Mesh Network of eHealth Intelligent Agents for Visually Impaired and Blind People

Smart assistive devices for blind and visually impaired (B&VI) people are of high interest today since wearable IoT hardware became available for a wide range of users. In the first project, the Raspberry Pi 3 B board measures a distance to the nearest obstacle via ultrasonic sensor HC-SR04 and recognizes human faces by Pi camera, OpenCV library, and Adam Geitgey module. Objects are found by Bluetooth devices of classes 1-3 and iBeacons. Intelligent eHealth agents cooperate with one another in a smart city mesh network via MQTT and BLE protocols. In the second project, B&VIs are supported to play golf. Golf flagsticks have sound marking devices with a buzzer, NodeMcu Lua ESP8266 ESP-12 WiFi board, and WiFi remote control. In the third project, an assistive device supports the orientation of B&VIs by measuring the distance to obstacles via Arduino Uno and HC-SR04. The distance is pronounced through headphones. In the fourth project, the soft-/hardware complex uses Raspberry Pi 3 B and Bytereal iBeacon fingerprinting to uniquely identify the B&VI location at industrial facilities.

Adaptation Strategies for Personalized Gait Neuroprosthetics

Personalization of gait neuroprosthetics is paramount to ensure their efficacy for users, who experience severe limitations in mobility without an assistive device. Our goal is to develop assistive devices that collaborate with and are tailored to their users, while allowing them to use as much of their existing capabilities as possible. Currently, personalization of devices is challenging, and technological advances are required to achieve this goal. Therefore, this paper presents an overview of challenges and research directions regarding an interface with the peripheral nervous system, an interface with the central nervous system, and the requirements of interface computing architectures. The interface should be modular and adaptable, such that it can provide assistance where it is needed. Novel data processing technology should be developed to allow for real-time processing while accounting for signal variations in the human. Personalized biomechanical models and simulation techniques should be developed to predict assisted walking motions and interactions between the user and the device. Furthermore, the advantages of interfacing with both the brain and the spinal cord or the periphery should be further explored. Technological advances of interface computing architecture should focus on learning on the chip to achieve further personalization. Furthermore, energy consumption should be low to allow for longer use of the neuroprosthesis. In-memory processing combined with resistive random access memory is a promising technology for both. This paper discusses the aforementioned aspects to highlight new directions for future research in gait neuroprosthetics.

Magnitude and associated factors of low back pain among nurses working at intensive care unit of public hospitals in Amhara region, Ethiopia

Background Low back pain is a common public health problem throughout the world with a global prevalence from 28% to 86%. Nurses working in intensive care units are handling people who are critically ill and helpless, which requires more assistance for transferring and handling activities. This possesses a risk for low back pain but little is known about it in Ethiopia. This study aimed to assess the magnitude of low back pain and associated factors among nurses who work at intensive care units in Amhara region public hospitals, North Ethiopia. Methods A multi-centered institution-based cross-sectional study was conducted at Amhara region public hospitals from March 1-30, 2020. A simple random sampling technique after proportional allocation was used to select the study participants. Data were collected using a standard modified Nordic musculoskeletal assessment tool. After data were checked for completeness and consistency, it was entered into Epidata version 3.1 and exported to Statistical Package for Social Science software version 26 for analysis. Descriptive statistics were computed. A binary logistic regression model was used to identify factors associated with low back pain. Finally, those variables with a p-value of <0.05 in multivariable analysis were considered statistically significant. Result Study was conducted among 412 intensive care unit nurses giving a response rate of 97.6%. The magnitude of low back pain was 313 (76%) [95% CI: (71.6%-79.9%)]. Being female [AOR = 2.674 (1.404, 5.076)], unavailability of assistive device for patient handling [AOR = 2.139 (1.035, 4.410)], lack of training on intensive care [AOR = 2.017 (1.092, 3.943)], lack of regular exercise [AOR = 2.164 (1.164, 4.108)] and job stress [AOR = 3.66 (1.955, 6.498)] were factors significantly associated with low back pain. Conclusions In this study the magnitude of low back pain was high. Being female, unavailability of an assistive device for patient handling, lack of training on intensive care, lack of regular exercise and job stress were factors associated with low back pain. Policymakers and concerned bodies should emphasize the accessibility of assistive devices for patient care, provision of training on intensive care, and adaptive working environment for intensive care unit nurses.

