Devices For People Research Articles

Exploring the effects of a real-time cardiac telerehabilitation using wearable devices in people with coronary artery disease following a recent myocardial infarction: a randomised controlled trial

Abstract Background Exercise-based cardiac rehabilitation (CR) is a non-pharmacological multidisciplinary program for individuals after myocardial infarction (MI), that offers multiple health benefits. One of the greatest barriers to CR participation is the travelling distance to the rehabilitation centre. Remotely monitored CR appears to be at least as effective in improving cardiovascular risk factors and exercise capacity as traditional centre-based CR. Nevertheless, the efficacy of a remotely monitored CR in people with recent MI has yet to be examined. Purpose The aim of this randomised controlled trial was to assess the effects of a real-time cardiac telerehabilitation monitored by wearable devices in people with recent MI. Methods Thirty people (8 women, 22 men) with CAD following a recent (i.e., < 4 week) MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 26-week CR, thrice per week. All patients performed the baseline and 24 weeks follow up measurements where peak oxygen uptake (VO2peak), mean daily steps, distance and calories were assessed. Results The online group showed improved in mean daily steps (P<0.05) and mean daily distance (P<0.05) at 24 weeks compared to the gym-based group. The paired sample t-test showed that all the assessed variables were statistically (P<0.001) improved for both groups at 24 weeks. Pearson’s r demonstrated positive correlations between VO2peak and mean daily distance (r= .375), and negative correlations between VO2peak and muscle (r= -.523) and fat masses (r= -.460). There was no exercise-induced adverse events during the study. Conclusion Our findings might indicate that a real-time online supervised CR exercise programme using wearable technology to monitor the hemodynamic responses in CAD post MI patients is equally effective to a gym-based exercise programme.Individualized scanwatch report

Exploring the feasibility, acceptability, and safety of a real-time cardiac telerehabilitation and tele coaching programme using wearable devices in people with a recent myocardial infarction.

Cardiac rehabilitation (CR) constitutes the recommended nonpharmacological approach for cardiac patients with cardiovascular disease such as people following a recent (i.e., < 4 week) myocardial infarction (MI). Recent evidence suggests that cardiac telerehabilitation may be as effective as traditional (i.e., in person) CR in people following a recent MI. Nevertheless, the feasibility, acceptability, and safety of such an exercise programme has yet to be examined. Forty-four (11 women, 33 men) people following a recent MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 24-week CR programme thrice per week. All patients performed the baseline, and 24 weeks follow up measurements where feasibility, acceptability, and safety were assessed. Eligibility and recruitment rates were found to be 61.5% and 42%, respectively. Compliance to the thrice weekly, 24-week exercise programme for the online- and gym-based groups were 91.6% and 90.9%, respectively. There were no dropouts during the exercise programmes, however four participants, two from each group, were lost to follow up at 6 months. The average percentage of peak HR (% HRpeak) for the online group was 66.6% ± 4.5 and for the gym-based group was 67.2% ± 5. The average RPE and affect during exercise was for both groups 12 ± 1 ("somewhat hard") and 3 ± 1 ("good"), respectively. During the 6-month exercise intervention period for both groups, the exercise-induced symptoms were minimal to none. The user suitability evaluation questionnaire revealed that the online real time telerehabilitation and tele coaching programme was enjoyable (4.85 ± 0.37) and did not induce general discomfort (1.20 ± 0.41). Our cardiac telerehabilitation programme seems to be feasible, acceptable, safe, and enjoyable for people with a recent MI. Our participants had an overall positive experience and acceptability of the cardiac telerehabilitation and tele coaching using wearable devices. ClinicalTrial.gov, ID NCT06071273, 10/02/2023, retrospectively registered.

