Assistive Technology Research Articles

Meeting the Needs of People With Severe Quadriplegia in the 21st Century: The Case for Implanted Brain-Computer Interfaces.

In recent decades, there has been a widespread adoption of digital devices among the non-disabled population. The pervasive integration of digital devices has revolutionized how the majority of the population manages daily activities. Most of us now depend on digital platforms and services to conduct activities across the domains of communication, finance, healthcare, and work. However, a clear disparity exists for people who live with severe quadriplegia, who largely lack access to tools that would enable them to perform daily tasks digitally and communicate effectively with their environment. The purpose of this piece is to (i) highlight the unmet needs of people with severe quadriplegia (including cases for medical necessity and perspectives from the community), (ii) present the current landscape of assistive technology for people with severe quadriplegia, (iii) make the case for implantable BCIs (how they address needs and why they are a good solution relative to other assistive technologies), and (iv) present future directions. There are technologies that are currently available to this population, but these technologies are certainly not usable with the same level of ease, efficiency, or autonomy as what has been designed for the non-disabled community. This hinders the ability of people with severe quadriplegia to achieve digital autonomy, perpetuating social isolation and limiting the expression of needs, opinions, and preferences. Most importantly, the gap in digital equality fundamentally undermines the basic human rights of people with severe quadriplegia.

Diagnosis of 42 Cases of Intrauterine Twin Pregnancy Complicated With Ectopic Pregnancy: A Retrospective Cohort Study.

The coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life-threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology. This retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high-risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes. Among the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full-term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%). Though the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP.

Congenital heart defects in children born after assisted reproductive technology: a CoNARTaS study.

Children born after assisted reproductive technology (ART) have worse perinatal outcomes compared with spontaneously conceived children. This study investigates whether children conceived after ART have a higher risk of congenital heart defects (CHDs) compared with children born after spontaneous conception (SC). All 7 747 637 liveborn children in Denmark (1994-2014), Finland (1990-2014), Norway (1984-2015), and Sweden (1987-2015), where 171 735 children were conceived after ART, were included. National ART and medical birth registry data were cross-linked with data from other health and population registries. Outcomes were major CHDs, severe CHDs, 6 hierarchical CHD lesion groups, and 10 selected major CHDs, diagnosed prenatally or up to 1 year of age (Denmark, Finland, and Sweden) and prenatally or at birth (Norway). The association between ART and CHDs was assessed with multivariable logistic regression analysis, with adjustment for available confounders. Major CHDs were detected in 3159 children born after ART (1.84%) and in 86 824 children born after SC [1.15%; adjusted odds ratio (AOR) 1.36; 95% confidence interval (CI) 1.31-1.41]. Risk was highest in multiples, regardless of conception method. Severe CHDs were detected in 594 children born after ART (0.35%) and in 19 375 children born after SC (0.26%; AOR 1.30; 95% CI 1.20-1.42). Risk was similar between ICSI and IVF and between frozen and fresh embryo transfer. Assisted reproductive technology-conceived children have a higher prevalence of major CHDs, being rare, but severe conditions. The absolute risks are, however, modest and partly associated with multiple pregnancies, more prevalent in ART.

Unraveling the mysteries of early embryonic arrest: genetic factors and molecular mechanisms.

Early embryonic arrest (EEA) is a critical impediment in assisted reproductive technology (ART), affecting 40% of infertile patients by halting the development of early embryos from the zygote to blastocyst stage, resulting in a lack of viable embryos for successful pregnancy. Despite its prevalence, the molecular mechanism underlying EEA remains elusive. This review synthesizes the latest research on the genetic and molecular factors contributing to EEA, with a focus on maternal, paternal, and embryonic factors. Maternal factors such as irregularities in follicular development and endometrial environment, along with mutations in genes like NLRP5, PADI6, KPNA7, IGF2, and TUBB8, have been implicated in EEA. Specifically, PATL2 mutations are hypothesized to disrupt the maternal-zygotic transition, impairing embryo development. Paternal contributions to EEA are linked to chromosomal variations, epigenetic modifications, and mutations in genes such as CFAP69, ACTL7A, and M1AP, which interfere with sperm development and lead to infertility. Aneuploidy may disrupt spindle assembly checkpoints and pathways including Wnt, MAPK, and Hippo signaling, thereby contributing to EEA. Additionally, key genes involved in embryonic genome activation-such as ZSCAN4, DUXB, DUXA, NANOGNB, DPPA4, GATA6, ARGFX, RBP7, and KLF5-alongside functional disruptions in epigenetic modifications, mitochondrial DNA, and small non-coding RNAs, play critical roles in the onset of EEA. This review provides a comprehensive understanding of the genetic and molecular underpinnings of EEA, offering a theoretical foundation for the diagnosis and potential therapeutic strategies aimed at improving pregnancy outcomes.

