bluuebunny/crossref_metadata_2025 huggingface dataset:
Teamwork Traits Associated with Positive Perceptions of the Dependability and Utility of Autonomous Advisors
Authors: Bendell Rhyse , Williams Jessica , Fiore Stephen M. , Jentsch Florian
Published: October 2023

Near future human-autonomy teams (HATs) will feature artificial agents with increasingly advanced social capabilities. The social atmosphere of a team is known to be important for successful teaming; however, it is not clear that factors influencing human-to-human exchanges will transfer directly to human-autonomy exchanges. Here, using data from the DARPA ASIST program, we employed four measures tapping individuals’ personality, social preferences, and social intelligence to explore differences in perceptions of human as compared to autonomous teammates’ dependability as well as perceived impacts regarding team coordination and performance. We found that psychological collectivism, sociable dominance, and extraversion were associated with positive perceptions of autonomous teammates serving as advisors, but not human teammates in the same role, and a reversed relationship for conscientiousness and openness. Awareness and examination of these factors in increasingly social HATs will be important for developing successful agents and selecting effective team members.
Tossing Your Tylenol: Supporting Sustainable Behavior in Medication Disposal Through Label Design
Authors: Renata Vianney , Parker Jah’inaya , Loganathar Shanmugapriya , Kamaraj Amudha V. , Li Mengyao
Published: October 2023

Pharmaceutical waste has proven harmful to society and the environment either stagnating in home medicine cabinets or seeping back into the ecosystem. This points to an unsustainable pattern of disposal of pharmaceutical waste. This paper presents the implementation of a user-centered design process paired with a sustainable behavior paradigm to address barriers to the proper disposal of pharmaceutical waste. The design process revealed that a lack of awareness of proper disposal methods is a contributing factor to improper disposal. Labels with images highlighting different strategies for the proper disposal of medication were prototyped. A message meant to motivate the user to properly dispose of medication accompanied the images. Three types of motivational messages (eco-affective, norm-based, and social implication based) were presented to assess their effectiveness and preference. User testing revealed issues with label interpretability and a preference for social-implication-based motivational messages. A final prototype incorporating user feedback is presented.
A Review of User Experience Requirements for a Procedural Training Task in Virtual Reality
Authors: Fussell Stephanie G.
Published: October 2023

The U.S. Air Force (USAF) Warfighter Interactions and Readiness Division is actively integrating virtual reality (VR) technology in Distributed Mission Operations Live, Virtual, and Constructive (DMO LVC) training. A head-mounted display (HMD) comparison methodology was pilot tested to evaluate the usability of multiple VR headsets for application in Warfighter training. This report discusses key factors and considerations that may impact usability and user experience, thereby impacting the training of the user. Implications on how these findings may correlate with training efficiencies are discussed.
Exploring Strategies to Improve Performance Accuracy on Vigilance-Based Tasks
Authors: McGough Olivia H. , Mayhorn Christopher B.
Published: October 2023

Vigilance is the ability to maintain attention on a task over time without becoming distracted. Many high-stakes fields require employees to regularly engage in vigilance tasks (e.g., TSA baggage screening). Understanding strategies to improve accuracy on such tasks can be critical in ensuring efficiency and safety. In the current work, trial-by-trial feedback and extrinsic motivators were tested as potential aids to improve accuracy on vigilance tasks. Measures of state boredom were also collected. Results provide insight that trial-by-trial feedback may be an effective tool to increase accuracy on basic vigilance tasks. Further research is needed to understand the impact of trial-by-trial feedback and extrinsic motivators on state boredom and their impact on applied tasks.
Restoring Consumer Trust in a Home Improvement Service Provider with Negative Reviews
Authors: Ponathil Amal , Bhanu Aasish , Madathil Kapil Chalil
Published: October 2023

With the growth in technology, the use of digital information to learn about a product or a service has increased substantially. Generally, users tend to trust a service provider until they find negative information.

However, when their trust is violated, it becomes difficult to rebuild it. This study focused on the type of response that a service provider can provide to restore a user’s trust. We recruited 400 participants through Qualtrics Research Services for a 2*5 between subjects study. The findings suggest that irrespective of the type of accusation, i.e., morality- or competence-based, both an elaborate apology and denial restore the trust in the service provider. However, these ratings fell within the average range, suggesting that both are only an initial action and additional information is needed to regain the trust lost due to an accusation.
Human Factors and New Nuclear: Advancements and Future Possibilities
Authors: Hildebrandt Michael , Hughes Green Niav M. , Blackett Claire , Boring Ronald , Egli Scott , Green Brian , Zhang Shuhui
Published: October 2023