IoT Attacks Detection Using Supervised Machine Learning Techniques

In recent times, the growing significance of Internet of Things (IoT) devices in people's lives is undeniable, driven by their myriad benefits. However, these devices confront cybersecurity threats akin to traditional network devices, as they depend on networks for connectivity and synchronization. Artificial Intelligence (AI) techniques, specifically Machine Learning (ML) and Deep Learning (DL), have demonstrated notable reliability in the field of cyberattack detection. This study focuses on detecting Flood and Brute Force cyberattacks using Machine Learning (ML) and Deep Learning (DL) models. The primary emphasis lies in identifying traffic features that significantly detect these types of attacks. The experimental study incorporates eight models: Decision Tree (DT), K-Nearest Neighbor (KNN), Random Forest (RF), Support Vector Machines (SVM), Logistic Regression (LR), Gradient Boosting (GB), Naïve Bayes (NB), and Artificial Neural Network (ANN). Two sets of experiments were conducted, with the first set involving six features and the subsequent set, after feature selection, focusing on a reduced set of three features. The evaluation of the proposed model's efficiency and performance relied on metrics such as Accuracy, Precision, Recall, and F1-score. Remarkably, all proposed models exhibited high performance in both sets of experiments. However, the Gradient Boosting (GB) classifier suppressed others, attaining an impressive accuracy level of 95.94% and 95.28% in the sets with six features and three features, respectively. Doi: 10.28991/HIJ-2024-05-03-01 Full Text: PDF

User experience of passive hip flexion device in people with multiple sclerosis: Exploring improvements and overcoming barriers

User experience of passive hip flexion device in people with multiple sclerosis: Exploring improvements and overcoming barriers

Performance of a Novel Continuous Glucose Monitoring Device in People With Diabetes.

In this multicenter study, performance of a novel continuous glucose monitoring (CGM) system was evaluated. Adult participants with diabetes were included in the study. They each wore three sensors of the CGM system on the upper arms for up to 14 days. During four in-clinic visits, frequent comparison measurements with capillary blood glucose (BG) samples were performed. The primary endpoint was the 20/20 agreement rate (AR): the percentage of CGM readings within ±20 mg/dL (at BG values <100 mg/dL) or ±20% (at BG values ≥100 mg/dL) of the comparator. Further evaluations included mean absolute relative difference (MARD) and 20/20 AR in different BG ranges and across the wear time. Data from 48 participants and 139 sensors were analyzed. During in-clinic sessions the 20/20 AR was 90.5% and the MARD was 9.2%. For BG ranges <70, 70-180, and >180 mg/dL, 20/20 AR was 94.3%, 89.0%, and 92.5%, respectively. At the beginning, middle, and end of sensor wear time, 20/20 AR was 92.8%, 91.5%, and 85.9%, respectively. The 14-day survival probability was 82.4%. Pain and bleeding after sensor insertion were within the expected range. Based on the study outcome, the use of the device is regarded as safe. The system showed a good performance compared to capillary BG measurements. This level of accuracy could be shown over the entire measurement range, especially in the low glycemic range, and the whole wear time of the sensors. The results of this study are supporting a non-adjunctive use of the device.

Diabetes technology in people with diabetes and advanced chronic kidney disease.

Diabetes is the leading cause and a common comorbidity of advanced chronic kidney disease. Glycaemic management in this population is challenging and characterised by frequent excursions of hypoglycaemia and hyperglycaemia. Current glucose monitoring tools, such as HbA1c, fructosamine and glycated albumin, have biases in this population and provide information only on mean glucose exposure. Revolutionary developments in glucose sensing and insulin delivery technology have occurred in the last decade. Newer factory-calibrated continuous glucose monitors provide real-time glucose data, with predictive alarms, allowing improved assessment of glucose excursions and preventive measures, particularly during and between dialysis sessions. Furthermore, integration of continuous glucose monitors and their predictive alerts with automated insulin delivery systems enables insulin administration to be decreased or stopped proactively, leading to improved glycaemic management and diminishing glycaemic fluctuations. While awaiting regulatory approval, emerging studies, expert real-world experience and clinical guidelines support the use of diabetes technology devices in people with diabetes and advanced chronic kidney disease.

Continuous glucose monitoring devices in people over 65 years: literature review

The use of continuous glucose monitoring (CGM) in elderly patients with diabetes is not well documented. The present study search to know the current status of use of CGM devices in patients with diabetes over 65 years of age. A systematic literature search was performed in PubMed and Scopus databases in November 2023. The following descriptors were used, linked using the Boolean operators AND and OR: Diabetes, Continuous glucose monitoring, Flash glucose monitoring, Glycemia, Glycemic control, Controlled diabetes, Diabetes care, Metrics, Older and Elder. The CASPe critical reading system and the PRISMA methodology were applied to document the review. Fourteen selected studies published between 2019 and 2023 were reviewed. Publications from European countries used small sample sizes and were intervention studies. The duration of the interventions was generally short: 7 were ≤14 days in duration and only 3 were 6-12 months in duration. Overall, the selected articles found that CGM improved glycemic outcomes due to a decrease in glycosylated hemoglobin value and an improvement in CGM metrics, and diabetes-associated complications in elderly patients with diabetes. CGM seems to be a useful and effective tool to improving glycemic outcomes of people with diabetes over age 65. Further studies under real-world conditions and of longer duration are needed to expand and improve the evidence.

