Assistive Technology Research Articles

A scoping review of digital fabrication techniques applied to prosthetics and orthotics: Part 1 of 2-Prosthetics.

Traditionally, the manufacture of prostheses is time-consuming and labor-intensive. One possible route to improving access and quality of these devices is the digitalizing of the fabrication process, which may reduce the burden of manual labor and bring the potential for automation that could help unblock access to assistive technologies globally. To identify where there are gaps in the literature that are creating barriers to decision-making on either appropriate uptake by clinical teams or on the needed next steps in research that mean these technologies can continue on a pathway to maturity. Scoping literature review. A comprehensive search was completed in the following databases: Allied and Complementary Medicine Database, MEDLINE, Embase, Global Health Archive, CINAHL Plus, Cochrane Library, Web of Science, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, and Engineering Village, resulting in 3487 articles to be screened. After screening, 130 lower limb prosthetic articles and 117 upper limb prosthetic articles were included in this review. Multiple limitations in the literature were identified, particularly a lack of long-term, larger-scale studies; research into the training requirements for these technologies and the necessary rectification processes; and a high range of variance of production workflows and materials which makes drawing conclusions difficult. These limitations create a barrier to adequate evidence-based decision-making for clinicians, technology developers, and wider policymakers. Increased collaboration between academia, industry, and clinical teams across more of the pathway to market for new technologies could be a route to addressing these gaps.

Implementation of a High-Accuracy Neural Network-Based Pupil Detection System for Real-Time and Real-World Applications

In this paper, the implementation of a new pupil detection system based on artificial intelligence techniques suitable for real-time and real-word applications is presented. The proposed AI-based pupil detection system uses a classifier implemented with slim-type neural networks, with its classes being defined according to the possible positions of the pupil within the eye image. In order to reduce the complexity of the neural network, a new parallel architecture is used in which two independent classifiers deliver the pupil center coordinates. The training, testing, and validation of the proposed system were performed using almost 40,000 eye images with a resolution of 320 × 240 pixels and coming from 20 different databases, with a high degree of generality. The experimental results show a detection rate of 96.29% at five pixels with a standard deviation of 3.38 pixels for all eye images from all databases and a processing speed of 100 frames/s. These results indicate both high accuracy and high processing speed, and they allow us to use the proposed solution for different real-time applications in variable and non-uniform lighting conditions, in fields such as assistive technology to communicate with neuromotor-disabled patients by using eye typing, in computer gaming, and in the automotive industry for increasing traffic safety by monitoring the driver’s cognitive state.

Mapping Dementia Care Technology: Tailored Digital Solutions across Stages

Over the years, there has been an increase in the development of assistive technologies. To date, the stages of dementia that these technologies can be best implemented has been underexplored. In previous work, researchers developed an infographic providing guidance on when best to introduce assistive technologies for people with dementia, and although this infographic is relevant, it was based solely on the experience of the authors during various national and international projects. However, various studies have been conducted on the use and implementation of technology for people with dementia, providing information on when care technology should be implemented. Therefore, the aim of this paper was to conduct a literature review, and based on the results, to design an infographic showing recommendations on when to implement an assistive technology. The infographic was evaluated during interviews with experts on the implementation of care technology for people with dementia. Our results propose earlier implementation for several technologies, as well as the importance of considering contextual factors such as personal characteristics, background and technical experience when implementing technology. The designed infographic can facilitate the digital transition for healthcare institutions and personnel by offering information into the implementation process of care technology.

Advanced Glycation End-Products of Follicular Fluid are Associated with Embryo Morphokinetic Parameters and ART Outcomes.

