bluuebunny/crossref_metadata_2025 huggingface dataset:
An Examination of Interstate Differences in Eligibility Criteria for Deafblindness
Authors: Travers Hilary E. , Schles Rachel Anne
Published: June 2023

Introduction: This study examined the interstate variability in eligibility criteria for the disability category of deafblindness. Methods: We systematically reviewed and coded information related to the location of state data, the use of federal language in state definitions, additional eligibility criteria (i.e., disability eligibility requirements, evaluative components), and required eligibility team members (i.e., specific school staff mentioned by profession to be present for eligibility determinations) for every U.S. state and territory, including Washington, DC. Results: We located deafblind eligibility data for 54 of 56 states. Thirty-one states provided an operationalized definition of deafblindness that included additional eligibility criteria. Seventeen states required students to first be found eligible as having visual and hearing impairments before they could be considered deafblind. Very few states required any eligibility team members with knowledge of sensory impairments or communication disorders to determine deafblind eligibility. Discussion: The findings of this work suggest there is large interstate variability in eligibility criteria for deafblindness. A universal operational definition of deafblindness with defined eligibility criteria may be necessary to ensure consistency in identification and access to appropriate personnel and services across states. Implications for Practitioners: Understanding the eligibility requirements in each state is critical to helping appropriately identify qualifying students with deafblindness. Practitioners should advocate for the identification of deafblind students by keeping any sensory-related information at the forefront of all eligibility discussions.
Parenting Concerns During the COVID-19 Pandemic: Results From a Canadian Crowdsourced Sample
Authors: Kingsbury Mila , Arim Rubab , Findlay Leanne
Published: June 2023

Early research suggests that the COVID-19 pandemic may impact parental functioning. The purpose of this study was to examine parents’ concerns during the pandemic and to explore the characteristics of families who may be particularly vulnerable to parenting concerns. Data were drawn from an online crowdsourcing survey of parents of children under age 15 in Canada ( N = 32,228). Many parents were very or extremely concerned about managing child behaviour (61%) and having less patience with, scolding, or yelling at their children (46%). Family characteristics, including working from home, age of children, number of adults in the home, and child disability were associated with these parenting concerns in logistic regression models. Results are discussed in the context of the known impacts of stress on parenting and families, highlighting family-level and pandemic-specific stressors.
Blood-brain barrier breakdown is linked to tau pathology and neuronal injury in a differential manner according to amyloid deposition
Authors: Moon Yeonsil , Jeon Hong Jun , Han Seol-Heui , Min-Young Noh , Kim Hee-Jin , Kwon Kyoung Ja , Moon Won-Jin , Kim Seung Hyun
Published: June 2023

The blood-brain barrier (BBB) breakdown has been suggested as an early marker for Alzheimer's disease (AD); yet the relationship between BBB breakdown and AD-specific biomarkers based on the amyloid/tau/neurodegeneration framework is not clear. This study investigated the relationship between BBB permeability, AD-specific biomarkers, and cognition in patients with cognitive impairment. In this prospective study, we enrolled 62 participants with mild cognitive impairment or dementia between January 2019 and October 2020. All participants were assessed through cognitive tests, amyloid positron emission tomography (PET), dynamic contrast-enhanced magnetic resonance imaging (MRI) for BBB permeability (Ktrans), cerebrospinal fluid studies for Aβ42/40 ratio, phosphorylated-tau Thr181 protein (p-tau), total tau protein (t-tau), and structural MRI for neurodegeneration. In amyloid PET (+) group, higher cortical Ktrans was associated with lower Aβ40 (r = −0.529 p = 0.003), higher Aβ42/40 ratio (r = 0.533, p = 0.003), lower p-tau (r = −0.452, p = 0.014) and lower hippocampal volume (r = −0.438, p = 0.017). In contrast, cortical Ktrans was positively related to t-tau level. (r = 0.489, p = 0.004) in amyloid PET (−) group. Our results suggest that BBB permeability is related to AD-specific biomarkers, but the relationship can vary by the presence of Aβ plaque accumulation.
A placebo-controlled, randomized, single and multiple dose study to evaluate the safety, tolerability, and pharmacokinetics of rimegepant in healthy participants
Authors: Bertz Richard , Bhardwaj Rajinder , Morris Beth A. , Ashbrenner Eric , Coric Vladimir , Croop Robert
Published: June 2023

Background

Rimegepant is an oral, small molecule calcitonin gene-related peptide receptor antagonist for acute treatment of migraine and migraine prevention.

