High User Research Articles

Accuracy of full-guided versus half-guided implant procedures carried out with digital implant planning software by students as part of a university curriculum.

This in vitro study investigated whether full-guided (FG) or half-guided (HG) implant placement is more suitable for beginners and to what extent the use of the coDiagnostiX (CDX) (10.5, Straumann Group, Basel, Switzerland) implant planning software proves useful in teaching. Twenty students planned implant positions with CDX which were then placed in a model using printed drill templates in the sense of FG implantation (group 1) and HG implantation (group 2). The implant positions could be compared with those of the reference model, and deviations could be determined. The results were tested for significance using the t-test for independent samples for groups 1 and 2. A total of 32 students subsequently completed a questionnaire about the software. Cronbach's α was also calculated to check the reliability of the questions for the individual subject areas. In both groups the greatest deviation occurred along the y-axis in the vestibular direction. It measured 1.390mm in group 1 and 1.570mm in group 2. Comparing both groups, there were significant deviations along the y-axis (p = .013), along the z-axis (p = .049), and in the total deviation (p = .031). The questionnaire was evaluated in design, with 95% positive answers. In contrast, the evaluation of the area of time and effort resulted in only 55% positive responses. Overall, experience with the software was rated as positive by 74%. Group 1 achieved more accurate results, especially along the y-axis in the vestibular direction. In both groups, the implants were placed too deep. The questionnaire indicated a software with high usability and is therefore very suitable for teaching. If clinically feasible, beginners should prefer full-guided implant placement.

Implementation of a Technology-Based Mobile Obstetric Referral Emergency System (MORES): Qualitative Assessment of Health Workers in Rural Liberia.

Maternal mortality remains a persistent challenge in low- and middle-income countries, where evidence-based interventions of obstetric triage and prehospital communication remain sparse. There is limited implementation evidence for technology-based approaches to improve obstetric care in such contexts. Liberia struggles with maternal mortality, particularly in rural areas where deaths are attributable to delays from absent triage and interfacility communication. We implemented a Mobile Obstetric Referral Emergency System (MORES) in rural Bong County to improve prehospital transfer, health worker attentiveness, and patient care for critical obstetric patients. MORES consisted of triage training and a 2-way, templated WhatsApp communication system to reduce delays among patients transferred from rural health facilities (RHF) to hospitals. This study aimed to examine MORES implementation outcomes of usability, fidelity, effectiveness, sustainability, and scalability, as well as additional impacts on the wider health system. A structured case study design interview was developed by Liberian and US experts in obstetric triage. Participants included 62 frontline obstetric health providers including midwives (38/62, 61%), nurses (20/62, 32%), physicians assistants (3/62, 5%), and physicians (1/62, 2%) from 19 RHFs and 2 district hospitals who had used MORES for 1 year. Individual interviews were conducted on MORES implementation outcomes, transcribed, and analyzed in NVivo (version 12; Lumivero) with a team-based coding methodology. Content analysis with a deductive approach examined implementation outcomes of usability, fidelity, effectiveness, sustainability, and scalability, while an inductive approach categorized the unanticipated impacts of MORES on the wider health system. Four domains were identified regarding MORES implementation: Usability and Fidelity, Effectiveness, Sustainability and Scalability, and Health System Impact. All participants perceived MORES to have high usability and fidelity, as the triage and messaging system was implemented as intended for critical obstetric patients (62/62, 100%). For effectiveness, MORES accomplished its intended aims by improving prehospital transfer (57/62, 92%), increasing health worker attentiveness (39/62, 63%), and contributing to improved patient care (34/62, 55%). MORES was perceived as sustainable and scalable (62/62, 100%), particularly if technological barriers (21/62, 34%) and staff training (19/62, 31%) were addressed. MORES impacted the wider health system in unanticipated ways including improved coordination and accountability (55/62, 89%), feedback mechanisms for hospitals and RHFs (48/62, 77%), interprofessional teamwork (21/62, 34%), longitudinal follow-up care (20/62, 32%), creating a record of care delays (17/62, 27%), and electronic health record infrastructure (13/62, 21%). MORES was perceived to have high usability, fidelity, effectiveness, sustainability, and scalability by frontline obstetric providers in rural Liberia. MORES accomplished the intended aims of improving prehospital transfer, increasing health worker attentiveness, and contributing to improved patient care. Additionally, MORES strengthened the health system through 6 domains which impacted individual and system levels. Future studies should quantitatively evaluate delay and morbidity reductions and strategies for scaling MORES.