Effects of progesterone administered to maternal rats during the teratogenesis-sensitive period through different routes on neurobehavior and gut microbiota in offspring

Objective: Progesterone (P4) is the optimal agent for luteal support in assisted reproductive technologies. Despite the availability of various formulations, the impacts of P4 treatment administered through different routes on offspring growth remain unevaluated. This study aimed to investigate and compare the effects of P4 administration through three different routes in pregnant rats during the teratogenesis-sensitive period on fertility outcomes and the behavior, plasma P4 and pregnenolone levels, and alterations in gut microbiota in the filial generation (F1) of offspring. Methods: Female rats that mated successfully were randomly classified into four groups: Group 1, the normal control group; Group 2, the IG group, in which utrogestan was administered via intragastric gavage; Group 3, the IM group, in which P4 was administered via intramuscular injection; and Group 4, the VAGIN group, in which P4 sustained-release vaginal gel was administered through the vagina. Except for the control group, P4 was administered in other groups through their respective routes for 13 consecutive days daily during the teratogenic-sensitive gestation period (days 6–18). The fertility outcomes of the maternal rats were observed, and open-field and three-chamber social preference tests were conducted to assess anxiety and social behavior, along with an exhaustive swimming experiment to evaluate the motor endurance of the offspring. Plasma P4 and pregnenolone levels in the offspring were measured, and fecal samples were assessed using gut microbiota sequencing and subsequent bioinformatics analysis. Results: No significant alterations in fertility outcomes were observed through three P4 administration routes—intragastric gavage, intramuscular injection, and vaginal administration—in rats. However, in behavioral experiments in offspring, a significant increase was observed in swimming time in the IG group than in the control group (P = 0.013). Furthermore, the offspring in the IG group exhibited a marked decrease in non-social behaviors compared with the control group (P = 0.030). No significant behavioral changes were observed in the F1 offspring in the open-field test. Additionally, the offspring in the IG group exhibited a significant elevation in plasma pregnenolone levels compared with the control group (P = 0.019) 30 days after birth. No notable differences in the α-diversity of gut microbiota were observed among the groups. However, significant differences in β-diversity were observed in both the IG and IM groups compared with the control group, indicating that P4 treatment via the two routes exhibited a significant impact on the gut microbiota composition of F1 offspring. Distinct differences were observed in the gut microbiota of the offspring among the three P4 treatment groups, with 22, 28, and 33 differential bacterial taxa identified in the IG, IM, and VAGIN groups, respectively, using linear discriminant effect size analysis, whereas Olivella appeared exclusively in the control group rather than in the P4 treatment groups. Conclusion: Oral administration of P4 to maternal rats during the teratogenesis-sensitive period enhanced motor endurance and plasma pregnenolone levels and altered the composition of the gut microbiota in the offspring. Our findings demonstrated different effects on offspring growth when P4 is administered orally, intramuscularly, or vaginally.

UNNIGSA: A Unified Neural Network Approach for Enhanced Stutter Detection and Gait Recognition Analysis

Stuttering, also known as stammering, is a speech disorder characterized by involuntary disruptions or disfluencies in a person's flow of speech. These disfluencies may include repetitions of sounds, syllables, or words; prolongations of sounds; and interruptions in speech known as blocks. This paper introduces Unified Neural Network for Integrated Gait and Speech Analysis (UNNIGSA), methodology that synergizes stutter detection (SD) and gait recognition through a unified neural network architecture. UNNIGSA is engineered to address two distinct yet interrelated challenges: the accurate detection of stuttering for enhanced beneficial interventions and the precise identification of individuals based on gait analysis. The system integrates a global attention mechanism to meticulously highlight salient features within speech patterns, thereby improving the accuracy of stutter classification and offering a potential leap forward in speech therapy practices. Additionally, UNNIGSA incorporates novel data processing techniques to manage the class imbalance prevalent in stuttering speech datasets, resulting in significantly enhanced performance over existing models. The methodology also extends the functionality of automatic speech recognition (ASR) systems, fostering greater inclusivity for individuals with speech disorders and enabling their more seamless interaction with virtual assistant technologies. Overall, UNNIGSA sets a new standard in the domains of speech disorder treatment and biometric identification, offering innovative solutions to long-standing challenges and paving the way for more inclusive and secure applications.

