To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Lightweight, adjustable, and affordable devices are needed to enable the next generation of effective, wearable adjuncts for rehabilitation. Used at home or in a rehabilitation setting, these devices have the potential to reduce compound pressures on hospitals and social care systems. Despite recent developments in soft wearable robots, many of these devices restrict the range of motion and lack quantitative assessment of moment transfer to the wearer. The decoupled design of our wearable device for upper-limb rehabilitation successfully delivers almost the full range of motion to the user, with a mean maximum flexion angle of 149° (SD = 8.5). In this article, for the first time, we show that in tests involving a wide range of participants, 82% of the moment produced by the actuator is applied to the wearer. This testing of elbow flexion moment transfer supports the effectiveness of the device. This research is a step toward effective pneumatic soft robotic wearable devices that are adaptable to a wide range of users – a necessary prerequisite for their widespread adoption in health care.
Occupational shoulder exoskeletons can relieve workers during strenuous overhead work. Passive solutions are lightweight, robust, and cost-effective, but they can also restrict user movement, have limited support, and cannot dynamically adapt to different working conditions. Semi-active and active systems are still mostly the subject of research, and existing systems are heavy or have limited performance and support. Here, we present a lightweight semi-active exoskeleton for shoulder support that incorporates a novel motorized torque adjustment mechanism that varies the effective lever arm with which a spring applies force to the supporting joint. The mechanism is integrated into lateral structures and can be actuated via Bowden cables with motors located on the user’s back. The technical performance of the system was experimentally characterized in terms of its dynamic support torque profiles at six different support levels. Furthermore, adjustment times and energy consumption were investigated. The system showed plateau-like support torque profiles in the intended working range and could be adjusted from nearly 0 Nm up to 12 Nm of maximum support per arm. Adjustment times varied between 0.5 s for the adjustment of 20% of the total adjustment range and 1.0 s for a full activation/deactivation. Adjustments consumed between 0.1 As and 1.9 As of battery charge, allowing long operating times of up to one working day, using only a small 2 Ah battery. As a result, the exoskeleton provides high performance by combining comparatively high support, rapid motorized support adjustment, and low energy consumption in a lightweight design.
The ageing population is anticipated to encounter several challenges related to sustainability. While policies such as ageing in place can benefit older adults in terms of familiarity and independence, these policies can also lead to increased social isolation. To facilitate ageing in the right place, it is crucial to understand how the design of environments promotes social sustainability. This article presents a scoping review of empirical research focused on the characteristics of housing and surrounding environments that support social integration, cohesion and participation of older adults. The search strategy was conducted in five databases, resulting in 20,477 articles. After screening 7,550 titles and abstracts based on predetermined inclusion and exclusion criteria, 19 articles were selected. The findings of these articles are presented across three themes: (1) housing environments, (2) environments beyond the home and (3) the social environment. Although there is no one-size-fits-all housing model for older adults, the authors suggest that ageing in place policies should be reconceptualized as ageing in ‘places’ and ‘spaces’, emphasizing the diversity of social needs of older adults. Understanding the environmental characteristics, the role of accessible and safe environments beyond the home, and how people and culture support a sense of belonging provides a policy direction for how to design socially sustainable environments for older adults in the future.
The remote center of motion (RCM) mechanism is one of the key components of minimally invasive surgical robots. Nevertheless, the most widely used parallelogram-based RCM mechanism tends to have a large footprint, thereby increasing the risk of collisions between the robotic arms during surgical procedures. To solve this problem, this study proposes a compact RCM mechanism based on the coupling of three rotational motions realized by nonlinear transmission. Compared to the parallelogram-based RCM mechanism, the proposed design offers a smaller footprint, thereby reducing the risk of collisions between the robotic arms. To address the possible errors caused by the elasticity of the transmission belts, an error model is established for the transmission structure that includes both circular and non-circular pulleys. A prototype is developed to verify the feasibility of the proposed mechanism, whose footprint is further compared with that of the parallelogram-based RCM mechanism. The results indicate that our mechanism satisfies the constraints of minimally invasive surgery, provides sufficient stiffness, and exhibits a more compact design. The current study provides a new direction for the miniaturization design of robotic arms in minimally invasive surgical robots.