After years of stagnation, interest in the development and construction of new nuclear power facilities is accelerating. Some of the proposed designs, such as small modular reactors and microreactors, are significantly different from the plants currently in operation. Therefore, much of the nuclear human factors knowledge acquired over the last 40 years may not be easily transferrable to these plants. At the same time, other kinds of human factors research, such as work on high-levels of automation and remote operation, become increasingly relevant. This panel aims to provide guidance for human factors practitioners in this shifting landscape by gathering experts with backgrounds in research, regulation, and operations.
Drivers’ trust & reliance on automated braking at intersections: Effects of automation braking profile & in-vehicle displays
Authors: Kanaan Dina , Laurent Luckyna , Donmez Birsen
Published: October 2023

An online, video-based, within-subjects experiment was conducted to investigate the effects of three different automation braking profiles and three in-vehicle display designs on drivers’ trust and reliance on automated braking systems. 36 participants watched videos of automated braking at intersections (with different braking times and displays) and rated their trust in the automation and comfort with the automation’s braking time. They then watched the same videos and were asked to press the space bar and pause the video if they believed they should take over from the automation and brake. The braking profile had a significant effect on the trust and comfort ratings, while both the braking profile and display had a significant effect on the takeover time. The findings provide insights on drivers’ trust and reliance on automation that is designed to avoid lateral collision hazards at intersections.
Theoretical Considerations and Applications for Social Robots in Virtual Reality
Authors: Pithayarungsarit Pawinee , Kim Min Ji , Kim Boyoung , Weiland Rydia , Phillips Elizabeth
Published: October 2023

While Virtual Reality (VR) has been used by researchers to investigate human-robot interaction (HRI), these efforts were largely focused on investigating HRI with industrial robots. In this current paper, we identify this gap in the literature and suggest the benefits and the limitations of investigating HRI in VR, and offer use cases for interacting with social robots in the VR space. We identify some use cases where interacting with a social robot in VR may be beneficial over interacting with a human in VR, and offer future directions and applications for this topic.
Effects of Spatial Uncertainty on Tactile Vigilance
Authors: DeLucia Patricia R. , Prakash Jayashri , Greenlee Eric T.
Published: October 2023

We examined effects of task demand on tactile vigilance by manipulating spatial uncertainty, which has been shown to affect visual vigilance. While holding a tactor in each hand, participants received a long or short (critical) vibration, and pressed a foot pedal when the critical stimulus occurred. In the “certain” condition, the spatial location of the stimulus alternated predictably across hands. In the “uncertain” condition, the stimulus was randomly assigned to either hand. We measured response time; proportion hits and false alarms; sensitivity and response bias; and stress and workload. Vigilance decrement was observed; sensitivity decreased and response time increased. Spatial uncertainty did not affect the occurrence or magnitude of the decrement. Results suggest that effects of cognitive demands are more similar between tactile and auditory modalities compared to the visual modality. Interface designers should be aware that spatial uncertainty likely has more detrimental effects on visual vigilance, compared to tactile vigilance.
A Perfect Storm: Helicopter Emergency Medical Services and Degraded Flying Conditions
Authors: Lawton Paige , Rosado Gabriela , Tooker McKenna C. , Boquet Albert
Published: October 2023

As a result of increasing availability, Helicopter Emergency Medical Services (HEMS) operations have become an important part of the healthcare system within the United States; however, this growth has come at a cost to the pilots and crew members who provide these services. For several decades, the largest contributing factor to HEMS accidents and fatalities has been flight into degraded conditions. Flying in dark night conditions as well as continued and inadvertent flight into IMC persist as the biggest risk factors for HEMS crews. Using the Human Factors Analysis and Classification System (HFACS), our analysis investigates the active failures which increase risk in HEMS operations and lead to accidents continuously occurring in degraded conditions.
Simulator Feature Framework: Requirements to Support Training, Research, and Education
Authors: Gideon Olugbenga , Ulrich Thomas A.
Published: October 2023

There is an expansion of nuclear power plant control room simulator use beyond traditional operator training. Modern simulator designs require more robust capabilities to serve the diverse needs of multiple user groups including researchers and educators. A common framework for evaluating simulator features to support training, research, and education is critical to ensure future simulators enable research for immediate and future plant modernization and advanced reactor deployment needs. An initial framework comprised of 8 feature categories was developed by reviewing published simulator-based research and analyzing simulator features against research objectives and results. Future research will focus on evaluating the suitability of this framework in characterizing and differentiating simulators across training, research, and education use cases.
Proof of Concept for a Data-Driven Vr Spatial Disorientation Training Tool for Navy Pilots
Authors: Erickson Isabel , Hidalgo Maartje , Reynolds Jonathan , Ficke Cherrise , Krumholtz Victoria , Drucker Jonathan , Blacker Kara J. , Pettijohn Kyle A. , Burcal Christopher J.
Published: October 2023