Advanced glycation end products (AGEs) can disrupt antioxidant system and steroidogenesis, resulting in detrimental effects on assisted reproductive technology (ART) outcomes. This study aimed to investigate the association of AGEs in follicular fluid (FF) with morphokinetic parameters of embryos and ART outcomes. Fifty women undergoing ART treatment were studied. AGEs, glucose, 25(OH) vitamin D, malondialdehyde (MDA) levels and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPX) activities were evaluated in FF. The expression of 3βHSD, CYP11A1, and CYP19A1 genes were analyzed in granulosa cells (GCs) by qRT-PCR technique. Morphokinetic parameters were evaluated using time-lapse technology. The FF level of AGEs was reversely associated with CAT, SOD, and GPX activities, and total and mature oocytes number, blastocyst formation rate, and high-grade embryos number, while it showed positive correlations with the FF MDA levels, the expression of steroidogenesis genes, number of immature oocytes, morphokinetic parameters, and number of low-grade embryos. Furthermore, the level of vitamin D in FF had an inverse association with AGEs and positive correlations with ART outcomes and morphokinetic parameters. Comparison between the those with positive and negative biochemical pregnancy showed no significant differences in terms of FF factors and just the expression of 3βHSD, CYP11A1, and CYP19A1 genes were higher in pregnant women (p < 0.05). AGEs could delay blastomere division and lead to an increase in the number of low-quality embryos, while vitamin D have an adverse effect on AGEs and a protective function against AGEs negative effects.

Prediction of embryo euploidy and pregnancy outcome by blastocyst morphology and development speed for women receiving single embryo transfer

Background Selection of high-quality blastocysts is the most important factor determining the success of assisted reproductive technology. The objective of this study is to assess the values of blastocyst morphological quality and development speed for predicting euploidy and clinical pregnancy outcome. Methods A total of 155 preimplantation genetic testing cycles including 959 blastocysts and 154 euploid blastocyst transfer cycles conducted between January 2018 and December 2019 were retrospectively analysed. The associations of blastocyst morphological quality and development speed (D) with chromosomal status, clinical pregnancy rate, early miscarriage rate, and ongoing pregnancy rate were evaluated by univariate and multivariate regression. Results The euploidy rate of development speed D5 blastocysts was significantly greater than that of D6 blastocysts (61.4% vs. 38.1%, P < 0.001), and the euploid rate of morphologically high-grade blastocysts was significantly greater than that of non-high-grade blastocysts. Development speed D5 (OR = 1.6, 95% CI 1.2–2.2, P = 0.02) and high-grade morphology (OR = 2.1, 95% CI 1.5–2.9, P = 0.01) were independent predictors of euploidy. The ongoing pregnancy rate of D5 blastocysts was significantly higher than that of D6 blastocysts (62.3% vs. 43.8%, P = 0.04). Transfer of euploid blastocysts with high-grade morphology resulted in a greater ongoing pregnancy rate than transfer of non-high-grade euploid blastocysts (60.7% vs. 43.2%, P = 0.049). Alternatively, D6 development speed was an independent risk factor for early pregnancy loss after euploid blastocyst transfer. Multivariate regression analysis adjusting for confounding factors identified maternal age, blastocyst development speed, and blastocyst morphological grade as independent predictors of euploidy but not of clinical pregnancy. Conclusion The recommended sequence of embryo transfer based on the present study is D5 high-grade > D6 high-grade > D5 non-high-grade > D6 non-high-grade.

Outcome measures applied to robotic assistive technology for people with cerebral palsy: a pilot study

The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants’ independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information.

Factors impacting community living outcomes among former long-term nursing home residents using the interdependence-Human Activity Assistive Technology (i-HAAT) model

ABSTRACT Despite an increased application of social theory in assistive technology (AT) outcomes research, there continues to be a gap in integrating AT conceptual models in research design, data analysis, and results interpretation. This paper merged two preexisting AT models, the Human Activity Assistive Technology model (HAAT) and the interdependence frame for AT into a novel framework, the interdependence-HAAT model (i-HAAT). This model was used to examine the outcomes of former long-term nursing home residents using AT. The model was also used as a framework to facilitate quantitative variable identification and categorization, emphasize the interconnectivity between domain variables, and explore the infrastructural supports necessary for the successful community reintegration of deinstitutionalized AT users. Meaningful integration of theory into practice is the essential next step in generating socially responsive research that addresses AT consumer needs and moves the field forward.