Evaluating the Usability of a Remote Ischemic Conditioning Device for Pre-Hospital Stroke Management: Insights from Paramedic Simulations

Background/Objectives: In acute stroke, often-prolonged hospital transport times present an opportunity for early interventions to salvage brain tissue. Remote ischemic conditioning (RIC), where brief cycles of ischemia–reperfusion in a limb are induced to protect the brain, is a promising treatment for this setting. We assessed the usability of a novel RIC system in a simulated emergency response scenario. Methods: Paramedics were asked to use the RIC device in an emergency stroke care and ambulance transport simulation, overseen by a confederate. Feedback on device use was collected through questionnaires, including the System Usability Scale (SUS) and the NASA Task Load Index (NASA-TLX), and a semi-structured interview. Questionnaire responses were summarized using descriptive statistics; interview transcripts were analyzed thematically. Results: Nine paramedics (including the confederate) participated, with a mean of 10.0 ± 10.3 years of professional experience. Questionnaire responses indicated high device usability (mean SUS score: 85.3 ± 12.9 out of 100) and low task-related demands, effort, and frustration (mean NASA-TLX domain scores: ≤3.9 out of 20). Seven paramedics stated they would use the device in daily practice. They expressed concerns related to display screen clarity, interference with standard procedures, cable management, device fragility, and patient discomfort. Suggested improvements included adding indicators of device performance and refining the cuff design. Conclusions: While the device was considered easy to use, paramedics also identified important areas of improvement. With a small, localized study sample, our findings are primarily applicable to the refinement of the RICovery system for use in future clinical trials in the same healthcare setting. However, feedback on the importance of mitigating potential interference of newly introduced procedures with those already established, robustness of equipment, and effective paramedic–patient communication may also help inform the design of other pre-hospital interventions.

Barriers, Facilitators, and Requirements for a Telerehabilitation Aftercare Program for Patients After Occupational Injuries: Semistructured Interviews With Key Stakeholders.

Patients with occupational injuries often receive multidisciplinary rehabilitation for a rapid return to work. Rehabilitation aftercare programs give patients the opportunity to help patients apply the progress they have made during the rehabilitation to their everyday activities. Telerehabilitation aftercare programs can help reduce barriers, such as lack of time due to other commitments, because they can be used regardless of time or location. Careful identification of barriers, facilitators, and design requirements with key stakeholders is a critical step in developing a telerehabilitation aftercare program. This study aims to identify barriers, facilitators, and design requirements for a future telerehabilitation aftercare program for patients with occupational injuries from the perspective of the key stakeholders. We used a literature review and expert recommendations to identify key stakeholders. We conducted semistructured interviews in person and via real-time video calls with 27 key stakeholders to collect data. Interviews were transcribed verbatim, and thematic analysis was applied. We selected key stakeholder statements about facilitators and barriers and categorized them as individual, technical, environmental, and organizational facilitators and barriers. We identified expressions that captured aspects that the telerehabilitation aftercare program should fulfill and clustered them into attributes and overarching values. We translated the attributes into one or more requirements and grouped them into content, functional, service, user experience, and work context requirements. The key stakeholders identified can be grouped into the following categories: patients, health care professionals, administrative personnel, and members of the telerehabilitation program design and development team. The most frequently reported facilitators of a future telerehabilitation aftercare program were time savings for patients, high motivation of the patients to participate in telerehabilitation aftercare program, high usability of the program, and regular in-person therapy meetings during the telerehabilitation aftercare program. The most frequently reported barriers were low digital affinity and skills of the patients and personnel, patients' lack of trust and acceptance of the telerehabilitation aftercare program, slow internet speed, program functionality problems (eg, application crashes or freezes), and inability of telerehabilitation to deliver certain elements of in-person rehabilitation aftercare such as monitoring exercise performance. In our study, the most common design requirements were reducing barriers and implementing facilitators. The 2 most frequently discussed overarching values were tailoring of telerehabilitation, such as a tailored exercise plan and tailored injury-related information, and social interaction, such as real-time psychotherapy and digital and in-person rehabilitation aftercare in a blended care approach. Key stakeholders reported on facilitators, barriers, and design requirements that should be considered throughout the development process. Tailoring telerehabilitation content was the key value for stakeholders to ensure the program could meet the needs of patients with different types of occupational injuries.