Spatial disorientation (SD) contributes to at least 30% of aviation mishaps, with most being fatal. These mishaps involve not only complex interactions between human, machine, mission, and environment, but also multiple internal neurophysiological systems. Given the complexity of these dynamics, SD competency (i.e., the ability to recognize, confirm, and recover from an SD incident) is hard to predict and teach in the classroom. The Aptima team has developed a data-driven, practical, and realistic virtual reality (VR) training platform for SD called MAVIS, which includes a set of subjective, objective (performance), and physiological measures to rigorously evaluate SD competencies. Preliminary results of this proof of concept confirm the validity of our theoretical framework with a small sample, although rigorous experimentation with a larger sample will be required to validate the approach and justify its operational use. These preliminary results indicated that (1) the MAVIS protocol induces SD; and (2) self-report, performancebased, and neurophysiological measures seem to associate with SD induction and its sequelae.
Human Factors, Ergonomics, and Biomechanical Engineering Approaches to Incidents involving Amusement Rides
Authors: Figueroa-Jacinto Rosemarie , Cargill Robert S. , Woodcock Kathryn
Published: October 2023

Amusement ride incidents resulting in major injuries are a rare occurrence. When they occur, in-depth assessment requires specialized expertise and methodologies. Human Factors, Ergonomics (HF/E), and Biomechanical Engineering (BMechE) professionals are uniquely equipped to evaluate incidents involving these complex systems. An HF/E approach would follow frameworks to understand whether, given the situation and the actions and limitations of the individual, the adverse incident would have been avoidable. As a complement, during the in-depth assessments, BMechE approaches consider principles of mechanical engineering, mechanics, and biology in the context of human responses. This study outlines HF/E and BMechE frameworks and approaches that can be leveraged when performing in-depth accident investigations involving amusement rides and explores areas to enhance these contributions.
Ergonomic Assessment of Structural Firefighter Turnout Suit Designs for Improved Mobility
Authors: McQuerry Meredith , Schofield Sherry , Ormsbee Michael J , Rentería Liliana I , Poley-Bogan Maddy , Griest Timothy D , Wilson Robert , Livin Leah , Cross Brett , Paterson Kieran
Published: October 2023

The purpose of this study was to design a novel turnout suit for improved mobility based on firefighter user needs. A wear trial assessment was performed to investigate the differences in range of motion (ROM), ease of movement, and comfort of a novel structural firefighter turnout suit versus existing suit models on the market today. Ten healthy firefighters wore three different turnout suits while their ROM was measured using electro-goniometers worn against the skin in the shoulder, elbow, hip, and knee joints. Perceived ease of movement ratings were gathered for 13 static joint exercises. A subjective perception survey was administered after completing the static protocol in each suit. A dynamometer measured peak force and torque in the elbow, knee, and shoulder joints. Results indicate significant differences occurred between the suits for perceived ease of movement ratings and hip ROM.
Repurposing a Digital Twin-Based Decision Support System as a Training Tool by Incorporating Learning Science Principles
Authors: Beaubien Jeffrey M. , Hidalgo Maartje , Yerdon Valarie , Haste Deepak , Ghoshal Sudipto , Wong Jason
Published: October 2023

The U.S. Navy has a sophisticated manpower planning process for recruiting, selecting, training, and placing thousands of enlisted Sailors into hundreds of specific jobs every year. Given the large number of “moving parts” in this manpower planning process, some inefficiencies are unavoidable. For example, there may be a non-trivial time gap between when some Sailors complete their job-specific training course and when they arrive at their duty station. During this time, their knowledge and skills will invariably decay due to lack of use. Electronic job aids, such as Interactive Electronic Technical Manuals (IETMs) and Decision Support Systems (DSS), are important to mission success because they help to reduce the need for Sailors to memorize rarely used factual details. However, IETMs and DSSs are job aids, not training tools. In this paper, we describe how we repurposed an existing digital twin-based DSS to create a ubiquitous, online training tool. We did so by leveraging the learning science principles of human performance measurement, adaptive learning with scaffolding, performance feedback, and training data analytics. We conclude with a series of best practices and lessons learned that other practitioners could follow when attempting to repurpose electronic job aids that were not originally designed for training.
Teamwork in Cybersecurity: Evaluating the Cooperative Board Game [d0x3d!] as an Experimental Testbed
Authors: Fausett Crystal M. , Keebler Joseph R.
Published: October 2023

It is crucial to identify the knowledge, skills, and attitudes (KSAs) that contribute to success in cybersecurity teams. We introduce a board game, [d0x3d!], as an experimental testbed designed to create a controlled environment and set of manageable tasks aimed at exploring teamwork competencies that may be relevant to the cybersecurity workforce. [d0x3d!] requires players to work together and share information to retrieve stolen digital assets. The authors aim to improve the efficacy of cybersecurity team training by incorporating modern teamwork theory and measurement. This testbed provides a low-cost and user-friendly platform for training, evaluation, and research.
Errors in Augmented Reality Interactions Affected Muscular Loads in the Neck and Shoulders
Authors: Kia Kiana , Hwang Jaejin , Kim Jay
Published: October 2023