Methods

This was a single-site, placebo-controlled, sequential, single and multiple ascending dose study in healthy males and females, aged 18–55 years, with no clinically significant medical history. The objectives were to assess the safety, tolerability, and pharmacokinetics of the oral capsule free-base formulation. Single oral doses of rimegepant from 25–1500 mg were evaluated in the single ascending dose phase, and 75–600 mg/day doses administered for 14 days were evaluated in the multiple ascending dose phase.

Results

No dose-related trends were observed in orthostatic systolic and diastolic blood pressure or heart rate after rimegepant administration. Rimegepant was rapidly absorbed with the median time of maximum observed plasma concentration from 1–3.5 hours. Rimegepant showed a more than dose-proportional increase in exposure from 25–1500 mg following a single dose and from 75–600 mg/day following multiple doses.

Conclusions

Rimegepant was safe and generally well tolerated at single oral doses up to 1500 mg and multiple doses up to 600 mg/day for 14 days in healthy participants in this study. Median terminal half-life ranged from 8–12 hours across the wide range of single doses studied.
Estimating Path Travel Costs in Large-Scale Networks Using Machine-Learning Techniques
Authors: Rostami Alireza , Kamjoo Ehsan , Fakhrmoosavi Fatemeh , Zockaie Ali
Published: June 2023

The integration of activity-based models (ABMs) with simulation-based dynamic traffic assignment (DTA) is proposed as a prominent alternative to the traditional four-step approach to modeling transportation networks. In DTA, the least-generalized cost path-finding algorithm is executed to route travelers to their optimal paths, while ABM requires travel-cost skims of the activities, regardless of actual paths, to assess various options available to users such as destination and mode choices. These skims can be calculated either by rerunning the shortest-path-finding algorithm or storing the dynamic travel-cost skims generated at the DTA level. Having a large-scale network with multiple user classes, these methods require high memory storage and run time. Therefore, this study presents a heuristic algorithm utilizing machine-learning methods to predict origin–destination (OD) travel distances, times, and costs using historical vehicle trajectory data generated at the DTA level. This study uses an ellipse boundary around the ODs to truncate the network and extract the relevant vehicle sub-trajectories. Extracted sub-trajectories are clustered into with-toll and non-toll groups based on trip costs to estimate travel distance, time, and monetary cost accordingly. This approach can also be used in navigation systems to have a better estimate of arrival times. Numerical results for the greater Chicago network show promising performance in travel-cost measures estimation with improved solution times. To test the scalability of the proposed method for different OD pairs, the prediction of the best ellipse size is carried out using random forest and neural network methods.
From Social Sphere to Intermediary Association: A Critical Analysis of Civil Society’s Neoliberal Transformation
Authors: Kutay Acar
Published: June 2023

In this paper, I examine the neoliberal transformation of civil society through Mitchel Foucault’s insights concerning knowledge, power, and governmentality. The objective of this paper is to trace the evolving understandings of civil society and how they relate to governmental rationalities and technologies of power. The traditional notion of civil society as a distinct and autonomous sphere has shifted toward an intermediary associations approach under neoliberalism. I posit that the mobilization of non-governmental organizations and civil society organizations by states, international organizations, and donor agencies since the 1990s constitutes a form of governmental technology, influenced by neoliberal rationalities. This technology serves the neoliberal agenda of undermining the social state, promoting market creation, and encouraging non-partisanship. This argument suggests that the rise of civil society as intermediary associations coincides with the decline of society.
Domestic Violence, Mental Health, and Resilience Among Older Adults in the U.S. During COVID-19
Authors: Yoon Sukyung , Mahapatra Neely
Published: June 2023

Objectives

The current study based on the Stress Process Model investigated the impact of experiences of domestic violence on mental health as well as resilience against negative mental health outcomes among older adults in U.S. during COVID-19.