Mapping cognitive activity from electrocorticography field potentials in humans performing NBack task

Objective. Advancements in data science and assistive technologies have made invasive brain-computer interfaces (iBCIs) increasingly viable for enhancing the quality of life in physically disabled individuals. Intracortical microelectrode implants are a common choice for such a communication system due to their fine temporal and spatial resolution. The small size of these implants makes the implantation plan critical for the successful exfiltration of information, particularly when targeting representations of task goals that lack robust anatomical correlates. Approach. Working memory processes including encoding, retrieval, and maintenance are observed in many areas of the brain. Using human electrocorticography (ECoG) recordings during a working memory experiment, we provide proof that it is possible to localize cognitive activity associated with the task and to identify key locations involved with executive memory functions. Results. From the analysis, we could propose an optimal iBCI implant location with the desired features. The general approach is not limited to working memory but could also be used to map other goal-encoding factors such as movement intentions, decision-making, and visual-spatial attention. Significance. Deciphering the intended action of a BCI user is a complex challenge that involves the extraction and integration of cognitive factors such as movement planning, working memory, visual-spatial attention, and the decision state. Examining field potentials from ECoG electrodes while participants engaged in tailored cognitive tasks can pinpoint location with valuable information related to anticipated actions. This manuscript demonstrates the feasibility of identifying electrodes involved in cognitive activity related to working memory during user engagement in the NBack task. Devoting time in meticulous preparation to identify the optimal brain regions for BCI implant locations will increase the likelihood of rich signal outcomes, thereby improving the overall BCI user experience.

Recent Advances in Robotic Surgery for Urologic Tumors.

This review discusses recent advances in robotic surgery for urologic tumors, focusing on three key areas: robotic systems, assistive technologies, and artificial intelligence. The Da Vinci SP system has enhanced the minimally invasive nature of robotic surgeries, while the Senhance system offers advantages such as tactile feedback and eye-tracking capabilities. Technologies like 3D reconstruction combined with augmented reality and fluorescence imaging aid surgeons in precisely identifying the anatomical relationships between tumors and surrounding structures, improving surgical efficiency and outcomes. Additionally, the development of artificial intelligence lays the groundwork for automated robotics. As these technologies continue to evolve, we are entering an era of minimally invasive, precise, and intelligent robotic surgery.

Modern aspects of preimplantation genetic testing of embryos in assisted reproductive technology programs (literature review)

Background. The success of assisted reproductive technologies depends on many factors, the main ones being the quality and genetic status of the embryo and endometrial receptivity. Preimplantation genetic testing is a tool that aims to reduce the risk of selecting an aneuploid embryo for transfer. Disputes surrounding the use of preimplantation genetic testing are conducted in the context of older patients, with recurrent miscarriage, with genetic karyotype abnormalities in a married couple, as well as multiple unsuccessful attempts at ART in the anamnesis.Purpose of review. To summarize and analyze the available data on current trends in the use of preimplantation genetic testing (PGT-A).Materials and methods. The review includes published data over the past 10 years regarding the effectiveness of ART programs and pregnancy outcomes after the use of preimplantation genetic testing. The literature search was conducted in Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley and Cochrane Library databases.Results. According to most authors, preimplantation genetic testing does not improve live birth rates per patient in the general population, but it does improve live birth rates when performing PGT-A on blastocyst-stage embryos in women over 35 years of age, as well as in women with a history of pregnancy loss to reduce risk miscarriage of a subsequent pregnancy.Conclusion. Preimplantation genetic testing is a valid method for assessing euploidy and mosaicism of an embryo before transfer. The feasibility of use, according to research results, is more related to conditions in which the risk of embryonic aneuploidy may increase, and is justified in high-risk patients, while the use of this technique in patients with a good prognosis is still questionable. First, trophectoderm biopsies may not reflect the ploidy of the inner cell mass. Secondly, even if we assume that this is the case, we cannot be sure that the embryonic cell line will not self-correct. In other words, once a diagnosis of PGT-A is received suggesting mosaicism or aneuploidy, the likelihood of a false-positive diagnosis is high.