Bridging the Gap: Virtual Reality as a Tool for De-Escalation Training in Disability Support Settings

Managing complex behaviors in disability support settings requires competent de-escalation skills. However, the current training methods often lack sufficient opportunities for realistic practice. This study details a three-stage development and evaluation of a virtual reality (VR) application for disability support staff to safely build de-escalation skills through simulated interactions. The first phase involved creating VR prototype scenarios depicting escalations with adolescent clients. Next, 12 disability support experts conducted content validation by refining the scenarios to confirm appropriateness and realism. Finally, a pilot study tested the tool’s usability and examined the initial construct validity in 20 participants. The prototype achieved high usability ratings (average 81.0 (SD 10.7) on the System Usability Scale). Additionally, a positive correlation between VR performance and empathy levels, as measured using the Toronto Empathy Questionnaire, was found (Pearson’s r = 0.487, p = 0.035). The promising results highlight the VR application’s potential as a transformative training tool. Future research should expand scenario diversity and compare VR with traditional methods to establish its efficacy in diverse settings and offer a path to enhance staff and student capabilities in challenging environments.

Dynamic fuzzy comprehensive evaluation of wet friction components performance degradation based on G1-CRITIC

High power density wet friction components are crucial in heavy equipment transmission systems, directly influencing equipment reliability. This paper proposes a fuzzy comprehensive evaluation method with combined weighting, which dynamically divides the performance degradation of wet friction components into three stages. It constructs a multi-indicator, multi-level evaluation system, in which the performance degradation data is obtained from the wet clutch accelerated life test. Additionally, we utilize the combined weighting method to dynamically allocate weights for evaluation indicators at different stages and introduce the trapezoidal distribution membership function. The accuracy of the fuzzy comprehensive evaluation model is then verified by using two prediction models as a comparison method. The results indicate that the model achieves an average relative error of 14.79% and a correlation coefficient R2 of 0.9580, indicating higher usability and accuracy than the prediction models. Furthermore, the evaluation indicator weights are more sensitive to pressure variations.

The Trail Making Test in Virtual Reality (TMT-VR): The Effects of Interaction Modes and Gaming Skills on Cognitive Performance of Young Adults

Virtual Reality (VR) is increasingly used in neuropsychological assessments due to its ability to simulate real-world environments. This study aimed to develop and evaluate the Trail Making Test in VR (TMT-VR) and investigate the effects of different interaction modes and gaming skills on cognitive performance. A total of 71 young female and male adults (aged 18–35) with high and low gaming skills participated in this study. Participants completed the TMT-VR using three interaction modes as follows: eye-tracking, head movement, and controller. Performance metrics included task completion time and accuracy. User experience, usability, and acceptability of TMT-VR were also examined. Results showed that both eye tracking and head movement modes significantly outperformed the controller in terms of task completion time and accuracy. No significant differences were found between eye tracking and head movement modes. Gaming skills did not significantly influence task performance using any interaction mode. The TMT-VR demonstrates high usability, acceptability, and user experience among participants. The findings suggest that VR-based assessments can effectively measure cognitive performance without being influenced by prior gaming skills, indicating potential applicability for diverse populations.

De-Med—a tool to identify and classify potentially inappropriate medication according to Beers criteria, STOPP, and FORTA: a cross-sectional study