Exoskeletons that make running easier could increase users’ physical activity levels and provide related health benefits. In this paper, we present the design of a portable, powered ankle exoskeleton that assists running and uses lightweight and compact twisted string actuators. It has limited durability at this stage of development, but preliminary results of its power to mass density and potential for reducing the metabolic cost of running are promising. The exoskeleton can provide high peak power of 700 W per leg, 7 times more than prior twisted-string devices, and high peak torques of 43 Nm. Kinetostatic and dynamic models were used to select mass-optimal components, producing a device that weighs 1.8 kg per leg and 2.0 kg in a backpack. We performed preliminary tests on a single participant to evaluate the exoskeleton performance during both treadmill running and outdoor running. The exoskeleton reduced metabolic energy use by 10.8% during treadmill running tests and reduced cost of transport by 7.7% during outdoor running tests compared to running without the device. Unfortunately, the twisted string wore out quickly, lasting an average of 4 min 50 s before breaking. This exoskeleton shows promise for making running easier if string life challenges can be addressed.
Older adults often experience a decline in functional abilities, affecting their independence and mobility at home. Wearable lower-limb exoskeletons (LLEs) have the potential to serve as both assistive devices to support mobility and training tools to enhance physical capabilities. However, active end-user involvement is crucial to ensure LLEs align with users’ needs and preferences. This study employed a co-design methodology to explore home-based LLE requirements from the perspectives of older adults with mobility impairments and physiotherapists. Four older adults with self-reported mobility limitations participated by creating personas to represent different user needs and experiences (i.e., PERCEPT methodology), alongside four experienced physiotherapists who contributed their professional insights. As assistive devices, LLEs were seen as valuable for promoting independence, supporting mobility, and facilitating social participation, with essential activities including shopping, toileting, and outdoor walking. Physiotherapists expressed enthusiasm for integrating LLEs into remote rehabilitation programs, particularly to improve strength, balance, coordination, and walking speed. Key design considerations included a lightweight, discreet device that is easy to don and doff and comfortable for extended wear. Physiotherapists highlighted the potential of digital monitoring to assess physical parameters and personalize therapy. Fatigue emerged as a significant challenge for older adults, reinforcing the need for assistive LLEs to alleviate exhaustion and enhance functional independence. A shortlist of LLE features was drafted and scored, covering activity and design applications. These findings provide valuable insights into the design and usability of home-based LLEs, offering a foundation for developing devices that improve acceptance, usability, and long-term impact on healthy ageing.
Designing optimal assistive wearable devices is a complex task, often addressed using human-in-the-loop optimization and biomechanical modeling approaches. However, as the number of design parameters increases, the growing complexity and dimensionality of the design space make identifying optimal solutions more challenging. Predictive simulation, which models movement without relying on experimental data, provides a powerful tool for anticipating the effects of assistive devices on the human body and guiding the design process. This study aims to introduce a design optimization platform that leverages predictive simulation of movement to identify the optimal parameters for assistive wearable devices. The proposed approach is specifically capable of dealing with the challenges posed by high-dimensional design spaces. The proposed framework employs a two-layered optimization approach, with the inner loop solving the predictive simulation of movement and the outer loop identifying the optimal design parameters of the device. It is utilized for designing a knee exoskeleton with a damper to assist level-ground and downhill gait, achieving a significant reduction in normalized knee load peak value by $ 37\% $ for level-ground and by $ 53\% $ for downhill walking, along with a decrease in the cost of transport. The results indicate that the optimal device applies damping torques to the knee joint during the Stance phase of both movement scenarios, with different optimal damping coefficients. The optimization framework also demonstrates its capability to reliably and efficiently identify the optimal solution. It offers valuable insight for the initial design of assistive wearable devices and supports designers in efficiently determining the optimal parameter set.
Observation unit (OU) design is based on the 3Ps: proximity, personnel and process. Key considerations involved in OU design include location, room size, unit size, personnel, and patient flow.