Patterns of KIR-genotypes in women with preimplantation losses after assisted reproductive technologies

Aim. To analyze the frequency and distribution of KIR genotypes in women with repeated preimplantation losses during ARTs compared to women with control group. Methods. DNA isolation from leukocytes by the salting method, PCR-SSP, agarose gel electrophoresis; methods of statistical analysis. Results. The molecular genetic determination of KIR genes in the group of women with recurrent implantation failures and in the control group of women was performed. The frequency and distribution of KIR genotypes in the study groups were determined. In women with RIF, a slightly shifted distribution of the frequency of KIR genotypes was found, towards the homozygous genotype by haplotype "A", the frequency of which was almost half of all identified genotypes (42.86 %). The distribution and frequency of KIR genotypes in the control group was normal and described by the Hardy-Weinberg principle. A comparative analysis of the study groups using statistical methods showed a significantly higher frequency of the KIR-AA genotype (χ2=8.875; p<0.005) in the group of women with RIF compared to the control group of women. The calculation of the odds ratio indicates a 2-fold increase of risk for recurrent implantation failures after ARTs (OR=1.94; CI 95 %: 1.25–3.00) in women with the KIR-AA genotype. Conclusions. We regard the KIR-AA genotype as a significant risk factor for preimplantation loss. KIR genotyping is considered an important molecular genetic test for determining the risk of fetal rejection by the maternal immune system, which will help to correctly direct treatment interventions to keep the pregnancy alive.

Main stream and scientific innovations in the field of obstetric services in the Ural Federal District

The article provides analytical data on the results of the obstetrics and childhood service of the Ural Federal District in 2023, analyzes the key indicators of the service over the past five years and provides directions for optimizing the work of the service. In the sphere of implementation of national projects “Healthcare” and “Demography”, applied scientific research and development of the “Ural Research Institute of Maternity and Child Care” of the Russian Ministry of Health makes a significant contribution to the development of medicine by improving methods of prediction, diagnosis, treatment and prevention of perinatal pathology, development of assisted reproductive technologies, which will improve the work of obstetrics and childhood services.

Effects of Two Types of Estrogen on the Follicular Wave for in Vivo Oocyte Collection in Brown Swiss Cows

The manipulation of follicular waves through hormonal treatments, such as estrogen administration, plays a crucial role in optimizing in-vivo oocyte collection for assisted reproductive technologies. The present study aimed to evaluate the effect of two specific types of estrogen on follicular wave dynamics and their impact on in-vivo oocyte collection in Brown Swiss cows. Fourteen cows, in their first lactation, weighing approximately 340 kg were randomly assigned to one of two treatments including T1 (estradiol cypionate) and T2 (estradiol benzoate). Both treatments were administered at 1.2 mg of estrogen, at day 0 of the experiment. All Brown Swiss cows were provided with a diet entirely consisting of alfalfa grazing. On day 7, follicular wave dynamics were assessed using a DP-50 vet ultrasound device equipped with a 7.5 MHz transducer for transvaginal follicular aspiration guidance. Follicle counts were categorized into three size ranges including 2-4 mm (small), 4-8 mm (medium), and greater than 8 mm (large). Additionally, the quantity and quality (viable oocytes) of the collected oocytes were evaluated by the Ovum Pick Up (OPU) team for oocyte viability on day 7. The study assessed the follicular dynamics (number of follicles) and efficiency of oocyte collection (viable oocytes) in cows treated with Estradiol Cypionate (T1) and Estradiol Benzoate (T2). The average number of small, medium-sized, and large follicles size were 6.048 ± 6.037, 3.16 ± 2.01, and 0.53 ± 0.67 respectively. The total number of follicles was 9.59 ± 3.56. The mean number of viable oocytes recovered was 3.024 ± 1.66, while the mean number of non-viable oocytes was 1.47 ± 1.01. The results indicated no significant differences between treatments in the size of small, medium, and large follicles, nor in the total number of follicles and viable oocytes recovered. However, a significant difference was observed in the number of non-viable oocytes recovered, with a higher mean in T2 (1.86) compared to T1 (1.09). The results indicated an adequate follicular response and viable oocyte recovery in both treatment groups (estradiol cypionate and estradiol benzoate). However, variations in oocyte viability were observed, with estradiol cypionate showing a slight advantage.