Abstract Objective A significant number of older adults are affected by the use of potentially inappropriate medications (PIMs), leading to various adverse outcomes, such as increased physical and cognitive impairment, frailty, hospitalization, and mortality. The objective of this study was to develop and test the reliability and feasibility of the De-Med tool. Methods This tool was developed using ReactJS for data extraction and manipulation. Users can upload drug lists for analysis, and the software delineates PIMs adhering to the Beers 2019 version, Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) Version 2, and Fit fOR The Aged (FORTA) 2021 criteria. Reliability was assessed by juxtaposing software-generated outputs with manual assessments conducted by independent research pharmacists using retrospective medication records. The System Usability Scale (SUS) and AttrakDiff Mini questionnaires were used to assess feasibility and usability, respectively. Key findings Manual and software-generated PIM identifications agreed completely, demonstrating high reliability (100% concordance). A total of 1496 PIMs were identified from 231 records, with an average of 0.63 encounters per patient. The overall usability score was 83.75, indicating “Excellent.” According to the AttrakDiff ratings, users attributed the software to both pragmatic (mean PQ:1.84) and hedonic (mean HQ:1.50) qualities, with moderate overall attractiveness (mean ATT:2.13). Conclusions This web-based tool successfully identified PIMs with perfect reliability, high usability, and a moderate level of attractiveness. This tool has the potential to improve medication management in older adults by reducing PIMs.

Golden Breath: Feasibility and acceptability of a biofeedback-based virtual reality game on reducing children's needle-related pain and fear

BackgroundNeedle procedures can cause pain and fear in children. Current literature reports that biofeedback-based virtual reality applications may help alleviate children's pain and fear. This study aims to evaluate the feasibility, acceptability, and safety of the newly developed game Golden Breath, which uses biofeedback-based virtual reality to reduce children's needle-related pain and fear. MethodsThe development of Golden Breath includes; (1) development of the application's features based on needs assessment, (2) gamification of the application content based on literature, (3) development of the prototype, (4) expert evaluation and feedback on the application content, (5) usability testing by 11 children (4–12 years). ResultsRegarding acceptability, the expert evaluation showed a high usability of the system. All children provided positive feedback and reported high satisfaction with Golden Breath. The game was feasible and effective for reducing children's pain and fear levels during needle procedures. Golden Breath was deemed safe for children because it did not cause symptoms such as dizziness, vomiting, or nausea. ConclusionThe expert evaluation, children's feedback, and pilot study results showed that the Golden Breath game is feasible, acceptable, and safe for children during the needle-related procedure. The pilot study revealed that the Golden Breath game effectively reduced pain and fear during blood sampling in children. Practice to implicationsIt is recommended that healthcare professionals use Golden Breath to optimize the well-being of children receiving treatment for chronic and acute diseases.

Development model of a high-performance multiple input multiple output microstrip antenna based on a planar series array with 8×2 elements for 5G communication systems

MIMO (Multiple Input Multiple Output) makes a major contribution to 5G communication systems by increasing network capacity and spectrum efficiency. In 5G, MIMO enables the use of multiple antennas at base stations and user devices, allowing simultaneous sending and receiving of data over multiple paths. This significantly increases data throughput and connection reliability, especially in environments with high user density. In addition, MIMO technology supports the implementation of beamforming, which focuses signals on a specific direction, reduces interference, and improves signal coverage and quality, making it one of the keys to achieving faster and more responsive 5G performance. Therefore, antennas with wide bandwidth, high gain and MIMO performance are crucial for supporting 5G communication systems. This paper proposes a high-performance MIMO microstrip antenna based on a series planar array with 8×2 elements operating at a resonant frequency of 3.5 GHz for 5G communication systems. A spiral stub and a feed inset are proposed to control the reflection coefficient and bandwidth of the antenna while the series planar array is proposed to increase the gain. To support the MIMO communication system, the proposed antenna is separated into two different ports with a certain distance. From the measurement results, the proposed antenna has high performance indicated by a wide bandwidth of 680 MHz (3–3.68 GHz) and a high gain of 17.8 dB at a resonant frequency of 3.5 GHz. In addition, the proposed antenna has high mutual coupling and diversity indicated by ECC and DG of 0.001 and 9.99 dB, respectively. This work provides a solution to design a high-performance microstrip antenna and can be implemented as a receiving antenna for 5G communication systems

Acceptability and psychometric properties of four scales assessing the impact of Type 2 diabetes on quality of life-Results of 'YourSAY: Quality of Life'.