Method

Participants included 522 older adults (ages 51–80 and older) living in US at the time of the survey. Path analysis using Mplus was employed. Results:The experience of domestic violence among older adults during the pandemic was positively associated with loneliness and anxiety directly and indirectly. However, resilience acted as a protective factor between the experiences of domestic violence and anxiety. Conclusion: The experience of domestic violence may increase loneliness and anxiety among older adults during challenging times; however, resilience may weaken these negative psychological outcomes both directly and indirectly. Findings and implications are discussed.
Effect of In-trough and Out-of-trough fixturing in vibro-polishing
Authors: Yuvaraj Hemanth Kumar , Gopasetty Sharan Kumar , Nagalingam Arun Prasanth , Sheng Benjamin Gan Rong , Gopinath Abhay , Yeo Swee Hock
Published: June 2023

Advanced compressor design with superior aerodynamic and fatigue life performance demands superior surface quality, typically Ra≤0.25 µm. Vibro-polishing is media finishing technology which is commonly employed to mass finish aerospace engine components such as blisks. Frequency of vibration, location, and orientation of workpiece, media size, lubrication etc. are known tuneable knobs to optimize the performance of Vibro-polishing. However, longer cycle times in vibro-polishing still pose a challenge. In this study, effect of In-trough (IT) and Out of trough (OOT) fixturing at various depths of immersion into the media is studied. Workpiece used was made of Ti-6Al-4V with a geometry representative of a blisk blade. OOT fixturing was observed to yield better surface quality than IT fixturing irrespective of the depth of immersion. Further, a very low Ra of about 0.10 µm was achieved with 1 h of processing at highest depth of immersion into the media in OOT fixturing, resulting in significant reduction in cycle time to reach aerospace component surface roughness of Ra≤0.25 µm. Further, uniform vibro-polished surface topography with no alterations in the as received microstructure was observed in both IT and OOT fixturing.
Prevalence of migraine in systemic lupus erythematosus: A meta-analysis
Authors: Sarangi Surjyapratap , Nahak Suraj K , Rupashree Anisha , Panigrahi Jogeswar , Panda Aditya K
Published: June 2023

Background

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical manifestations, including neurological issues in about 25%–75% of cases. Among the neurological involvement cases, most cases show migraine. However, the prevalence of migraine varied worldwide, and in some studies, a higher incidence of migraine in SLE cases was reported compared to healthy controls. In the present study, we adopted a meta-analysis approach to find out the prevalence of migraine in SLE patients worldwide and investigate whether migraine frequency is more prevalent in SLE patients than controls.

Material and methods

Various literature databases such as Scopus, PubMed, Science Direct, and Google Scholar were screened for eligible studies. The last search was performed on January 21, 2023. Publication biases were accessed by Egger’s regression analysis and funnel plots. Cochrane Q statistics and I2 values explored the presence or absence of heterogeneity. All statistical analysis of meta-analysis was performed in comprehensive meta-analysis software v3.

Results

Based on predefined inclusion and exclusion criteria, 17 reports comprising 2901 SLE patients and 575 healthy controls were considered in the present study. The meta-analysis revealed the prevalence of migraine to be 34.8%. Furthermore, migraine was more prevalent in SLE patients than healthy controls (OR: 1.964, p = 0.000, 95% CI = 1.512–2.550). Similar trends were also observed while considering another 10 independent reports those were not disclosed about the migraine diagnosis criteria (number of reports: 27, SLE: 3473, HC: 741, prevalence: 33.5%, SLE vs HC: OR = 2.107, p = 0.000, 95% CI = 1.672–2.655). Subgroup analysis demonstrated that SLE patients from South America had a higher prevalence of migraine (56.2%).

Conclusions

About one-third of SLE patients experience migraine worldwide. The prevalence of migraine is more frequent in SLE patients than the healthy controls.
Broström Repair With and Without Augmentation: Comparison of Outcomes at Median Follow-up of 5 Years
Authors: Comfort Spencer M. , Marchetti Daniel C. , Duncan Parker P. , Dornan Grant J. , Haytmanek C. Thomas , Clanton Thomas O.
Published: June 2023

Background:

An augmented Broström repair with nonabsorbable suture tape has demonstrated strength and stiffness more similar to the native anterior talofibular ligament (ATFL) compared to Broström repair alone at the time of repair in cadaveric models for the treatment of lateral ankle instability. The study purpose was to compare minimum 2-year patient-reported outcomes (PROs) following treatment of ATFL injuries with Broström repair with vs without suture tape augmentation.