The necessary staffing for an observation unit including physicians, advanced practice practitioners (APPs), residents, and support staff with the need for appropriate consultants and the design/set up needed for optimal functioning of the unit is discussed.
Chapter 1 explains the basic principles of observation medicine including the definitions of observation medicine, the types of observation units, key components of an observation unit including staffing, design, equipment/supplies, location, size, length of stay, a business plan, CQI/PI, and the many benefits of observation for the patient, families, physicians (not just the emergency department staff but also primary care and the specialist physicians), the emergency department, the hospital and the health care system.
The final chapter serves to draw the various strands of the book together, surveying what has been discovered, and expanding on the fundamental arguments of the book. It therefore begins with an analysis of Pinterest, which stands as an emblem of all that literacy means in postdigital times, whether that be sophisticated multimodal practices, durational time, or algorithmic logic. Looking back over the screen lives discussed in the book, including those of the crescent voices and of Samuel Sandor, this chapter crystallizes the personal take on screen lives that the book offers, reiterating the need to ‘undo the digital’ and find the human in, on, with, at, and against screens. It also presents some of the problems scholarship must meet, such as digital inequalities, whether that be in terms of time, awareness, or skill with technology. However, despite the considerable negative forces at work in screen lives which the book has taken care to unravel, this concluding chapter advocates ‘taking the higher ground’ and enacting wonder in interactions with screens.
Chapter 4 delves deeper into screen life, adopting an even more human-centred focus, in order to uncover the affective aspect of screen lives. Maintaining an embodied approach, this chapter explores how affective experiences with screens are intentionally elicited through how media is designed, how affect on screens might differ from affect outside screens, and how digital affect can inform practices, and practices induce affect. The chapter begins by defining affect, then digital affect more specifically, before turning to interviewees for their perspectives on how they feel and sense on screens, touching on topics such as micro digital affect, algorithms, and the pandemic. Crescent voices in this chapter help illustrate how digital affect is vital to understanding digital literacy practices and screen lives, especially the double-edged aspects of our affective relationships to screens.
This book is about the science and ethics of clinical research and healthcare. We provide an overview of each chapter in its three sections. The first section reviews foundational knowledge about clinical research. The second section provides background and critique on key components and issues in clinical research, ranging from how research questions are formulated, to how to find and synthesize the research that is produced. The third section comprises four case studies of widely used evaluations and treatments. These case examples are exercises in critical thinking, applying the questions and methods outlined in other sections of the book. Each chapter suggests strategies to help clinical research be more useful for clinicians and more relevant for patients.
Wildlife health surveillance is a rapidly evolving field. The goal of this commentary is to share the authors perspectives on the evolving expectations of wildlife health surveillance. We describe the basis for developing our opinions using multiple information sources including a narrative literature review, convenience samples of websites and conversations with experts. With increasing prominence of wildlife health, expectations for surveillance have increased. Situational awareness and threat or vulnerability detection were expected outputs. Action expectation themes included knowledge mobilization, reliable action thresholds and evidence-based decision making. Information expectations were broad and included the need for information on social and ecological risk drivers and impacts and evaluation of surveillance systems. Surveillance systems developers should consider: (1) What methods can equivalently and reliably manage the biases, uncertainties and ambiguities of wildlife health information; (2) How surveillance and intelligence systems support acceptable, ethical, efficient and effective actions that do not generate unintended consequences; and (3) How to generate evidence to show that surveillance and intelligence systems lead to decisions affecting vulnerability or resilience to endemic health threats, emerging diseases, climate change and other conservation threats.