The use of augmented reality (AR) head-mounted displays is becoming increasingly prevalent due to their ability to provide interactive experiences with high degrees of freedom. However, AR interactions have been shown to be associated with increased biomechanical loads in the neck and shoulders. This repeated-measures study evaluated the effects of interaction errors on neck and shoulder biomechanical loads during AR tasks. Twenty participants performed two standardized AR tasks (omni-directional pointing and cube placing) with and without AR interaction errors. During the tasks, neck and shoulder angles and muscle activity were collected. The results showed that the presence of errors led to increased neck extension and shoulder flexion angles. Peak muscle activity in the shoulders (anterior and medial deltoids) also increased with errors. These findings highlight the importance of reducing interaction errors in AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders
A Framework for Human-Algorithm Teaming in Biometric Identity Workflows
Authors: Howard John J. , Rabbitt Laura R. , Shuggi Isabelle M. , Sirotin Yevgeniy B.
Published: October 2023

Biometric identity workflows are made up of multiple subsystems which can be automated to varying degrees using computer algorithms. Setting the appropriate level of automation for each subsystem is crucial for optimal system performance, which relies on synergistic human-algorithm teams. In this work, we leverage an automation design framework from prior research to define levels of automation for each biometric subsystem. This framework aligns a four-stage model of human processing with equivalent system functions. We propose applying this framework as a method to determine the appropriate allocation of tasks between humans and algorithms within a biometric identity workflow. While previous work has focused on the role of the human in the comparison and decision subsystems, we emphasize the need to consider the full biometric system in determining the role of humans in biometric identity workflows.
Impact of Engaging with Intelligent Tutoring System Lessons Prior to Class Start
Authors: Sinatra Anne M. , Robinson Rebecca L. , Goldberg Benjamin , Goodwin Gregory
Published: October 2023

A study was conducted using the Generalized Intelligent Framework for Tutoring (GIFT) intelligent tutoring system (ITS) software and an Army Schoolhouse course. Existing materials were provided and used to create 9 computer-based GIFT lessons that included adaptive tutoring versions of the materials. These lessons included a Pre-Test, 7 content lessons (on the areas of Detect, Engage, and Assess), and a Post-Test. Six participants completed the Pre-Test, Post-Test, and all lessons. Overall Post-Test scores were significantly higher than Pre-Test scores, and remediation also had a positive impact on Post-Test scores. This study demonstrates that completing self-paced ITS lessons prior to initial class instruction can lead to positive learning impacts prior to the start of a class.
Impact of Central Vision Loss on Eye Movements and Time-to-Contact Judgments
Authors: Cloutier Melissa , DeLucia Patricia R.
Published: October 2023

Age-related macular degeneration (AMD) leads to loss of central vision and typically occurs in older adults. Loss of central vision has been associated with degraded mobility, including difficulties with streetcrossing decisions, which implies that there also may be degraded timeto-contact (TTC) judgments. Further, individuals with AMD have shorter saccades compared to individuals with normal vision leading to difficulty with tracking objects. This study investigated the impact of eye movements on TTC judgments in an AMD group using a predicted motion task in a virtual reality system. Results indicated that longer saccades were associated with more accurate TTC judgments and showed that the AMD group had shorter saccades, and less accurate TTC judgments. As such, difficulties with judgments of collisions in individuals with AMD may result from inefficient eye movements.
Encouraging Isometric Holds and Reducing Stress: Comparing Dogs and Robots as Motivators
Authors: Finkbeiner Kristin M. , Helton William S.
Published: October 2023

The Attention Restoration Theory (ART) indicates interacting with nature (animals) is restorative to directed attention, via activation of involuntary attention (Kaplan, 1995). Dogs specifically have been linked to promoting exercise and stress reduction (Wells, 2009; Wohlfarth et al., 2013). The application of ART to the expenditure of physical effort was currently explored, hypothesizing that live dog interaction may increase effects of ART during an isometric hold. Sixty participants randomly assigned to an interaction group (dog, robot or toy) completed two isometric holds at maximal effort (before and after interaction) while reporting ratings of perceived effort (RPE) and stress. Results show no significant differences between conditions for duration of holds or RPE. However, ratings of stress were lower for dog interaction than other conditions, implying the presence of dogs help alleviate stress, without affecting performance. Further studies are needed to determine whether ART impacts executive control (directed attention) or affect.
Building Situation Awareness and Team Cohesion through Effective Information Sharing in a Distributed Team-Based Command and Control Scenario
Authors: Chubala Chrissy M. , Hunter Aren , Dithurbide Lori , Neyedli Heather F.
Published: October 2023