To assess and compare the psychometric properties and acceptability of four diabetes-specific quality of life (QoL) scales among adults with Type 2 diabetes (T2D). Adults (≥18 years) with T2D living in the United Kingdom (n = 1465) or Australia (n = 248) completed a cross-sectional, online survey including the following: ADDQoL, DCP, DIDP and Diabetes QoL-Q (presented in randomised order), followed by rating scales to assess clarity, relevance, ease of completion, length and comprehensiveness of each scale. Demographic, clinical and psychosocial characteristics were collected. Acceptability (scale completeness and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, confirmatory, divergent and known-groups) were examined. Data were analysed by country to assess cross-country reproducibility. High completion rates (≥89%) and positive user ratings were observed across scales indicating broad acceptability. The DIDP was the strongest performing scale: highest completion rate (97%), user ratings (≥84% positive) and most satisfactory psychometric properties (highest variance explained, consistent factor loadings >0.5 on all items and most permissible model fit parameters). Scale-level floor effects may suggest domain omissions for the brief DIDP. The current study provides novel insights into the acceptability, validity and reliability of diabetes-specific QoL measures for adults with T2D. Consistent with the published Type 1 diabetes cohort findings, the DIDP is recommended as a brief, acceptable and psychometrically sound measure. However, selection needs to be considered in the context of the specific research or clinical aims and further evidence (e.g. responsiveness) may be required before it can be recommended for use in trials or prospective studies.

Assessment of gamified mixed reality environments for upper limb robotic rehabilitation: pilot study on healthy adults

Exoskeletons for rehabilitation have the potential to aid movement and promote intensive, task-oriented, and personalized motor training. However, robotic-assisted training and user experience could be further improve by including Mixed Reality Environments (MREs) and using a gamification approach. This paper presents the design and evaluation of a MR solution based on Microsoft Hololens 2 for robot-assisted bilateral shoulder training. It is based on gamified MREs designed to guide and encourage bilateral synchronous and asynchronous movements of the upper extremities while a 6 Degrees of Freedom (DOF) exoskeleton (FLOAT) provides motor assistance only to the impared limb. The robotic-assisted bimanual tasks involve the use of rehabilitative tools (such as a dowel rod), as a means to interact with the virtual world and to enable the intact limb guide and control the motions of the disable limb. The gamified MR training solution generates meaningful performance metrics from the kinematic analysis of hands movement, captured by Hololens. The subjective evaluation of the gamified MR solution focused on usability, cognitive load, and user experience. Meanwhile, the objective evaluation encompassed the analysis of the robot-assisted movements with and without gamified MREs, a comparative analysis between metrics obtained from Hololens and Vicon data, and the collection of reference data and trajectories. There were twenty-one healthy adults involved in the evaluation of the system. The results with the gamified MREs highlight excellent system usability, low cognitive load, and high user experience. Additionally, integrating gamified MREs into robot-assisted movements enhances shoulder movements. Data collection with Hololens demonstrated to be reliable and consistent. Furthermore, the normal reference values, paths, and velocity profiles obtained from healthy individuals offer a foundation for assessing the performance of individuals with disabilities. In summary, the introduction of gamified MREs for robot-assisted bilateral shoulder movements marks a significant and promising advancement in rehabilitation technology.

Integration of renewable energy-powered cold storage solutions for reducing post-harvest food waste in rural agricultural areas

Post-harvest food loss remains a critical challenge in rural agricultural areas, exacerbated by inadequate storage facilities and unreliable energy access. This study develops and optimizes an advanced renewable energy-powered cold storage system tailored for rural settings, integrating solar and wind energy with phase change materials (PCMs) for efficient energy storage. The system incorporates Internet of Things (IoT)-based sensors and artificial intelligence (AI)-driven energy management to maintain optimal storage conditions and enhance energy efficiency. Field trials conducted in Lincolnshire, UK, and Appalachian regions of the US demonstrated significant reductions in post-harvest food loss by an average of 43.5%, extensions in produce shelf-life by up to 300%, and increased income for smallholder farmers by approximately 43%. The system also achieved an 80% reduction in greenhouse gas emissions compared to conventional diesel-powered systems. Economic analyses revealed a shorter payback period and higher return on investment, confirming the system's viability. High user satisfaction and adoption rates indicate the system's practicality and potential for widespread implementation. The findings suggest that integrating renewable energy with smart technologies in cold storage solutions offers a scalable and sustainable approach to enhancing food security, promoting economic growth in rural areas, and supporting environmental objectives globally.