Age-related increase in live-birth rates of first frozen thaw embryo versus first fresh transfer in initial assisted reproductive technology cycles without PGT

BackgroundThe landscape of assisted reproductive technology (ART) has seen a significant shift towards frozen-thawed embryo transfers (FET) over fresh transfers, driven by technological advancements and clinical considerations. This study aimed to compare live birth outcomes between primary FET and fresh transfers, focusing on cycles without preimplantation genetic testing (PGT), using United States national data from the SART CORS database spanning from 2014 to 2020.MethodsWe performed a retrospective cohort study of autologous first ART cycles without PGT comparing primary embryo transfer (frozen thaw vs. fresh) success rates from the 2014–2020 SARTCORS database. Live-birth rates (LBR) and cumulative live-birth rates (CLBR) were compared between first FET versus first fresh embryo transfer from an index retrieval. Multivariate logistic regression (MLR) determined association between live birth outcomes and method of transfer. In a subsequent sub-analysis, we compared these two embryo transfer methods among patients with either diminished ovarian reserve (DOR) or male factor infertility.Results228,171 first ART cycles resulted in primary embryo transfer. 62,100 initial FETs and 166,071 fresh transfers were compared. Initial FETs demonstrated higher LBR and CLBR compared to fresh transfers (LBR 48.3% vs. 39.8%, p < 0.001; CLBR 74.0% vs. 60.0%, p < 0.0001). MLR indicated greater chances of live birth with FET across all age groups, with adjusted odds ratio (aOR) of live-birth incrementally increasing with advancing age groups. For DOR cycles, LBR and CLBR were significantly higher for FET compared to fresh (33.9% vs. 26.0%, p < 0.001, 44.5% vs. 37.6%, p < 0.0001), respectively. MF cycles also demonstrated higher LBR and CLBR with FET (52.3% vs. 44.2%, p < 0.001, 81.2% vs. 68.9%, p < 0.0001), respectively. MLR demonstrated that in DOR cycles, initial FET was associated with greater chance of live birth in age groups ≥ 35yo (p < 0.01), with aOR of live birth increasingly considerably for those > 42yo (aOR 2.63, p < 0.0001).ConclusionsOverall LBR and CLBR were greater for first FET than fresh transfers with incremental increases in odds of live birth with advancing age, suggesting the presence of a more favorable age-related change in endometrial receptivity present in frozen-thawed cycles. For both DOR and MF cycles, LBR and CLBR after primary transfer were greater for first FET than fresh. However, this was particularly evident in older ages for DOR cycles. This suggests that supraphysiologic stimulation in older DOR cycles may be detrimental to endometrial receptivity, which is in part corrected for in FET cycles.

Between hospitality and the inhospitable: Critical judgments on the professional-beneficiary relationship within assisted reproductive technology

ABSTRACT In recent decades, the health sector has witnessed the emergence of social movements of patients aimed at redefining public policies on access to and provision of medical care. These changes are reflected in the conceptual models of patient-centred care, developed to guide medical practice towards patients’ expectations and wishes. However, different patient-centred models remain eminently focused on the dimension of solicitude when attending to patients’ specific needs: interpersonal relations based on the caregiver’s attention to the patient’s singularity. Namely, patients can express other moral references concerning their experiences in clinical contexts. That is the case with hospitality. Based on a Portuguese research project focused on the clinical experience of ART beneficiaries, this article aims to analyse hospitality as a moral orientation with specific proprieties associated with attending to patients’ singularity, thus aiming to contribute to the ongoing discussion and revision of the conceptual models of patient-centred care.