Functional performance of a vibrotactile sensory substitution device in people with profound vision loss.

This study has shown a vibrotactile sensory substitution device (SSD) prototype, VibroSight, has the potential to improve functional outcomes (i.e., obstacle avoidance, face detection) for people with profound vision loss, even with brief familiarization (<20 minutes). Mobility aids such as long canes are still the mainstay of support for most people with vision loss, but they do have limitations. Emerging technologies such as SSDs are gaining widespread interest in the low vision community. The aim of this project was to assess the efficacy of a prototype vibrotactile SSD for people with profound vision loss in the face detection and obstacle avoidance tasks. The VibroSight device was tested in a movement laboratory setting. The first task involved obstacle avoidance, in which participants were asked to walk through an obstacle course. The second was a face detection task, in which participants were asked to step toward the first face they detected. Exit interviews were also conducted to gather user experience data. Both people with low vision (n = 7) and orientation and mobility instructors (n = 4) completed the tasks. In obstacle avoidance task, participants were able to use the device to detect (p<0.001) and avoid (p<0.001) the obstacles within a significantly larger range, but were slower (p<0.001), when compared with without the device. In face detection task, participants demonstrated a great level of accuracy, precision, and sensitivity when using the device. Interviews revealed a positive user experience, although participants identified that they would require a lighter and compact design for real-world use. Overall, the results verified the functionality of vibrotactile SSD prototype. Further research is warranted to evaluate the user performance after an extended training program and to add new features, such as object recognition software algorithms, into the device.

Implementation research: a protocol for two three-arm pragmatic randomised controlled trials on continuous glucose monitoring devices in people with type 1 diabetes in South Africa and Kenya

BackgroundSelf-monitoring of glucose is an essential component of type 1 diabetes (T1D) management. In recent years, continuous glucose monitoring (CGM) has provided an alternative to daily fingerstick testing for the optimisation of insulin dosing and general glucose management in people with T1D. While studies have been conducted to evaluate the impact of CGM on clinical outcomes in the US, Europe and Australia, there are limited data available for low- and middle-income countries (LMICs) and further empirical evidence is needed to inform policy decision around their use in these countries.MethodsThis trial was designed as a pragmatic, parallel-group, open-label, multicentre, three-arm, randomised (1:1:1) controlled trial of continuous or periodic CGM device use versus standard of care in people with T1D in South Africa and Kenya. The primary objective of this trial will be to assess the impact of continuous or periodic CGM device use on glycaemic control as measured by change from baseline glycosylated haemoglobin (HbA1c). Additional assessments will include clinical outcomes (glucose variation, time in/below/above range), safety (adverse events, hospitalisations), quality of life (EQ-5D, T1D distress score, Glucose Monitoring Satisfaction Survey for T1D), and health economic measures (incremental cost-effectiveness ratios, quality adjusted life years).DiscussionThis trial aims to address the substantial evidence gap on the impact of CGM device use on clinical outcomes in LMICs, specifically South Africa and Kenya. The trial results will provide evidence to inform policy and treatment decisions in these countries.Trial registrationNCT05944731 (Kenya), July 6, 2023; NCT05944718 (South Africa), July 13, 2023.

Tecnologia assistiva e baixa visão: apps e recursos de acessibilidade em dispositivos móveis

Abstract Introduction Mobile electronic devices have assumed and/or complemented the place of optical, non-optical, electronic and computer resources in solving the functional alterations in people with low vision. Objective Considering the wide and continuous use of mobile electronic devices in people’s lives, this study aimed to characterize smartphone and/or tablets applications that assume the function of Assistive Technology (AT) resources and are used in the daily life of people with low vision. Method The methodology adopted in this investigation was descriptive in nature, under the case study design. Twenty-eight people with low vision participated in the study, who are members of an existing group in WhatsApp. The data collection took place in the virtual space of this application, individually, through semi-structured interviews. The data were transcribed and analyzed based on the founded theory. Results Participants reported using 50 applications that enabled the use of mobile devices as AT, and nine accessibility resources through which users access to mobile devices were guaranteed. Conclusion It was possible to identify the potential of these applications in solving difficulties faced by people with low vision, as well as portraying how this population has benefited from new possibilities in AT and information and communication technologies in navigation activities, consumption of food and purchases, execution of household, recreation and socialization, contrast, communication, labor and academic tasks.