Within complex command and control domains, where teams are often geographically distributed and heterogeneous in expertise, the formulation of a course of action depends upon effective information sharing between teammates. The communication and development of situation awareness (SA) may both depend upon and help foster trust and cohesion among teammates. However, distributed and heterogeneous environments present challenges for the development of trust and cohesion. This study investigated the relationship between information sharing, SA, trust, and team cohesion in a distributed team-based emergency management scenario. Participants played the role of humanitarian aid experts, public health experts, and migration and social services experts responding to a potential outbreak of cholera following a natural disaster. The results of exploratory analyses provide preliminary support for a complex relationship between effective information sharing, the convergence of higher-level SA, and the development of team cohesion, and propose a roadmap for further exploration of this rich dataset.
The Role of Human Factors in Evaluating and Updating Requirements for Flight Deck Displays and Controls
Authors: Fercho Kelene A. , Beringer Dennis B. , Donovan Colleen
Published: October 2023

The remarkable level of safety of aviation operations is due, in part, to Federal Aviation Administration requirements and guidance that govern civilian aviation activities in the United States National Airspace System. At times, these requirements and guidelines need reevaluation and updating—for example, due to a known change in the pilot workforce or with flight deck technology. This paper provides examples of when this may be necessary, and explains the role that human factors research plays in this process. One objective of this paper is to make the case that it is necessary to periodically review and update requirements and guidance, even if the equipment or technology haven’t changed; often the human operators have changed or additional information is now available. Additionally, the process described here may be applicable to international aviation authorities, other federal agencies, and the private sector, as a best practice and critical safety initiative.
Range Anxiety among Battery Electric Vehicle Users: Both Distance and Waiting Time Matter
Authors: Wang Jiyao , Huang Chunxi , He Dengbo , Tu Ran
Published: October 2023

Range anxiety is a major concern of battery electric vehicles (BEVs) users or potential users. Previous work has explored the influential factors of distance-related range anxiety. However, time-related range anxiety has rarely been explored. The time cost when charging or waiting to charge the BEVs can negatively impact BEV users’ experience. As a preliminary attempt, this survey study investigated time-related anxiety by observing BEV users’ charging decisions in scenarios when both battery level and time cost are of concern. We collected and analyzed responses from 217 BEV users in mainland China. The results revealed that time-related anxiety exists and could affect users’ charging decisions. Further, users’ charging decisions can be a result of the trade-off between distance-related and time-related anxiety, and can be moderated by several external factors (e.g., regions and individual differences). The findings can support the optimization of charge station distribution and EV charge recommendation algorithms.
Assessing safety through agent-based simulation for aircraft carrier flight decks
Authors: Cummings M.L
Published: October 2023

Aircraft carrier flight decks are dangerous work environments that require high degrees of coordination between humans in and around aircraft. It is impossible to run experiments in such settings to determine if new policies and rules could reduce the risk of injury. In order to explore possible safety improvement strategies in such settings where deaths still occur, an agent-based simulation environment was developed that allows for exploration of the impact of new procedures and technologies during aircraft launches. In this Optimal Manning Simulation (OMS), safety is measured through unexpected halo violations, where people inadvertently enter a bubble of high risk around an aircraft. An analysis with OMS demonstrated that safety-focused agent-based simulations could uncover not only where personnel face high risks but also when such risks could significantly increase. Thus, OMS can be used not only in a descriptive and predictive manner but also prescriptively to inform future policies.
The Influence of Viability, Independence, and Self-Governance on Trust and Public Acceptance of Uncrewed Air Vehicle Operations
Authors: Sato Tetsuya , Inman Jessica , Politowicz Michael S. , Chancey Eric T. , Yamani Yusuke
Published: October 2023

Trust is expected to be a critical construct that drives successful use of advanced air mobility technologies. As yet, though, the role of trust in human-autonomy interaction is underexplored. Kaber (2018) argues that autonomy requires the highest level of three independent dimensions – viability, independence, and self-governance. The present study examined whether trust varies across the three dimensions of autonomy under varying levels of risk. Participants in the high-risk group read a series of vignettes on a drone that delivers medical supplies over a city where the current study was conducted. Participants in the low-risk group read a series of vignettes on a drone that delivers fast food over a fictitious city. Each vignette described a drone that is either autonomous (i.e., possesses all dimensions) or automated (i.e., one of the dimensions is compromised). Results imply that the three dimensions of autonomy do not equally influence human-technology trust and behavior.
Examining Central Fatigue Pathways under Stress: Integrating Insights from Graph Theoretical Neural Modeling and Motor Cortex Excitability
Authors: Tyagi Oshin , Mehta Ranjana K.
Published: October 2023

Acute cognitive stress affects neuromuscular fatigue, but the underlying mechanisms are not well understood. The aim of this study was to identify the influence of stress on central fatigue and associated functional changes in the brain. Thirty participants, balanced by sex, performed intermittent elbow flexion contractions at 30% of their maximum strength till voluntary fatigue. Endurance time, strength loss, and voluntary activation loss rate were collected. Functional hemodynamic changes in the participants’ prefrontal and motor areas of the brain were also collected and used to calculate functional integration and segregation in the PFC and M1. Results show that stress had a facilitative effect on fatigability and the fatigue related decline in the functional integration and segregation of prefrontal cortex were not observed under stress. These findings demonstrate how the imposition of dual task demands in the workplace delays the perception of neuromuscular fatigue, thereby increasing the risk of injury.
Cardiorespiratory Fitness, Motor Coordination, and Academic Achievement in School Students (11-13 years)
Authors: Tanineh Wafa , Halaweh Hadeel
Published: October 2023