Voice Assistant Utilization among the Disability Community for Independent Living: A Rapid Review of Recent Evidence

The rapid advancement and widespread adoption of voice assistance technology have shown promise in benefiting individuals with disabilities, offering increased social participation, independence, and leisure activities. However, barriers to their full utilization have been identified, leading to potential abandonment by users with disabilities. This rapid review is aimed at filling the gap in the literature by investigating the utilization of voice assistants among people with disabilities for independent living and community participation. A comprehensive search was conducted in academic literature databases, including PubMed, Embase, and Web of Science, and gray data was sourced from public social media domains through Infegy. The analysis included 48 articles and 281 social media posts that met the inclusion criteria. Neurodiversity, disabilities affecting vision, and general disabilities were the most frequently discussed categories in both sources. The most common tasks performed using voice assistants were interface control, reminders, and environmental control, with a focus on enabling independence. Barriers to use mentioned in the literature included cognitive load during use, speech interpretation, lack of nonverbal control, and privacy concerns, while gray data reported limited functionality and speech interpretation as primary barriers. Amazon Alexa was the most discussed brand in both sources. The findings highlight the need for further research and innovation to fully harness the potential benefits of voice assistants for individuals with disabilities. By addressing the identified barriers and tailoring voice assistance technology to cater to the specific needs of different disability types, this technology can become a powerful tool for enhancing the lives of individuals with disabilities and promoting greater independence and community participation.

Challenges in Implementing Assistive Devices in Teaching Learners who are Visually Impaired in full Service Classrooms

The study aimed to explore the challenges experienced in the implementation of assistive devices in the teaching of learners who are visually impaired in inclusive classrooms. The study encapsulates qualitative research techniques were used for data collection and analysis. The study revealed that through the assistance of technology, learners were motivated and could easily communicate with one another even outside their school which also encouraged their critical thinking. Effective educational outcomes from assistive technology use are dependent upon a coordinated assessment and implementation process. There were different challenges found to be hindering the successful implementation of assistive devices. These challenges were a lack of professional support for teachers teaching learners who are visualy impaired in inclusive classrooms; educators’ negativity and poor attitude; teachers’ lack of knowledge in utilising assistive devices profitably; insufficient funding and procurement in purchasing assistive devices in schools.

Why Disability Is Technologically Mediated?

AbstractThe social model of disability is predicated upon the dichotomy of disability and impairment, which proves vulnerable to objections. Phenomenological approaches to disability in particular found this sharp distinction contrived, and accordingly implausible. Moreover, the social model ignores lived body of individuals and the inside-out perspective on disability. A phenomenological approach thus places the emphasis on the embodied nature of being-in-the-world. Yet, when it comes to the role of technology in disabled people’s life, and in particular assistive technologies, it does not do justice to the role they play, and as a result, technology is treated predominantly as instrumental. In this article, I suggest taking a more systematic approach to technology in disability studies and bringing its role into an interrogation. To that purpose, I will draw from the postphenomenology movement to show how technology may actively mediate individuals’ life and, perhaps more importantly, how disability is technologically mediated.

Metabolomic profiling of embryo culture media in patients with repeated implantation failure during assisted reproductive technology cycles.

This study investigated the metabolic status of the spent culture media from embryos of patients with repeated implantation failure (RIF) undergoing in vitro fertilization-intracytoplasmic sperm injection cycles in comparison with the embryos from healthy fertile women. Metabolite levels in spent culture media were assessed and compared between embryos from RIF patients (n=35) and oocyte donors as controls (n=15). Protein levels of insulin-like growth factor 1 (IGF-1) were determined using Western blotting. Concentrations of glucose, pyruvate, and lactate were measured using spectrophotometry. Ionic colorimetric assay kits were utilized to analyze the concentrations of sodium, chloride, calcium, and magnesium ions. High-performance liquid chromatography was employed to measure the concentrations of glutamic acid, aspartic acid, methionine, phenylalanine, and histidine. Glucose consumption and lactate secretion were higher in the control group than in the RIF group. The magnesium concentration was significantly higher in the control group than in the RIF group, but glutamic acid and aspartic acid concentrations were lower in the control group than in the RIF patients (p<0.05). The levels of IGF-1, sodium, calcium, chloride, methionine, histidine, and phenylalanine did not show statistically significant differences between the two groups. The metabolic profile of the culture medium of the embryos in the RIF group differed from that of the control group. These findings suggest potential factors that may affect implantation capacity in RIF patients and provide a new perspective on embryo selection.