Initial Evaluation of Acceptability, Engagement, and Effectiveness of the MO App to Provide Tailored and Comprehensive Support for Smoking Cessation: Development and Usability Study.

Despite the growing availability of smoking cessation apps, low engagement and cessation rates have remained a significant challenge. To address this issue, we used a user-centered design to iteratively develop a mobile app (MO) to provide comprehensive, tailored, and evidence-based content to support smokers in their quitting journey. This study examined the acceptability, use, and preliminary efficacy of the MO app for smoking cessation. Specifically, we sought to understand smokers' preferred features, engagement, and satisfaction with MO; identify concerns in using the app and ways to improve the app; and evaluate its smoking cessation outcomes. Through 3 cohorts, we recruited 10, 12, and 85 adult smokers who attempted to quit smoking to pilot-test the MO app between December 2019 and July 2022. Participants were instructed to complete a baseline survey, interact with the app for 6 weeks, and fill in a postsurvey at week 6. Participants in cohort 3 completed an additional postsurvey at week 12. Participants' app use was tracked and analyzed. The primary outcome measures were participants' 7-day point prevalence abstinence at 6 and 12 weeks. Participants reported high levels of satisfaction with the MO app across all 3 cohorts, rating it between 4.40 and 4.76 on a scale of 5 for acceptability. Users engaged with app activities for an average of 89 to 159 times over 35 days. The most liked features of the app included "quit plan," "tracking," "reminders and notifications," "MOtalks," and "motivational quotes." The 7-day point prevalence abstinence rate of the modified intention to treat population in cohort 3 was 58% at 6 weeks and 52% at 12 weeks. Those who interacted more frequently with app features and engaged with more diverse activities were more likely to maintain abstinence at weeks 6 and 12. For each additional time logged into the app, the odds of staying abstinent at week 12 increased by 5% (odds ratio [OR] 1.05, 95% CI 1.01-1.08). Participants who earned >5000 points during app use also had higher odds of quitting at both 6 weeks (OR 3.12, 95% CI 1.25-7.75) and 12 weeks (OR 4.65, 95% CI 1.83-11.76), compared with those who earned <5000 points. Our study demonstrated that MO is a feasible mobile phone app with high acceptability and usability and can effectively deliver smoking cessation support to individuals who want to quit. Implications for developing and evaluating mobile phone apps for smoking cessation are discussed.

Addressing health inequality and inequity for people with intellectual disabilities: a collective responsibility for all nurses

Purpose People with intellectual disabilities are high users of acute hospital care. Given their varied and often complex health-care needs, they often experience health inequalities and inequities, contributing to poorer health outcomes. As nurses are the largest health-care workforce with a patient-facing role, they have an important responsibility in meeting this populations health needs. The purpose of this paper is to explore key issues relating to the role nurses play in providing equitable health care for people with intellectual disabilities. Design/methodology/approach This service feature draws upon relevant literature to examine key contextual issues highlighting the importance of nurses in providing equitable health care for people with intellectual disabilities. Findings The findings from this service feature highlight the importance of nurses taking a leadership role in advocating for, and actively supporting the health needs of people with intellectual disabilities. Nurses’ leadership role, along with implementing reasonable adjustments, should be underpinned by education and training relating to the bespoke health needs of people with intellectual disabilities. This should help nurses promote the health and well-being of this population. Originality/value Addressing this populations health needs is a collective responsibility of all nurses. There are many examples of how nurses can be supported through policy, education, training and advocacy and this needs to be considered by key stakeholders and addressed as a matter of priority.

Usability of an AI-based independent pedestrian navigation device designed for blind people