Objective. This study aimed to investigate the association between motor coordination (MC), cardiorespiratory fitness (CRF), and academic achievement (AA) among school students aged 11 to 13 in the West Bank/Palestine. Methods. A total of 252 students were assessed through tests measuring gross and fine motor coordination (Flamingo balance, plate tapping, and other tests). The CRF was evaluated by the 3-minute step test, while AA was measured using grade point average (GPA) and subject-specific grades. Results. A significant correlation was recorded between MC, CRF, and AA ( P = .00), rs range (0.436-0.718); Students who engaged in physical activity demonstrated better MC, CRF, and AA compared to their inactive counterparts ( P = .00, Cohen’s d ranged between 0.53 and 1.35). Conclusion. Enhanced MC and CRF significantly impacted AA, with effect sizes ranging from moderate to large. Promoting physical activity interventions is vital to improve MC and CRF which could positively improve academic achievement among school students.
Dalbavancin Use in Persons Who Use Drugs May Increase Adherence Without Increasing Cost
Authors: Russo Tiffany A. , Ritchie Hannah R. , Schimmel Jennifer J. , Lorenzo Michael P.
Published: October 2023

Background: Dalbavancin (DAL) may obviate concerns regarding misuse of IV access in persons who use drugs (PWUD) completing treatment for infections in an outpatient setting. However, hesitancy to adopt its use exists due to the cost-prohibitive nature of DAL and perceived issues with insurance reimbursement. Our study looks to determine the financial impact of DAL use in actual, measured cost, and health care utilization, data as well as the effect on treatment completion rates. Methods: This is a retrospective cohort comparing cost information and treatment completion rates of patients who received DAL to a random sample of patients with Staphylococcus aureus bacteremia prior to the institutional availability of DAL. Results: From June 2020 to January 2022, 29 PWUD received DAL. Dalbavancin use resulted in the completion of intended duration in 19 patients (66%) compared with 11 (55%) without DAL. The contribution margin with DAL use was $7180 compared with $6655 without; this was not statistically significant ( P = 0.47). Conclusion: Dalbavancin use in PWUD may increase treatment completion, with no statistically significant difference in contribution margins.
Induction of ferroptosis by artesunate nanoparticles is an effective therapeutic strategy for hepatocellular carcinoma
Authors: Nie Dengyun , Guo Ting , Zong Xinyu , Li Wenya , Zhu Yinxing , Yue Miao , Sha Min , Lin Mei
Published: October 2023

Artesunate (ART) has great value in the field of tumor therapy. Interestingly, in this study, we found that ART could obviously induce ferroptosis in hepatocellular carcinoma (HCC) cells, but its low water solubility and bioavailability limited its application potential. Hence, we synthesized ART-loaded mesoporous silica nanoparticles (MSNs) conjugated with folic acid (FA) (MSN-ART-FA) with tumor-targeting performance and assessed their characteristics. We evaluated the ability of MSN-ART and MSN-ART-FA to induce ferroptosis of hepatoma cells via testing levels of reactive oxygen species (ROS), Fe2+, malondialdehyde (MDA) and glutathione (GSH), observation of mitochondrial morphology, as well as the expression of key proteins in ferroptosis. The results showed that prepared MSN-ART and MSN-ART-FA could remarkedly improve the bioavailability of ART to enhance ferroptosis, thereby inhibiting cell proliferation, migration and invasion in vitro. Besides, MSN-ART-FA group displayed slower tumor growth and smaller tumor volumes than MSN-ART group in HepG2 xenograft mouse model. It provided a potential therapeutic option for HCC and expanded the horizon for the clinical treatment of other cancers.

Graphical Abstract
Development and evaluation of an algorithm to link mothers and infants in two US commercial healthcare claims databases for pharmacoepidemiology research
Authors: Weaver James , Hardin Jill H. , Blacketer Clair , Krumme Alexis A. , Jacobson Melanie H. , Ryan Patrick B.
Published: October 2023

Background

Administrative healthcare claims databases are used in drug safety research but are limited for investigating the impacts of prenatal exposures on neonatal and pediatric outcomes without mother-infant pair identification. Further, existing algorithms are not transportable across data sources. We developed a transportable mother-infant linkage algorithm and evaluated it in two, large US commercially insured populations.