The Path Towards Virtualized Wireless Communications: A Survey and Research Challenges

To keep up with the increasing number of connected devices in people’s daily lives, it is necessary to develop intelligent mechanisms that perform the entire network management, interconnecting Wi-Fi, and the emerging beyond Fifth-Generation (5G) communications. Hence, it is essential to consider multiple usage scenarios, while managing end devices’ limitations. As a result, developing a system that allows network operators to link Wi-Fi services on their main networks becomes a critical issue. These include a new paradigm that tackles optimal and dynamic resource allocation techniques. Thus, to consider in a combined way, the applications requirements, the resources available, and the different tiers involved, mechanisms such as virtualization and slicing have emerged to handle the heterogeneous context of the next-generation wireless communications. Moreover, the allocation of Radio Access Network (RAN) resources needs to be addressed. For this purpose, Open-RAN has in mind an open environment, which relies on virtualized functions and is mostly vendor agnostic. This technology will enable high data rates while maintaining adequate Quality of Service (QoS) in wireless communications. This paper advances current literature, which mainly discusses these themes individually, by providing a comprehensive survey in Next Generation Wireless Communications, highlighting their integration with beyond 5G Communications. First, we introduce the Wi-Fi evolution and explain the main standards developed over the years. Second, we present the most recent Wi-Fi standards, Wi-Fi 6 and 7, compared with 5G and beyond. Lastly, we explain the concepts related to slicing, virtualization, RAN, Open-RAN and the open research challenges.

Exploration on the application of electronic information technology in signal processing based on big data

Abstract Mobile phones are the most commonly used electronic devices in people’s daily life. The image, voice, and other information in these devices need to be processed through signal transmission. The role of signal processing is to process the acquired information in a certain way to get the final result. In order to ensure that the whole processing program can work normally, it is necessary to implement good control to achieve the desired effect. However, with the continuous progress and development of science and technology, its requirements are becoming increasingly strict. The traditional signal processing method is unreliable, has poor real time, and has error-prone characteristics, which can no longer meet the accuracy requirements of current information acquisition equipment. Therefore, people begin to study more complex and precise information processing methods and apply these algorithms to various advanced electronic devices to achieve better results. From the perspective of big data, electronic information technology is generated and developed based on massive data processing. It not only has a strong storage function but also has strong computing power and a wide range of application scenarios. It has strong applicability in real life. In this article, the signal to be processed was divided into several wavelet components in different frequency ranges by empirical mode decomposition technology, and then the signal was denoised by combining three wavelet denoising methods to obtain noise data with good signal-to-noise ratio and high classification accuracy. Finally, the corresponding feature information was extracted according to the signal-receiving model to improve the system recognition rate. This article compared the traditional signal processing methods with the signal processing approaches from the perspective of electronic information technology. The results showed that the processing method had a high computing speed and could better solve the problem of detection performance degradation caused by interference. User satisfaction had also increased by 2.87%, which showed that signal processing based on big data and information processing technology had broad application prospects in communication systems. The core of open computer science is to build a unified, efficient, and scalable computing platform based on massive data processing and use signal processing and computer technology to manage and optimize the scheduling of information resources to better meet various business needs.

999-P: Cost-Effectiveness of MiniMed 780G Therapy Compared with Multiple Daily Injections (MDI) with Intermittently Scanned Continuous Glucose Monitoring (isCGM) in People with Type 1 Diabetes (T1D)—A United States Perspective