Social Economic Barriers to Information Communication Technology (ICT) Access for Persons with Disabilities in Africa: Literature Review

The 2006 United Nations Convention on the Rights of Persons with Disabilities, (PWDs) enacted in May 2008, has been instrumental in championing the rights of people with disabilities. A significant aspect of the Convention is information communication technology (ICT) accessibility. Article 9 specifically calls for signatories to “promote access for persons with disabilities to new ICTs and systems, including the Internet” and to “promote the design, development, production, and supply of available ICTs and systems at a premature stage, so that these technologies and systems become accessible at an affordable price. ICT access is important for social economic incorporation of (PWDs) in Africa, with computer technology and the Internet significantly enhancing their independence. A report from the High-Level Meeting on Disability and Development at the United Nations in September 2013 underscores the importance of ICTs for the inclusion of PWDs. While inaccessible ICT designs can create barriers, innovative technologies offer unprecedented support: text-to-speech technology enables millions to access digital versions of otherwise inaccessible print documents, and new tools like GPS, image recognition, near-field communications, and Internet connectivity provide solutions for independent living. However, several socioeconomic barriers impede access to these technologies, exacerbating existing inequalities and limiting participation in the digital age. This article explores the multifaceted challenges PWDs face in accessing ICT in Africa, emphasizing the intersections of disability with poverty, education, infrastructure, and policy. It investigates the financial constraints that make assistive technologies and Internet services unaffordable, the educational barriers affecting digital literacy among PWDs, and infrastructural challenges such as inadequate ICT facilities and the lack of accessibility features in existing technologies. The article also addresses policy and regulatory gaps that fail to prioritize the needs of PWDs in national ICT strategies. By identifying these barriers, the article advocates for inclusive policies and targeted interventions to enhance ICT accessibility for PWDs in Africa. The discussion is informed by a review of relevant literature and data from various African countries. Ultimately, the article highlights the necessity of implementing policies related to ICT access and a collaborative approach involving governments, the private sector, civil society, and international organizations to bridge the digital divide and promote the social and economic empowerment of PWDs

Reproductive outcomes in fresh transfer cycles and antagonists with premature luteinizing and/or progesterone surge: a single center retrospective cohort study.

The optimal outcome of assisted reproductive technology is a successful live birth after fresh embryo transfer. However, the success pregnancy rate of fresh embryo transfer cycle in antagonist protocol is lower than that observed in other protocols. Despite the use of antagonists (GnRH-ant), the incidence of luteinizing hormone surge and elevated progesterone levels remain at approximately 5%-38%. Progesterone is widely recognized to exert adverse effects on fresh embryo transfer outcomes. This study aimed to investigate the impact of luteinizing hormone surge and progesterone levels on live birth rate following fresh embryo transfer and explore appropriate progesterone thresholds to enhance pregnancy outcomes. This retrospective cohort study included a total of 1,177 antagonist protocol cycles with fresh embryo transfer. The patients were divided into four groups based on the presence of premature LH surge and progesterone level on trigger day>1.5ng/ml. Then, the relationship between the variables and the pregnancy outcome was analyzed and compared in each group. The transient rise of luteinizing hormone did not impact pregnancy outcomes (P=0.345; P=0.3; P=0.787), in contrast to progesterone levels on the day of hCG administration (P=0.047*; P=0.015*; P=0.021*). In cases with luteinizing hormone surge, elevated progesterone levels were correlated with higher antral follicle count (AFC), and as progesterone levels increased, a greater quantity of oocytes and embryos were obtained. However, there was no statistically significant difference in pregnancy outcomes. In cases without luteinizing hormone surge, elevated progesterone levels led to significantly poorer pregnancy outcomes. Furthermore, the curve-fitting and threshold-effect analysis revealed a notable decline in live birth rates when progesterone exceeded or equaled 1.10ng/ml (OR, 0.25; 95% CI, 0.09-0.66; P = 0.005*). The GnRH-ant dosage addition should be carefully selected in flexible antagonist protocols. The presence of elevated progesterone levels may be associated with improved embryo quality when luteinizing hormone surge occurred. In the absence of a luteinizing hormone surge, progesterone levels showed a larger impact on the pregnancy outcome, and fresh embryo transfer should not be performed if the progesterone level on the day of hCG administration is higher than 1.10ng/ml.