Methods:

Between 2009 and 2018, patients >18 years old who underwent primary surgical treatment for an ATFL injury with either a Broström repair alone (BR Cohort) or Broström repair with suture tape augmentation (BR-ST Cohort) were identified. Demographic data and PROs, including Foot and Ankle Ability Measure (FAAM) with activities of daily living (ADL) and sport subscales, 12-Item Short Form Health Survey (SF-12), Tegner Activity Scale, and patient satisfaction with surgical outcome, were compared between groups, and proportional odds ordinal logistic regression was used.

Results:

Ninety-one of 102 eligible patients were available for follow-up at median 5 years. The BR cohort had 50 of 53 patients (94%) completed follow-up at a median of 7 years. The BR-ST cohort had 41 of 49 (84%) complete follow-up at a median of 5 years. There was no significant difference in median postoperative FAAM ADL (98% vs 98%, P = .67), FAAM sport (88% vs 91%, P = .43), SF-12 PCS (55 vs 54, P = .93), Tegner score (5 vs 5, P = .64), or patient satisfaction (9 vs 9, P = .82). There was significantly higher SF-12 MCS (55.7 vs 57.6, P = .02) in the BR-ST group. Eight patients underwent subsequent ipsilateral ankle surgery, of which one patient (BR-ST group) was revised for recurrent lateral ankle instability.

Conclusion:

At median 5 years, patients treated for ATFL injury of the lateral ankle with Broström repair with suture tape augmentation demonstrated similar patient-reported outcomes to those treated with Broström repair alone.

Level of Evidence:

Level II, retrospective cohort study.
Edoxaban Versus Low-Molecular-Weight Heparin in Hospitalized COVID-19 Patients With Atrial Fibrillation
Authors: Olivera Pável , Velásquez-Escandón César , Campoy Desirée , Flores Katia , Canals Tania , Johansson Erik , Herranz María José , Martínez Laia , Cerezo-Manchado Juan José , Salinas Ramón
Published: June 2023

Objective

During the first wave of the SARS-CoV-2 pandemic, management of anticoagulation therapy in hospitalized patients with atrial fibrillation (AF) was simplified to low-molecular-weight heparin (LMWH) followed by oral anticoagulation, mainly owing to the risk of drug–drug interactions. However, not all oral anticoagulants carry the same risk.

Methods

Observational, retrospective, and multicenter study that consecutively included hospitalized patients with AF anticoagulated with LMWH followed by oral anticoagulation or edoxaban concomitantly with empirical COVID-19 therapy. Time-to-event (mortality, total bleeds, and admissions to ICU) curves, using an unadjusted Kaplan-Meier method and Cox regression model adjusted for potential confounders were constructed.

Results

A total of 232 patients were included (80.3 ± 7.7 years, 50.0% men, CHA2DS2-VASc 4.1 ± 1.4; HAS-BLED 2.6 ± 1.0). During hospitalization, patients were taking azithromycin (98.7%), hydroxychloroquine (89.7%), and ritonavir/lopinavir (81.5%). The mean length of hospital stay was 14.6 ± 7.2 days, and total follow-up was 31.6 ± 13.4 days; 12.9% of patients required admission to ICU, 18.5% died, and 9.9% had a bleeding complication (34.8% major bleeding). Length of hospital stay was longer in patients taking LMWH (16.0 ± 7.7 vs 13.3 ± 6.5 days; P = .005), but mortality and total bleeds were similar in patients treated with edoxaban and those treated with LMWH followed by oral anticoagulation.

Conclusions

Mortality rates, arterial and venous thromboembolic complications, and bleeds did not significantly differ between AF patients receiving anticoagulation therapy with edoxaban or LMWH followed by oral anticoagulation. However, the duration of hospitalization was significantly lower with edoxaban. Edoxaban had a similar therapeutic profile to LMWH followed by oral anticoagulation and may provide additional benefits.
Exploring Gender and Ethnoracial Differences and Trends in Methamphetamine Treatment
Authors: Guerrero Erick G , Amaro Hortensia , Kong Yinfei , Khachikian Tenie , Marsh Jeanne C
Published: June 2023

Introduction:

Given the significant rise in methamphetamine use and related mortality in the United States, it is critical to explore differences in treatment trends with particular attention to women and ethnoracial groups in hard-hit areas like Los Angeles County.

