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Patients with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, an incurable disease in which motor neurons are selectively destroyed, gradually lose their mobility as organ dysfunction begins, and eventually, patients find it challenging to make even minor movements and simple communications. To communicate with patients with quadriplegia, researchers have focused on movements of the eye, the only moving organ for patients with ALS, and they have investigated the detection of eyeblinks using brainwaves or cameras or other ways to select letters on a screen via eyeball movements based on eye-tracking cameras. However, brainwave-based techniques, which use the electrical signals of eye movements to determine patient’s intentions, are sensitive to noise, often resulting in the inaccurate identification of intent. Alternatively, a camera-based method that uses letter selection detects the movement of eye feature-points, and this method makes it easy to identify a patient’s intentions using a predefined decision-making process. However, it has long processing time and is prone to inaccuracy due to errors in either the Morse code implementation assigned to all alphabets or the sequential selection methods. Therefore, we have proposed iMouse-sMc, a simplified Morse code-based user interface model using an eye mouse for faster and easier communication with such patients. Furthermore, we improved the detection performance of the eye mouse by applying image contrast techniques to enable communication with patients even at night. To verify the excellent performance of the proposed eye mouse for a user interface, we conducted comparative experiments with existing camera-based communication models based on various words. The results revealed that the time of communication was reduced to 83 s and the intention recognition accuracy was improved by ~28.16%. Additionally, even in low-light environments, where existing models are unable to communicate with the patients due to difficulties with eye detection, the proposed model demonstrated its eye detection capability and proved that it can be used universally for communication with patients during the day and at night.

OBJECTIVES To investigate the prevalence of potentially inappropriate prescribing (PIP) for cardiovascular system (CVS) and antiplatelet/anticoagulant (AP/AC) drugs among Korean elderly patients, using the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria version 2 and to identify the risk factors related to PIP. METHODS The 2016 National Aged Patient Sample data, comprising National Health Insurance claim records for a random sample of 20% of patients aged ≥ 65 years, were used to calculate PIP prevalence of outpatient prescriptions. For criteria including drug-disease interactions, PIP prevalence per indication was estimated. RESULTS Among 1,274,148 elderly patients and 27,062,307 outpatient prescription claims, 100,085 patients (7.85%) and 341,664 claims (1.27%) had one or more PIP. The most frequent PIP was “non-steroidal anti-inflammatory drug with concurrent antiplatelet agent (s) without proton-pump inhibitor prophylaxis” in the claim-level (0.97%) and patient-level (6.33%) analyses. “Beta-blocker with bradycardia” (16.47% of claims) and “angiotensin receptor blockers in patients with hyperkalaemia” (23.89% of claims) showed the highest PIP prevalence per indication. Logistic regression analysis revealed that, among the patient and health care provider characteristics, female, older age, more severe comorbidities, polypharmacy, higher level of healthcare organization, and specialty of prescriber were significantly associated with a higher risk of PIP. CONCLUSIONS Our findings of a high prevalence of PIP for CVS and AP/AC drugs among the elderly suggest that an effective strategy is urgently needed to improve the prescription practices of these drugs.

This study aimed to evaluate the kinematics and kinetics of the lower limb in both the intact and amputated leg in individuals with transtibial amputations wearing Energy storage and return feet (ESRFs) with fixed ankles and Prosthetic feet with adaptive ankles (PFAAs) during level walking. Three individuals with transtibial amputations walked on level ground wearing their own ESRFs and PFAAs. Spatiotemporal parameters, kinematics, and kinetics of the lower-extremity joints were measured in the amputated and intact legs. There were differences in the kinematics of the joints in the amputated leg and of the ankle in the intact leg between ESRFs and PFAAs. Differences in joint moments, power, and stiffness in most joints in both legs and braking impulse were found between ESRFs and PFAAs. Thus, although it was a pilot study with three subjects, ankle angle control mechanisms (ESRFs: Fixed ankle vs. propriofoot: Mechanical motor vs. elan and echelon: Hydraulic actuator) might affect biomechanical features during level walking.