SilentInterpreter: Analysis of Lip Movement and Extracting Speech Using Deep Learning

Lip reading presents a captivating avenue for advancing speech recognition algorithms, leveraging visual cues from lip movements to recognise spoken words. This paper introduces a novel method employing deep neural networks to convert lip motions into textual representations. The methodology integrates convolutional neural networks for visual feature extraction, recurrent neural networks to capture temporal context, and the Connectionist Temporal Classification loss function for aligning lip features with phonemes. Additionally, dynamic learning rate scheduling and a unique callback mechanism for training visualization are incorporated into the process. Post-training on a sizeable dataset, the model demonstrates notable convergence, showcasing its ability to discern intricate temporal correlations. Comprehensive evaluations, combining quantitative metrics and qualitative assessments, validate the model's effectiveness. Visual inspections of lip reading capabilities and standard speech recognition criteria evaluation highlight its performance. The study delves into the impact of various model topologies and hyperparameters on performance, providing valuable insights for future research directions. This research contributes a deep learning framework for accurate and efficient speech recognition, expanding the landscape of lip reading technologies. The findings open paths for further refinement and deployment across diverse domains, including assistive technologies, audio-visual communication systems, and human-computer interaction. Keywords: lip reading, deep learning, convolutional neural networks, recurrent neural networks, CTC loss, speech recognition

Brain-computer interfaces and human factors: the role of language and cultural differences—Still a missing gap?

Brain-computer interfaces (BCIs) aim at the non-invasive investigation of brain activity for supporting communication and interaction of the users with their environment by means of brain-machine assisted technologies. Despite technological progress and promising research aimed at understanding the influence of human factors on BCI effectiveness, some topics still remain unexplored. The aim of this article is to discuss why it is important to consider the language of the user, its embodied grounding in perception, action and emotions, and its interaction with cultural differences in information processing in future BCI research. Based on evidence from recent studies, it is proposed that detection of language abilities and language training are two main topics of enquiry of future BCI studies to extend communication among vulnerable and healthy BCI users from bench to bedside and real world applications. In addition, cultural differences shape perception, actions, cognition, language and emotions subjectively, behaviorally as well as neuronally. Therefore, BCI applications should consider cultural differences in information processing to develop culture- and language-sensitive BCI applications for different user groups and BCIs, and investigate the linguistic and cultural contexts in which the BCI will be used.

Accessible Educational Resources: Assistive Technology and Information Design Promoting Educational Inclusion for People with Hearing Disabilities

This article explores how accessible educational resources, assistive technology and information design can collaborate to promote the educational inclusion of people with hearing impairments. Combining these approaches contributes to the understanding of content, engagement and participation of students with hearing impairment, as well as enhancing their communication and interaction, raising self-esteem and confidence. This study aims to investigate how these resources can promote the educational inclusion of people with hearing impairment, identifying their capabilities and limitations and proposing strategies to improve accessibility and quality of life in the educational environment. The methodology employed will be the systematic literature review (RBL). It is concluded the importance of these approaches for the educational and social inclusion of people with hearing impairment. Investments in research and development of these resources are fundamental to promote the inclusion of these people on equal terms in society.

Prevalence of infertility and barriers to family building among male physicians.