Abstract Background 2.2 billion people live with visual impairment (VI) worldwide and face orientation and mobility challenges in various aspects of their lives. Despite technological advancements, the most used mobility solutions for VI are still the walking cane and the guide dog. The objective of this research is to assess the system usability of an AI-based independent pedestrian navigation device (.lumen glasses), designed for blind people. Methods During 31st of October and 2nd of November 2023, 27 visually impaired people living in Bucharest, Romania, tested the .lumen glasses for 1-3 hours during an outdoor navigation task. The glasses use AI to recognize the user’s environment and haptic and audio feedback to guide them. The System Usability Scale (SUS), a 10-item instrument, was used to evaluate the level of usability the participants ascribe to the .lumen glasses. Qualitative feedback was collected as part of the post-test survey and analyzed using thematic analysis. Data were triangulated to identify usability issues. Results The mean age of the participants was 30.3 years old (SD = 12.07, min=21 max =56, range: 48), 55.6% (N = 15) of the participants were male, 96,3% (N = 26) were completely blind, and 81.5% were using a white cane for orientation and mobility. Our findings reveal a mean SUS score of 83.65 (SD = 15.23, range 47.5, min=52.5, max=100) indicating high usability. The thematic analysis revealed 5 themes: (1) auditive and (2) haptic feedback in navigation, (3) hardware (adjustment system &amp; buttons), (4) tutorial &amp; presentation of how the device works and (5) other aspects (usage in combination with other assistive technologies etc.). The participants declared that the glasses are intuitive to use and promote the feeling of safety and independence. Conclusions Data suggest that the .lumen glasses area promising assistive technology for the mobility of VI. Findings are currently used to steer the development and implementation of the AI-based system. Key messages • According to participants’ feedback, .lumen glasses are a scalable AI-based mobility solution that can make navigation and orientation easier for visually impaired individuals. • .lumen glasses designed for the visually impaired individuals are one of the current and limited assistive technology improving the mobility and orientation.

Association of HbA1C with mortality and cardiovascular outcome in patients with type 2 diabetes using drugs with different hypoglycemic risk

Abstract Background Previous clinical trials showed that intensive glucose control did not reduce macrovascular events and mortality. It was speculated that severe hypoglycaemia contributed to these adverse outcomes. More contemporary clinical trials using newer anti-diabetic agents with less hypoglycaemic potential showed a linear relationship between major adverse cardiovascular events (MACE) and HbA1c reduction according to a meta-regression analysis. Purpose The aim of this study was to examine the association between clinical outcomes and HbA1c under different treatment backgrounds in the real-world setting. We hypothesised that when using drugs with minimal hypoglycaemic risk, lower HbA1c would be associated with better outcomes. Methods This was a retrospective population-based cohort study using a multi-centre electronic medical record database. Eligible patients were those diagnosed with type 2 diabetes between 2009 and 2020 who received non-insulin antidiabetic drugs. Patients were stratified into two groups based on the drugs received: drugs with high hypoglycaemic risk (sulphonylurea, meglitinide) and drugs with low hypoglycaemic risk (thiazolidinediones, acarbose, DPP4 inhibitors, GLP1 agonists, SGLT-2 inhibitors). Patients were excluded if they had received these drugs for less than 180 days or had received both high and low hypoglycaemic risk oral drugs simultaneously. HbA1c levels were assessed from the index date to the date of the interested outcome or the end of the study period (31 December 2021), whichever came first. The relationship between HbA1c and clinical outcomes was examined using a Cox proportional hazards model. The outcomes of interest included all-cause mortality and MACE. Results The study population consisted of 6,923 patients, including 3,639 high hypoglycaemic risk drug users and 3,284 low hypoglycaemic risk drug users. Patients with lower HbA1c levels during the follow-up period were older and frailer. After adjusting for baseline covariates, the association between the risk of death and HbA1c presented a U-shaped pattern, and this U-shaped association was similar in the two treatment cohorts (Table 1). On the other hand, the association between the risk of MACE and HbA1c presented a J-shaped pattern. In the high hypoglycaemic risk drug cohort, patients with the highest HbA1c levels (mean HbA1c 9.6%) were associated with a higher risk of MACE compared to the group with a mean HbA1c of 7.2% (hazard ratio [HR] 4.16, 95% confidence interval [CI] 2.07-8.37); lower HbA1c levels were not associated with a lower risk of MACE (Table 2). In contrast, in the low hypoglycaemic risk drug cohort, lower HbA1c levels were associated with a higher risk of MACE (HR 3.82, 95% CI 1.29-11.28). Conclusion Lower HbA1c levels were not associated with a lower risk of all-cause mortality and MACE. Furthermore, this phenomenon was independent of the hypoglycaemic risk of anti-diabetic drugs.

Exploring the Effectiveness of Technology-Assisted Interventions for Promoting Independence in Elderly Patients: A Systematic Review.