A GSM Based Assistive Device for Blind, Deaf and Dumb

This paper tries to overcome the shortcomings of the recent technology that fails to enhance the communication between physically disabled people by designing an assistive device. This device uses a GSM modem with a SIM card and no smartphones are needed which makes the device affordable. Here, the sender sends the message to the phone number of the disabled person and he/she receives the SMS that gets converted to text and voice message and vibrations to Braille pad using a microcontroller which is easily readable by the disabled person.

Neighborhood Walkability and Physical and Mental Health among Older Adults Living in a Deprived Community

Background Identifying the factors to improve the quality of life (QOL) is vital to decrease morbidity and mortality rates among older adults. Although unfavorable neighborhood features have a significant negative impact on QOL, few studies have investigated these relationships in a deprived community. The purpose of the study was to understand how neighborhood walkability is associated with QOL using the SF-36 among urban-dwelling older adults. Methods This is a cross-sectional survey. Participants were recruited in 2018 and 2019 at regional health clinics in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. Results Of the 132 participants, the majority were female (66%), African American (77%), single, divorced, or widowed (75%), and educated below GED level (84%). After adjusting for gender, assistive device use, medication, and the Supplemental Security Income receipt, multiple regression analysis revealed that those with better perceptions of land-mixed use and accessibility within their neighborhood were more likely to have better physical health (β = .36, p&lt;.05). However, the perceptions of greater pedestrian safety were associated with the poor physical and mental health (PCS; β = -0.19, p &lt;.05; MCS; β = -0.25, p &lt; .05). Perceptions of the presence of walking hazards and crime were not significantly associated with QOL. Discussion Findings suggest that neighborhood walkability characteristics are associated with physical health. The development of walking programs with accessible neighborhoods will be urgent to improve the health-related QOL for older adults living in a targeted community.

Spine surgery under awake spinal anesthesia: an Egyptian experience during the COVID-19 pandemic

OBJECTIVE Despite tremendous advancements in biomedical science and surgical technique, spine surgeries are still associated with considerable rates of morbidity and mortality, particularly in the elderly. Multiple novel techniques have been employed in recent years to adequately treat spinal diseases while mitigating the perioperative morbidity associated with traditional spinal surgery. Some of these techniques include minimally invasive methods and novel anesthetic and analgesic methods. In recent years, awake spine surgery with spinal anesthesia has gained attention as an alternative to general anesthesia (GA). In this study, the authors retrospectively reviewed a single-institution Egyptian experience with awake spine surgery using spinal anesthesia during the COVID-19 pandemic. METHODS Overall, 149 patients who were admitted to As-Salam International Hospital in Cairo for lumbar and lower thoracic spine surgeries, between 2019 and 2020, were retrospectively reviewed. Patient demographics and comorbidities were collected and analyzed. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were assessed at different time intervals including preoperatively, immediately after surgery, and 1 year postoperatively. Patient satisfaction was queried through a questionnaire assessing patient preference for traditional anesthesia or spinal anesthesia. RESULTS Of the 149 patients who successfully received spine surgery with spinal anesthesia, there were 49 males and 100 females. The cohort age ranged from 22 to 85 years with a mean of 47.5 years. The operative time ranged from 45 to 300 minutes with a mean estimated blood loss (EBL) of 385 ± 156 mL. No major cardiopulmonary or intraoperative complications occurred, and patients were able to eat immediately after surgery. Patients were able to ambulate without an assistive device 6 to 8 hours after surgery. Decompression and fusion patients were discharged on postoperative days 2 and 3, respectively. VAS and ODI scores demonstrated excellent pain relief, which was maintained at the 1-year postoperative follow-up. No 30- or 90-day readmissions were recorded. Of 149 patients, 124 were satisfied with spinal anesthesia and would recommend spinal anesthesia to other patients. The remaining patients were not satisfied with spinal anesthesia but reported being pleased with their postoperative clinical and functional outcomes. One patient was converted to GA due to the duration of the procedure. CONCLUSIONS Patients who received spinal anesthesia for awake spine surgery experienced short stays in the hospital, no readmissions, patient satisfaction, and well-controlled pain. The results of this study have validated the growing body of literature that demonstrates that awake spine surgery with spinal anesthesia is safe and associated with superior outcomes compared with traditional GA. Additionally, the ability to address chronic debilitating conditions, such as spinal conditions, with minimal use of valuable resources, such as ventilators, proved useful during the COVID-19 pandemic and could be a model should other stressors on healthcare systems arise, especially in developing areas of the world.