The muscular restructuring and loss of function that occurs during a transfemoral amputation surgery has a great impact on the gait and mobility of the individual. The hip of the residual limb adopts a number of functional roles that would previously be controlled by lower joints. In the absence of active plantar flexors, swing initiation must be achieved through an increased hip flexion moment. The high activity of the residual limb is a major contributor to the discomfort and fatigue experienced by individuals with transfemoral amputations during walking. In other patient populations, both passive and active hip exosuits have been shown to positively affect gait mechanics. We believe an exosuit configured to aid with hip flexion could be well applied to individuals with transfemoral amputation. In this article, we model the effects of such a device during whole-body, subject-specific kinematic simulations of level ground walking. The device is simulated for 18 individuals of K2 and K3 Medicare functional classification levels. A user-specific device profile is generated via a three-axis moment-matching optimization using an interior-point algorithm. We employ two related cost functions that reflect an active and passive form of the device. We hypothesized that the optimal device configuration would be highly variable across subjects but that variance within mobility groups would be lower. From the results, we partially accept this hypothesis, as some parameters had high variance across subjects. However, variance did not consistently trend down when dividing into mobility groups, highlighting the need for user-specific design.
Real-time measurement of head rotation, a primary human body movement, offers potential advantages in rehabilitating head or neck motor disorders, promoting seamless human–robot interaction, and tracking the lateral glance of children with autism spectrum disorder for effective intervention. However, existing options such as cameras capturing the entire face or skin-attached sensors have limitations concerning privacy, safety, and/or usability. This research introduces a novel method that employs a battery-free RFID tag-based wearable sensor for monitoring head orientation, as a substitute for the existing options like camera. By attaching a pair of passive RFID tags to the front of the head at a specific distance from each other, the signal strength of each tag within the pair differs based on the discrepancy in distance from the RFID reader caused by head rotation. Important parameters including distance between the tags, distance from the reader, and tag types, are investigated to suggest optimal sensor design. In tests involving random head rotations by 10 healthy adults, there was a significant correlation between the orientation of the head and gaze in the yaw direction and the differences in signal strength from the sensor pairs. The correlation coefficients ($ {r}^2 $) were satisfactory, at 0.88 for head and 0.83 for left eye pupil orientations. However, the sensor failed to estimate pitch rotations for head and gaze, due to the insufficient vertical spacing between the tags. No demographic factors appeared to influence the results.
Chemical industries must in the near future change their general basic raw materials from fossil carbon sources to renewables according to political decisions in most of the world. This is following concern over the use of raw materials that increase the concentration of green house gases like CO2 in the atmosphere. This calls for a new inventory of raw materials and extensive changes in the manufacturing process of many common chemicals. Chemical Product Design is a systematic procedure for inventing new ways of making chemical products and, in this chapter, we shall go through a number of cases where a radical new way of concepting chemicals and manufacturing processes is exemplified.
In this chapter, we argue that while it has often been suggested that utility models are a product of late nineteenth-century German thinking and that they are foreign to the United Kingdom, utility model protection was first introduced to the United Kingdom in the Utility Designs Act 1843. As such, it is clear that utility model protection has a long established (albeit somewhat tarnished) pedigree in British law and that utility model protection came into force in the United Kingdom some fifty years before its German counterpart. In this chapter we highlight the key features of the Utility Designs Act 1843, the way the Act was received, and speculate on the reasons why the Act was forgotten
Statistical power is an important detail to consider in the design phase of any experiment. This paper serves as a reference for experimental economists on power calculations. We synthesize many of the questions and issues frequently brought up regarding power calculations and the literature that surrounds that. We provide practical coded examples and tools available for calculating power, and suggest when and how to report power calculations in published studies.
Answer Set Programming with Quantifiers (ASP(Q)) has been introduced to provide a natural extension of ASP modeling to problems in the polynomial hierarchy (PH). However, ASP(Q) lacks a method for encoding in an elegant and compact way problems requiring a polynomial number of calls to an oracle in $\Sigma _n^p$ (that is, problems in $\Delta _{n+1}^p$). Such problems include, in particular, optimization problems. In this paper, we propose an extension of ASP(Q), in which component programs may contain weak constraints. Weak constraints can be used both for expressing local optimization within quantified component programs and for modeling global optimization criteria. We showcase the modeling capabilities of the new formalism through various application scenarios. Further, we study its computational properties obtaining complexity results and unveiling non-obvious characteristics of ASP(Q) programs with weak constraints.