy. Greater CMR-derived LVMI was associated with higher risk of incident dilated (hazard ratio [HR] 2.58 per 1-SD increase, 95% CI 2.10-3.17) and hypertrophic (HR 2.62, 95% CI 2.09-3.30) cardiomyopathies. A polygenic risk score (PRS) for LVMI was also associated with incident hypertrophic cardiomyopathy within a separate set of UK Biobank participants (HR 1.12, 95% CI 1.01-1.12) and among individuals in an external Mass General Brigham dataset (HR 1.18, 95% CI 1.01-1.37). In summary, using CMR-derived LVM available at scale, we have identified 12 common variants associated with LVMI (11 novel) and demonstrated that both CMR-derived and genetically determined LVMI are associated with risk of incident cardiomyopathy.Journal Subject Termsmachine learning, left ventricular hypertrophy, genetics