Longitudinal Association of Fall risk for Community Dwelling Elderly with and without ADRD

Falls amongst elderly with ADRD and are a major cause of functional impairment and increased mortality. The primary purpose of this study was to examine if fall status of community dwelling elderly residents with and without ADRD differs over a four year period and additionally does receipt of rehabilitation in any year modifies this association. National Health and Aging Trends Study (NHATS) data from 2015-2018 was used and sample consisted of participants age 65 and older who were community dwellers. Baseline characteristics of individuals in ADRD (n= 264) and non-ADRD group (n=2,971) was compared using chi square statistic. A generalized estimating equation model (multivariate logistic regression) was used to estimate odds ratio of falls in the two groups, adjusted for sociodemographic and clinical conditions that are predictors of fall risk. At baseline, ADRD group comprised of older, frail individuals who reported increased use of assistive device (AD) and presence of depression. Those in the non-ADRD group at baseline had significantly decreased odds for falls however no statistically significant change was observed for fall status over four years in the two groups (non-ADRD vs ADRD) and this association was not modified by receipt of rehabilitation. Those who used AD, had depression and received rehabilitation had increased odds for falls however no differences were found for those who lived alone and were frail. Future studies should examine the bi-directional interplay between falls and rehabilitation in elderly with ADRD with inclusion of other predictors of fall risk to study their unique characteristics.

Effect of assistive devices on the precision of digital impressions for implants placed in edentulous maxilla: an in vitro study

Purpose To examine the effect of assistive devices on the precision of digital impression for multiple implants placed in the edentulous maxilla. Methods A reference model representing an edentulous maxilla with four implants was developed. The digital impression group included three settings: Type 0, without an assistive device; Type 1, with an assistive device connecting only neighboring implants; and Type 2, with an assistive device connecting not only neighboring implants but also the two posterior implants, with perpendicular branches from this bar towards the anterior implants. Digital impressions were made five times for each type using three intraoral scanners (IOSs). For conventional method, silicone impressions and verification jigs were prepared; fabricated plaster models were scanned using a laboratory scanner/industrial 3D scanner. In analysis 1, two-way ANOVA analyzed the effect of IOSs and assistive devices on the precision of digital impressions. In analysis 2, one-way ANOVA compared the silicone impressions, the verification jigs, and the most precise group of digital impressions from analysis 1. Results In analysis 1, the IOS and assistive device type (F = 25.22, p < .0001) effects and the interaction between these two factors (F = 5.64, p = .0005) were statistically significant. In analysis 2, CON, VJ, and digital impression with Type 2 devices (most precise devices in analysis 1) were compared; better precision was obtained by digital impression with Type 2 device than by CON and VJ (F = 30.08, p < .0001). Conclusions For implants placed in an edentulous maxilla, digital impressions with assistive devices can provide better precision compared to silicone impressions and verification jigs.

Assistive Devices: Technology Development for the Visually Impaired

Technology has been contributing significantly to the development of assistive devices for disabled persons (DPs). Many of these devices aim to assist people who are blind or visually impaired, providing them with friendlier ways to interact with their surroundings (obstacles, objects, and navigation). However, the high cost of these devices makes it difficult for DPs to purchase them. The development of an assistive device kit to be used by the visually impaired in controlled environments (indoor) or urban spaces (outdoor) is presented in this work with a didactic and detailed approach. This low-cost kit (USD 50 per device) consists of a Smart Cane, Smart Cap, and Smart Glove. The methodology addressed aims to support and encourage the reproduction, customization, and manufacture of new assistive devices with low cost and wide applicability. The devices are functional, benefit usability, and, due to the characteristics of the project and the materials used in their construction, do not impact the ergonomics of the visually impaired or disabled person who may use these devices. The devices that integrate the assistive kit can be used independently or combined. In addition to having detection, fall-control, navigation, and real-time tracking functions, they are independent of additional local infrastructure for their use.