Methods

We used two US commercial health insurance claims databases during the years 2000 to 2021. Mother-infant links were constructed where persons of female sex 12–55 years of age with a pregnancy episode ending in live birth were associated with a person who was 0 years of age at database entry, who shared a common insurance plan ID, had overlapping insurance coverage time, and whose date of birth was within ± 60-days of the mother’s pregnancy episode live birth date. We compared the characteristics of linked vs. non-linked mothers and infants to assess similarity.

Results

The algorithm linked 3,477,960 mothers to 4,160,284 infants in the two databases. Linked mothers and linked infants comprised 73.6% of all mothers and 49.1% of all infants, respectively. 94.9% of linked infants’ dates of birth were within ± 30-days of the associated mother’s pregnancy episode end dates. Characteristics were largely similar in linked vs. non-linked mothers and infants. Differences included that linked mothers were older, had longer pregnancy episodes, and had greater post-pregnancy observation time than mothers with live births who were not linked. Linked infants had less observation time and greater healthcare utilization than non-linked infants.

Conclusions

We developed a mother-infant linkage algorithm and applied it to two US commercial healthcare claims databases that achieved a high linkage proportion and demonstrated that linked and non-linked mother and infant cohorts were similar. Transparent, reusable algorithms applied to large databases enable large-scale research on exposures during pregnancy and pediatric outcomes with relevance to drug safety. These features suggest studies using this algorithm can produce valid and generalizable evidence to inform clinical, policy, and regulatory decisions.
The HortONS study. Treatment of chronic cluster headache with transcutaneous electrical nerve stimulation and occipital nerve stimulation: study protocol for a prospective, investigator-initiated, double-blinded, randomized, placebo-controlled trial
Authors: Fogh-Andersen Ida Stisen , Sørensen Jens Christian Hedemann , Petersen Anja Sofie , Jensen Rigmor Højland , Meier Kaare
Published: October 2023

Background

Chronic cluster headache (CCH) is a debilitating primary headache disorder. Occipital nerve stimulation (ONS) has shown the potential to reduce attack frequency, but the occipital paresthesia evoked by conventional (tonic) stimulation challenges a blinded comparison of active stimulation and placebo. Burst ONS offers paresthesia-free stimulation, enabling a blinded, placebo-controlled study.

Identification of a feasible preoperative test would help select the best candidates for implantation.

This study aims to explore ONS as a preventive treatment for CCH, comparing burst stimulation to tonic stimulation and placebo, and possibly identifying a potential preoperative predictor.

Methods

An investigator-initiated, double-blinded, randomized, placebo-controlled trial is conducted, including 40 patients with CCH. Eligible patients complete a trial with the following elements: I) four weeks of baseline observation, II) 12 weeks of transcutaneous electrical nerve stimulation (TENS) of the occipital nerves, III) implantation of a full ONS system followed by 2 week grace period, IV) 12 weeks of blinded trial with 1:1 randomization to either placebo (deactivated ONS system) or burst (paresthesia-free) stimulation, and V) 12 weeks of tonic stimulation.

The primary outcomes are the reduction in headache attack frequency with TENS and ONS and treatment safety. Secondary outcomes are treatment efficacy of burst versus tonic ONS, the feasibility of TENS as a predictor for ONS outcome, reduction in headache pain intensity (numeric rating scale), reduction in background headache, the patient’s impression of change (PGIC), health-related quality of life (EuroQoL-5D), self-reported sleep quality, and symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS).

Data on headache attack characteristics are registered weekly. Data on patient-reported outcomes are assessed after each trial phase.

Discussion

The study design allows a comparison between burst ONS and placebo in refractory CCH and enables a comparison of the efficacy of burst and tonic ONS. It will provide information about the effect of burst ONS and explore whether the addition of this stimulation paradigm may improve stimulation protocols.

TENS is evaluated as a feasible preoperative screening tool for ONS outcomes by comparing the effect of attack prevention of TENS and tonic ONS.

Trial registration

The study is registered at Clinicaltrials.gov (trial registration number NCT05023460, registration date 07–27-2023).
Resisting and disrupting HIV-related stigma: a photovoice study
Authors: Restall Gayle , Ukoli Patricia , Mehta Punam , Hydesmith Elizabeth , Payne Mike
Published: October 2023

Background

The stigma associated with human immunodeficiency virus (HIV) is a significant global public health concern. Health care providers and policy makers continue to struggle with understanding and implementing strategies to reduce HIV-related stigma in particular contexts and at the intersections of additional oppressions. Perspectives and direction from people living with HIV are imperative.

Methods

In this project we amplified the voices of people living with HIV about their experiences of HIV-related stigma in Manitoba, Canada. We used an arts-based qualitative case study research design using photovoice and narrative interviews. Adults living with HIV participated by taking pictures that represented their stigma experiences. The photos were a catalyst for conversations about HIV and stigma during follow-up individual narrative interviews. Journaling provided opportunities for participants to reflect on their experiences of, and resistance to, stigma. Interviews were audio recorded and transcribed. Photos, journals, and transcribed interviews were analyzed using inductive qualitative methods

Results

Through pictures and dialogue, participants (N = 11; 64% women) expressed the emotional and social impacts of stigmas that were created and supported by oppressive structures and interpersonal attitudes and behaviours. These experiences were compounded by intersecting forms of oppression including racism, sexism, and homophobia. Participants also relayed stories of their personal strategies and transitions toward confronting stigma. Strategies were themed as caring for oneself, caring for children and pets, reconstituting social support networks, and resisting and disrupting stigma. Participants made important recommendations for system and policy change.