Parent, meaning who? Biotechnological revolution in human procreation and succession law in Poland

Recent developments in assisted reproductive technology (ART) – the use of third parties in the process of fertilization and pregnancy, and cryopreservation of human sperm, ova and human embryos – have contested many previously unchallenged paradigms related to parenthood. Currently, the thesis that a person is created by the physical consummation of two living parents of the opposite sex, is no longer as simple and clear cut. Undoubtedly, these changes affect social norms, including the legal systems of individual states which take divergent stances on the above-mentioned issues. For example, in their approach to filiation relations of a child born through ART and how his/her parents’ data are entered on the child’s birth certificate. Intensified migration movements of Poles to the USA and an increased number of cross-border (Polish and American) relationships have resulted in a growing frequency of foreign birth certificates appearing in Poland. Though incompatible with the Polish law, such certificates provide grounds for certain claims to be filed since vital records are documents of particular importance in every legal order, and in succession proceedings they are of fundamental value. Thus, a question arises as to the viewpoint of Polish law in regard to American birth certificates which do not comply with the rules in force in Poland regarding the filiation indicated therein. Can a child inherit by operation of law from people of the same sex indicated in his/her birth certificate issued abroad and can he/she inherit from all the parents named in such a certificate even if there are more than two of them? Does a child conceived several years after the death of his/her father, whose data feature on the American birth certificate, have a right to inherit from him in Poland? This article attempts to answer these questions.

Discovering the barriers to scaling a co-design approach for the provision of custom assistive technology within healthcare services

Introduction: Using computer-aided design and 3D printing within a co-design process to produce assistive technology (AT) has a positive impact in delivering customised solutions to end-users’ needs. However, to date its adoption within healthcare services has been limited. This work aims to gather clinicians’ insights to identify and analyse barriers inherent in the AT design, manufacturing, and provision processes and inform a detailed understanding of the current AT eco-system. It forms part of a long-term ambition to efficiently scale up a service for the co-design of custom AT across specialties and healthcare services. Methods: Five interactive workshops were run with 21 healthcare professionals currently involved in AT provision. Participants were recruited from two health boards in the UK. Thematic analysis was used to identify common barriers to scaling up a custom AT approach. Additionally, an eco-system map was created to determine the key stakeholders and their interactions. Results: Nineteen descriptive themes, grouped into four analytical themes, were identified related to the design of AT, access to AT, healthcare staffing and healthcare system pressures. The eco-system map identified sixteen individual stakeholders and ten different groups of significant corporate stakeholders. Discussion: The identified barriers relate to both the provision of off-the-shelf and the co-design of customised AT. Further promoting the scaling up of a co-design custom AT process requires: improving communication between stakeholders, enabling information about AT to be easily accessible, ensuring feedback is gathered and used, and creating tools that enable non-expert designers to modify custom AT designs safely and effectively.

Assistive technologies, including orthotic devices, for the management of contractures in adults after a stroke.

Contractures (reduced range of motion and increased stiffness of a joint) are a frequent complication of stroke. Contractures can interfere with function and cause cosmetic and hygiene problems. Preventing and managing contractures might improve rehabilitation and recovery after stroke. To assess the effects of assistive technologies for the management of contractures in adults after a stroke. We searched CENTRAL, MEDLINE, Embase, five other databases, and three trials registers in May 2022. We also searched for reference lists of relevant studies, contacted experts in the field, and ran forward citation searches. Randomised controlled studies (RCTs) that used electrical, mechanical, or electromechanical devices to manage contractures in adults with stroke were eligible for inclusion in this review. We planned to include studies that compared assistive technologies against no treatment, routine therapy, or another assistive technology. Three review authors (working in pairs) selected all studies, extracted data, and assessed risk of bias. The primary outcomes were passive joint range of motion (PROM) with and without standardised force, and indirect measures of PROM. The secondary outcomes included hygiene. We also wanted to evaluate the adverse effects of assistive technology. Effects were expressed as mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs). Seven studies fulfilled the inclusion criteria. Five of these were meta-analysed; they included 252 adults treated in acute and subacute rehabilitation settings. All studies compared assistive technology with routine therapy; one study also compared assistive technology with no treatment, but we were unable to obtain separate data for stroke participants. The assistive technologies used in the studies were electrical stimulation, splinting, positioning using a hinged board, and active repetitive motor training using a non-robotic device with electrical stimulation. Only one study applied stretching to end range. Treatment duration ranged from four to 12 weeks. The overall risk of bias was high for all studies. We are uncertain whether: • electrical stimulation to wrist extensors improves passive range of wrist extension (MD -7.30°, 95% CI -18.26° to 3.66°; 1 study, 81 participants; very low-certainty evidence); • a non-robotic device with electrical stimulation to shoulder flexors improves passive range of shoulder flexion (MD -9.00°, 95% CI -25.71° to 7.71°; 1 study; 50 participants; very low-certainty evidence); • assistive technology improves passive range of wrist extension with standardised force (SMD -0.05, 95% CI -0.39 to 0.29; four studies, 145 participants; very low-certainty evidence): • a non-robotic device with electrical stimulation to elbow extensors improves passive range of elbow extension (MD 0.41°, 95% CI -0.15° to 0.97°; 1 study, 50 participants; very low-certainty evidence). One study reported the adverse outcome of pain when using a hinged board to apply stretch to wrist and finger flexors, and another study reported skin breakdown when using a thumb splint. No studies reported hygiene or indirect measures of PROM. Only seven small RCTs met the eligibility criteria of this review, and all provided very low-certainty evidence. Consequently, we cannot draw firm conclusions on the effects of assistive technology compared with routine therapy or no therapy. It was also difficult to confirm whether there is a risk of harm associated with treatment using assistive technology. Future studies should apply adequate treatment intensity (i.e. magnitude and the duration of stretch) and use valid and reliable outcome measures. Such studies might better identify the role of assistive technology in the management of contractures in adults after a stroke.