The aging global population presents significant challenges for healthcare systems. Technology-assisted interventions have emerged as promising tools to enhance independence and well-being among elderly individuals. The aim of this study was to evaluate the effectiveness of technology-assisted interventions in promoting independence among elderly patients and identify key barriers and facilitators to their implementation. A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, IEEE Xplore, ACM Digital Library, Cochrane Library, and Scopus. Studies evaluating technology-assisted interventions for promoting independence in elderly patients were included. Data were synthesized through narrative and thematic analysis. Fourteen studies met inclusion criteria. Technology-assisted interventions demonstrated positive impacts on physical and cognitive functioning, health management, quality of life, and technological engagement among elderly patients. Improvements were observed in areas such as mobility, chronic disease management, mental health, and daily living activities. High usability and adherence rates were reported for well-designed interventions. However, challenges in user-centered design, personalization, and integration with existing healthcare systems were identified. Technology-assisted interventions show promise in promoting independence among elderly patients. Future research should focus on addressing identified challenges and conducting larger, long-term studies to confirm effectiveness and sustainability.

Advances in the Neuro-Rehabilitation of Parkinson’s Disease: Insights from a Personalized Multidisciplinary Innovative Pathway

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that requires comprehensive and personalized rehabilitation. This retrospective study focused primarily on the usability and patient acceptability of the innovative pathway. In addition, the secondary objective was to evaluate the effectiveness of a personalized and multidisciplinary rehabilitation pathway on cognitive function, especially executive functions. Methods: We conducted a retrospective study on 80 patients with PD (Hoehn and Yahr scores 1–3). Patients were divided into an experimental group (EG), which received the innovative pathway, and a control group (CG), which received traditional therapy. The rehabilitation program included three phases: initial outpatient assessment, a two-month inpatient program, and a telerehabilitation phase in a day hospital (DH) or home environment. Interventions combined traditional therapies with treatments based on robotic and virtual reality. Cognitive assessments (Mini Mental State Examination—MMSE—and frontal assessment battery—FAB), mood (Hamilton Rating Scale—Depression—HRS-D), anxiety (HRS-Anxiety—HRS-A), and goals achievement (GAS) were the primary outcome measures. Results: At baseline, there were no significant differences between the groups in terms of age, gender, education, or test scores. After rehabilitation, EG showed significant improvements in all measures (p &lt; 0.001), particularly in cognitive tests and goal achievement. CG improved in GAS (p &lt; 0.001) and mood (HRS-D, p = 0.0012), but less than EG. No significant changes were observed in the MMSE of CG (p = 0.23) or FAB (p = 0.003). Conclusions: This study highlights the high usability and acceptability of VR and robotics in PD rehabilitation, contributing to improved adherence and patient engagement. The experimental group showed greater cognitive benefits, particularly in executive functions. These results are in line with the existing literature on personalized technology-based rehabilitation strategies for PD.

Socio-Economic Factors Influencing Adaptation Strategies of Tomato Producers’ to Climate Change in North West, Nigeria

This work evaluated socio-economic factors influencing adaptability strategy of tomato producers to climate change in North West, Nigeria. Primary data utilized were based on well-designed questionnaire distributed to 100 tomato producers. Data were analyzed using descriptive statistics adaptability strategy use index, multinomial Logit model, and principal component model. The outcome shows that the average age of tomato producers approximates 44 years. They are literate with an average of 12 years of school education. About 51% of tomato producers had access to credit, and they are smallholder farmers with average of 0.81 hectares of farm land. The major climate change adaptation strategies used by tomato producers and their corresponding indexes include planting of heat and drought tolerant crop (0.9704), use of improved seeds (0.9675), mulching (0.8976), soil and water conservation technique (0.8312), and use of organic manure (0.7917). The significant predictors influencing the choice of low climate change adaptation strategy users include years of school education, age, experience in tomato farming, and income earned from tomato farming. The significant predictors influencing high climate change adaptation strategy users include years of school education, and income earned from tomato farming. The major challenges faced by tomato producers and their corresponding Eigen values include a lack of improved seeds (8.6935), lack of technology (5.93660, lack of processing and storage facilities (3.9274), and lack of capacity building for producers (3.5173). Improved seeds, irrigation facilities, and farm technologies should be made available to tomato producers to combat threats of climate variability and increase productivity.