Fertility declines with increasing age and physicians often delay childbearing beyond prime reproductive years for the sake of medical training. However, the risks of infertility in male physicians compared to the general population remain poorly studied. To characterize rates of infertility among male physicians and identify barriers in access to fertility care and family building. Between June 2022 and December 2022, male physicians were invited to complete a questionnaire regarding fertility and family building. Surveys were disseminated electronically via social media and professional medical societies using Qualtrics (Provo, UT). Two hundred thirty-five responses were included in the final analysis. The mean age of respondents was 36.3±7.4 years. Of 151 respondents with children or currently attempting to have children, 66 (43.7%) delayed family building due to their medical training or career. The most influential factors affecting timing of children were lack of flexibility in schedule, lack of time, stress, and financial strain. Forty-three (18.3.%) respondents had seen a doctor for fertility evaluation; an additional 12 (5.1%) said they considered doing so but did not, mostly due to being too busy. Sixty (25.5%) had undergone semen testing in the past. Thirty-one (13.2%) reported a diagnosis of fertility issues in either themselves or their partner. Twenty-seven (11.5%) endorsed either them or their partner having undergone assistive reproductive technologies or other procedures for infertility. A significant proportion of male physicians delayed building their family or seeking fertility evaluation due to their medical career. Around 23.4% of male physicians have either seen or considered seeing a physician for fertility evaluation, suggesting a high prevalence of infertility in this cohort. Our results indicate a need for interventions to support family building and fertility evaluation and treatment among male physicians.

Complete hydatidiform mole with a coexisting twin live fetus (CHMTF): the uncommon diagnostic enigma—simplified

Abstract Background Twin pregnancy comprising of a complete hydatidiform mole with a coexisting twin live fetus is an uncommon condition with an incidence rate of 1 in 20,000 to 1 in 100,000 pregnancies, more so in assisted reproductive technologies. The primary diagnosis is made on ultrasound and adjunct fetal MRI helps in unequivocally differentiating it from other disorder. Case presentation We present a case report of a twin pregnancy consisting of complete hydatidiform mole with a coexisting twin live fetus in a 27-year-old primigravida conception, primarily focusing on its diagnostic algorithm and related clinical aspects, adding to the paucity of existing literature. Conclusions Following the correct diagnostic algorithm with imaging studies like USG and more importantly MRI, combined with the bioclinical picture helps in reaching the accurate diagnosis.

Micro/Nanorobotics in In Vitro Fertilization: A Paradigm Shift in Assisted Reproductive Technologies

In vitro fertilization (IVF) has transformed the sector of assisted reproductive technology (ART) by presenting hope to couples facing infertility challenges. However, conventional IVF strategies include their own set of problems such as success rates, invasive procedures, and ethical issues. The integration of micro/nanorobotics into IVF provides a prospect to address these challenging issues. This article provides an outline of the use of micro/nanorobotics in IVF specializing in advancing sperm manipulation, egg retrieval, embryo culture, and capacity future improvements in this swiftly evolving discipline. The article additionally explores the challenges and obstacles associated with the integration of micro/nanorobotics into IVF, in addition to the ethical concerns and regulatory elements related to the usage of advanced technologies in ART. A comprehensive discussion of the risk and safety considerations related to using micro/nanorobotics in IVF techniques is likewise presented. Through this exploration, we delve into the core principles, benefits, challenges, and potential impact of micro/nanorobotics in revolutionizing IVF procedures and enhancing affected person outcomes.

The Town Crier: A Use-Case Design and Implementation for a Socially Assistive Robot in Retirement Homes

The use of new assistive technologies in general, and Socially Assistive Robots (SARs) in particular, is becoming increasingly common for supporting people’s health and well-being. However, it still faces many issues regarding long-term adherence, acceptability and utility. Most of these issues are due to design processes that insufficiently take into account the needs, preferences and values of intended users. Other issues are related to the currently very limited amount of long-term evaluations, performed in real-world settings, for SARs. This study presents the results of two regional projects that consider as a starting hypothesis that the assessment in controlled environments and/or with short exposures may not be enough in the design of an SAR deployed in a retirement home and the necessity of designing for and with users. Thus, the proposed methodology has focused on use-cases definitions that follow a human-centred and participatory design approach. The main goals have been facilitating system acceptance and attachment by involving stakeholders in the robots design and evaluation, overcoming usage barriers and considering user’s needs integration. The implementation of the first use-case deployed and the two-phase pilot test performed in a retirement home are presented. In particular, a detailed description of the interface redesign process based on improving a basic prototype with users’ feedback and recommendations is presented, together with the main results of a formal evaluation that has highlighted the impact of changes and improvements addressed in the first redesign loop of the system.