How ‘Open’ is Distance Higher Education for Students with Disabilities? A Literature Review

This study attempts to answer the question of how "Open" Distance Higher Education is for Students with Disabilities (SwD) through a literature review. To this end, published books, journals, reports, and articles were examined using authoritative research sources such as Google Scholar, ResearchGate, and ERIC. In addition, laws related to Persons with Disabilities and education were also utilized. This paper is divided into four sections, where accessibility in Open and Distance Higher Education is analyzed in relation to SwD more broadly, concluding in the last section by discussing Open and Distance Higher Education and SwD in Greece. The existing literature and related research are very limited. The findings show that Distance Education offers significant opportunities for inclusive education, mainly due to the flexibility it provides. For students with mobility disabilities, Distance Higher Education offers the possibility of education without geographical limitations, especially when physical presence is impossible due to a lack of appropriate accessible building infrastructure. Furthermore, while multiform distance learning material can enhance accessibility, they can also pose barriers for SwD, as all tools and resources need to be accessible to everyone. Subtitles are an important accessibility tool, especially for deaf or hard of hearing learners. Additionally, examinations should be equally accessible to all learners, regardless of their disability. The distance learning material should be based on the principles of Universal Design for Learning. Also, assistive technologies and voice reading software play an important role, especially for visually impaired learners. Assistive technology and AI tools can help students depending on the type of disability. Under the current circumstances, the accessibility of SwD to Distance Higher Education, including in Greece, faces significant challenges. In conclusion, Distance Higher Education has the potential to support inclusive education, but it is necessary to implement appropriate accessibility standards and strategies.

Enhancing Quality of Life: the Impact of Assistive Technology on User Well-Being

Enhancing Quality of Life: the Impact of Assistive Technology on User Well-Being

Elucidating the Role of Sirtuin 3 in Mammalian Oocyte Aging.

The field of reproductive biology has made significant progress in recent years, identifying specific molecular players that influence oocyte development and function. Among them, sirtuin 3 (SIRT3) has attracted particular attention for its central role in mediating mitochondrial function and cellular stress responses in oocytes. So far, studies have demonstrated that the knockdown of SIRT3 leads to a decrease in blastocyst formation and an increase in oxidative stress within an embryo, underscoring the importance of SIRT3 in maintaining the cellular redox balance critical for embryonic survival and growth. Furthermore, the literature reveals specific signaling pathways, such as the SIRT3- Glycogen synthase kinase-3 beta (GSK3β) deacetylation pathway, crucial for mitigating oxidative stress-related anomalies in oocyte meiosis, particularly under conditions like maternal diabetes. Overall, the emerging role of SIRT3 in regulating oocyte mitochondrial function and development highlights the critical importance of understanding the intricate connections between cellular metabolism, stress response pathways, and overall reproductive health and function. This knowledge could lead to the development of novel strategies to support oocyte quality and fertility, with far-reaching implications for assisted reproductive technologies and women's healthcare. This commentary aims to provide an overview of the importance of SIRT3 in oocytes by synthesizing results from a multitude of studies. The aim is to elucidate the role of SIRT3 in oocyte development, maturation, and aging and to identify areas where further research is needed.