It all depends how tired I am and whether I am lying on my back, side or stomach. Usually, when operating it one-handed, I have all four fingers behind the device and my thumb on the front edge. With a slight move and tap of my thumb I can turn the page forward. If I want to turn a page backwards, it is usually easiest just to give it a quick tap with the other hand. Not much of a problem since pages are usually being turned forward.
I use my left hand to hold the device when reading in Japanese. And I use my right hand to hold it when reading in left to right languages.
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