Conclusions

These stories of oppression and resistance can inspire action to reduce HIV-related stigma. People living with HIV can consider the strategies to confront stigma that were shared in these stories. Health care providers and policy makers can take concerted actions to support peoples’ transitions to resisting stigmas. They can facilitate supportive and anti-oppressive health and social service systems that address medical care as well as basic needs for food, shelter, income, and positive social and community connections.
Analysis of the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019
Authors: Li Yan , Li Hao , Jiang Yi
Published: October 2023

Background

Communicable diseases contribute substantially to morbidity and death rates worldwide, particularly in low-and middle-income countries. Pacific Island countries face unique challenges in addressing these diseases due to their remote locations and limited resources. Understanding the burden and trends of these diseases in this region is crucial for developing effective public health interventions.

Objective

This study aimed to analyze the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019.

Methods

We utilized data from the 2019 Global Burden of Disease (GBD) study to analyze indicators including incidence, death, and disability-adjusted life years (DALYs). Excel 2016, R 4.2.1, and GraphPad Prism 9 were used to analyze and visualize the data. Joinpoint regression models were used for trend analysis, and the average annual percent change (AAPC) was calculated.

Results

From 1990 to 2019, the standardized incidence rate of communicable diseases in Pacific Island countries showed an upward trend (AAPC = 0.198%, 95% CI = 0.0174 ~ 0.221), while the standardized death rate (AAPC = -1.098%, 95% CI = –1.34 ~ 0.86) and standardized DALY rate (AAPC = -1.008%, 95% CI = -1.187 ~ -0.828) showed downward trends. In 2019, the standardized incidence, death, and DALY rates of communicable diseases were higher among males than among females, but the standardized death and DALY rates among males decreased faster than those among females from 1990 to 2019. There were significant differences in the disease burden among different Pacific Island countries. The Solomon Islands had the highest standardized death rate (363.73/100,000), and Guam had the lowest (50.42/100,000). Papua New Guinea had the highest standardized DALY rate (16,041.14/100,000), and the Cook Islands had the lowest (2,740.13/100,000). In 2019, the main attributable risk factors for communicable disease deaths in Pacific Island countries were child and maternal malnutrition (28.32%), followed by unsafe water, sanitation, and handwashing (27.14%), air pollution (16.11%), and unsafe sex (14.96%). There were considerable geographical variations in risk factors.

Conclusion

The burden of communicable diseases in Pacific Island countries remains high, despite improvements in mortality and disability-adjusted life-year rates over the past few decades. This study provides valuable insights into the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019. The findings reveal several important insights and highlight the need for targeted public health interventions in the region.
Association between number of dissected lymph nodes and survival in patients undergoing resection for clinical stage IA pure solid lung adenocarcinoma: a retrospective analysis
Authors: Rong Yu , Liu Junfeng , Han Nianqiao , Shi Zhihua , Jiang Tao , Zhang Nan , Xu Xi’e , Yin Jinhuan , Du Hui
Published: October 2023

Background

Lymph node dissection is essential for staging of pure solid lung adenocarcinoma and selection of treatment after surgical resection, particularly for stage I disease since the rate of lymph node metastasis can vary from 0 to 23.7%.

Methods

We retrospectively screened all adult patients (18 years of age or older) who underwent lobectomy for pure solid cT1N0M0 lung adenocarcinoma between January 2015 and December 2017 at our center. Cox proportional hazard regression was used to assess the association between the number of dissected lymph nodes and recurrence-free survival (RFS) and to determine the optimal number of dissected lymph nodes.

Results

The final analysis included 458 patients (age: 60.26 ± 8.07 years; 241 women). RFS increased linearly with an increasing number of dissected lymph nodes at a range between 0 and 9. Kaplan-Meier analysis revealed significantly longer RFS in patients with ≥ 9 vs. <9 dissected lymph nodes. In subgroup analysis, ≥ 9 dissected lymph nodes was not only associated with longer RFS in patients without lymph node metastasis (n = 332) but also in patients with metastasis (n = 126). In multivariate Cox proportional hazard regression, ≥ 9 dissected lymph nodes was independently associated with longer RFS (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.26 to 0.73; P = 0.002).

Conclusions

≥9 Dissected lymph nodes was associated with longer RFS; accordingly, we recommend dissecting 9 lymph nodes in patients undergoing lobectomy for stage IA pure solid lung adenocarcinoma.