Objective: A simulation study assessed cost-effectiveness of the MiniMed 780G (MM780G) system compared to MDI paired with isCGM devices in people with T1D. Methods: The IQVIA Core Diabetes Model was used to estimate complications, costs, and quality of life over patients’ lifetimes. Demographic and clinical characteristics were sourced from a 6-month randomized controlled trial (ClinicalTrials.gov, NCT04235504). The cohort had a mean±SD age of 41.5±11.6 years, was 46% male, and had an A1C of 9.0%±0.97% at baseline. The MM780G reduced A1C by 1.5±0.7% after 6 months, compared to a 0.2±0.8% reduction by MDI + isCGM. Rates of hypoglycemia and diabetic ketoacidosis were taken from the literature for the MDI + isCGM group and were assumed to be 50% lower in MM780G patients. Probabilistic sensitivity and scenario analyses were conducted to assess the impact of parameter uncertainty and model assumptions. Results: Results from the base case indicate that MM780G was associated with increased quality-adjusted life expectancy (QALE) compared to MDI + isCGM (10.75±0.14 years for MM780G vs. 9.61±0.12 for MDI + isCGM), as well as increased costs ($544,509 ± $17,464 for MM780G vs. $438,551 ± $16,307 for MDI + isCGM). The incremental cost-effectiveness ratio (ICER) in the base case was $93,595 per QALE. The probabilistic sensitivity analysis indicates a 96.6% probability that MM780G is cost-effective compared to MDI + isCGM in T1D at a willingness-to-pay (WTP) threshold of $150,000 per QALE. The scenario, assuming a 25% treatment effect for hypoglycemia and diabetic ketoacidosis, found that MM780G was associated with an ICER of $128,990 per QALE, and a 70.5% probability of cost-effectiveness compared to MDI + isCGM at a WTP threshold of $150,000. Conclusions: At a WTP threshold of $150,000, MM780G is cost-effective in T1D compared to MDI + isCGM. Disclosure M.Kommareddi: Employee; Medtronic. K.Wherry: Employee; Medtronic, Stock/Shareholder; Medtronic.

Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose and intermittently scanned continuous glucose monitoring in people with type 1 diabetes receiving multiple daily insulin injections in Denmark.

To determine the cost-effectiveness of the Dexcom G6 real-time continuous glucose monitoring (rt-CGM) system compared with both the self-monitoring of blood glucose (SMBG) and the Abbott FreeStyle Libre 1 and 2 intermittently scanned CGM (is-CGM) devices in people with type 1 diabetes receiving multiple daily insulin injections in Denmark. The analysis was performed using the IQVIA Core Diabetes Model, which associates rt-CGM use with glycated haemoglobin reductions of 0.6% and 0.36% based on data from the DIAMOND and ALERTT1 trials, respectively, compared with SMBG and is-CGM use. The analysis was performed from the payer perspective over a 50-year time horizon; future costs and clinical outcomes were discounted at 4% per annum. The use of rt-CGM was associated with an incremental gain of 1.37 quality-adjusted life years (QALYs) versus SMBG. Total mean lifetime costs were Danish Krone (DKK) 894 535 for rt-CGM and DKK 823 474 for SMBG, resulting in an incremental cost-utility ratio of DKK 51 918 per QALY gained versus SMBG. Compared with is-CGM, the use of rt-CGM led to a gain of 0.87 QALYs and higher mean lifetime costs resulting in an incremental cost-utility ratio of DKK 40 879 to DKK 34 367 per QALY gained. In Denmark, the rt-CGM was projected to be highly cost-effective versus both SMBG and is-CGM, based on a willingness-to-pay threshold of 1× per capita gross domestic product per QALY gained. These findings may help inform future policies to address regional disparities in access to rt-CGM.

EPS6.05 A phase 3b study of the effects of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) on cough and physical activity in people with cystic fibrosis (CF)

Objectives: We assessed the impact of ELX/TEZ/IVA treatment on cough frequency and physical activity using wearable devices in people with CF.

Service Selection Using an Ensemble Meta-Learning Classifier for Students with Disabilities

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.

Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke.

Sensor-based devices can record pressure or force over time during grasping and therefore offer a more comprehensive approach to quantifying grip strength during sustained contractions. The objectives of this study were to investigate the reliability and concurrent validity of measures of maximal tactile pressures and forces during a sustained grasp task using a TactArray device in people with stroke. Participants with stroke (n = 11) performed three trials of sustained maximal grasp over 8 s. Both hands were tested in within- and between-day sessions, with and without vision. Measures of maximal tactile pressures and forces were measured for the complete (8 s) grasp duration and plateau phase (5 s). Tactile measures are reported using the highest value among three trials, the mean of two trials, and the mean of three trials. Reliability was determined using changes in mean, coefficients of variation, and intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used to evaluate concurrent validity. This study found that measures of reliability assessed by changes in means were good, coefficients of variation were good to acceptable, and ICCs were very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s in the affected hand with and without vision for within-day sessions and without vision for between-day sessions. In the less affected hand, changes in mean were very good, coefficients of variations were acceptable, and ICCs were good to very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s and 5 s, respectively, in between-day sessions with and without vision. Maximal tactile pressures had moderate correlations with grip strength. The TactArray device demonstrates satisfactory reliability and concurrent validity for measures of maximal tactile pressures in people with stroke.

Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke.

Hyper-resistance after a central nervous system injury has been largely referred to as spasticity, which is but one of its neural components. Assessment largely relies on clinical scales (Modified Ashworth scale - MAS and Modified Tardieu scale, MTS) which are unable to distinguish between the non-neural (tissue-related) and the neural (central nervous system-related) components. This study assessed criterion validity and reliability (reproducibility) of muscle stiffness measures, namely, maximum elastic stiffness (ELmax), viscous stiffness (VI), and path length (L-path) in the hand flexor muscles among people with stroke. Measurements were obtained with a wrist-electromechanical oscillatory device (w-EOD). Twenty-four people with arm impairment after stroke were evaluated with the w-EOD and clinical assessment (MAS and MTS), twice on the same day (short-term reliability) and once 10 days later (long-term reliability). For criterion validity, a Spearman coefficient ( r ) was calculated between stiffness values and the clinical scales. For reliability, intraclass correlation coefficients (ICCs), SEM, and MDC95 were calculated. Moderate correlations were observed between EL max and MAS ( r = 0.49) and MTS (V2, r = 0.43; V3, r = 0.49) of the wrist flexors, and finger flexors (MAS, r = 0.60; MTS V2, r = 0.56; MTS V3, r = 0.55). There was a poor correlation between the clinical scales and VI and L-path. Reliability was excellent for all stiffness measurements at short term (EL max : 0.95, VI: 0.94, L-path: 0.92) and good at long term (EL max : 0.87, VI: 0.76, L-path: 0.82). In conclusion, stiffness measurements are valid and reliable to evaluate hyper-resistance in people with stroke.

Perceived Usability of Tablet Crushers: Comparison of Devices by People with and without Limited Hand Functions

Tablet crushing is a common practice used by patients and their carers, mainly to facilitate swallowing. Various tablet-crushing devices with different designs are currently available on the market. This study aimed to compare the usability of different tablet-crushing devices in people with and without limited hand functions. The hand function of 100 adults recruited from the general community (40 of whom self-reported a limited hand function) was assessed using the hand and finger function subscale of the Arthritis Impact Measurement Scale version 2. The hand strength was measured using a dynamometer. Participants crushed tablets using 11 crushing devices and completed a Rapid Assessment of Product Usability and Universal Design questionnaire for each device. Hand-held twist-action crushers with an ergonomic grip received the highest usability scores among both groups, irrespective of the cost (p < 0.05). Crushers with bags were scored lower by those with limited hand functions, although the score improved if the device was automatic. Preferences regarding electronic crushers significantly changed once the cost was revealed. Economical twist-action crushers with ergonomic grips and without bags or cups were the most favoured crushers.

TOEIC의 간접 발화 영역에 반영된 폴라이트니스 고찰 : Brown &amp; Levinson의 체면 위협 행위와 Leech의 가치 거래 개념의 비교를 중심으로

Politeness is a linguistic strategy used to assign value to a hearer by mitigating the face-threatening acts that a speaker commits to the hearer or lowering the self value of the speaker. Using positive and negative politeness are significant strategies to alleviate face-threatening acts, but are not being applied universally throughout all languages. Maintaining the face of the hearer reflects the individualism and egalitarianism that is aligned with a Western view, so it can be challenging to apply that view to some Eastern languages possessing honorific expressions. This is because communication functions not only to exchange information between individuals, but also serves the important role of complying with the order and the roles assigned to each individual in a society. Therefore, certain utterances may be decoded differently according to one's cultural background, or to the extent to which they may offend the hearer. Politeness as a value transaction overcomes the limits of the concept of politeness of face. The most coherent answer to questions in TOEIC's indirect utterance type is not approached from the viewpoint of the speaker-listener's face-threatening level, but from the view of the value of the requested information. Although the correct answer does not seem to consider the speaker’s face, it plays a sufficient role if minimum value to the required information in each question is provided. In this way, politeness can be recognized as a useful device for people from different cultural backgrounds beyond only the problem of courtesy.