Methods:

We analyzed a large sample across 4 waves: 2011 (105 programs, 10 895 clients), 2013 (104 programs, 17 865 clients), 2015 (96 programs, 16 584 clients), and 2017 (82 programs, 15 388 clients). We completed a comparative analysis to identify differences across subgroups and a trend analysis of treatment episodes by gender and ethnoracial group to differentiate users of methamphetamine and users of other drugs.

Results:

Treatment clients using methamphetamine increased over time for each gender and race. There were also significant differences across age groups. Women comprised a greater proportion of treatment episodes involving methamphetamine use (43.3%) compared to all other drugs combined (33.6%). Latinas represented 45.5% of methadone-related admissions. Compared with other drug users, methamphetamine users had a lower successful treatment completion rate and were served by programs with less financial and culturally responsive capacity.

Conclusions:

Findings highlight a sharp increase in treatment admissions for methamphetamine users of all gender and ethnocultural groups. Women, especially Latinas, saw the most significant increases, with a widening gender gap over time. All subgroups of methamphetamine users had a lower treatment completion rate compared with users of other drugs, and critical differences existed in the programs where they received services.
Remote Evidence-Based Health Promotion Programs During COVID: A National Evaluation of Reach and Implementation for Older Adult Health Equity
Authors: Steinman Lesley , Chavez Santos Erica , Chadwick Kelly , Mayotte Caitlin , Johnson Selisha (Snowy) , Kohn Marlana , Kelley James , Denison Paige , Montes Clarissa , Spencer-Brown Lesha , Lorig Kate
Published: June 2023

Introduction.

Evidence-based health promotion programs (EBPs) support older adults where they live, work, pray, play, and age. COVID-19 placed a disproportionate burden on this population, especially those with chronic conditions. In-person EBPs shifted to remote delivery via video-conferencing, phone, and mail during the pandemic, creating opportunities and challenges for older adult health equity.

Method.

In 2021–2022, we conducted a process evaluation of remote EBPs by purposively sampling diverse U.S. organizations and older adults (people of color, rural, and/or with disabilities). The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) + Equity framework was used to understand program reach and implementation, including FRAME to describe adaptations for remote delivery. Analyses include descriptive statistics and thematic analysis of participant and provider surveys and interviews, and joint display tables to compare learnings.

Results.

Findings from 31 EBPs through 198 managers/leaders and 107 organizations suggest remote delivery increases EBP reach by improving access for older adults who are underserved. For programs requiring new software or hardware, challenges remain reaching those with limited access to—or comfort using—technology. Adaptations were to context (e.g., shorter, smaller classes with longer duration) and for equity (e.g., phone formats, autogenerated captioning); content was unchanged except where safety was concerned. Implementation is facilitated by remote delivery guidelines, distance training, and technology support; and hindered by additional time, staffing, and resources for engagement and delivery.

Conclusions.

Remote EBP delivery is promising for improving equitable access to quality health promotion. Future policies and practices must support technology access and usability for all older adults.
Review on Deep Learning-Based CAD Systems for Breast Cancer Diagnosis
Authors: Arun Kumar S. , Sasikala S.
Published: June 2023

Breast Cancer (BC) is a major health issue in women of the age group above 45. Identification of BC at an earlier stage is important to reduce the mortality rate. Image-based noninvasive methods are used for early detection and for providing appropriate treatment. Computer-Aided Diagnosis (CAD) schemes can support radiologists in making correct decisions. Computational intelligence paradigms such as Machine Learning (ML) and Deep Learning (DL) have been used in the recent past in CAD systems to accelerate diagnosis. ML techniques are feature driven and require a high amount of domain expertise. However, DL approaches make decisions directly from the image. The current advancement in DL approaches for early diagnosis of BC is the motivation behind this review. This article throws light on various types of CAD approaches used in BC detection and diagnosis. A survey on DL, Transfer Learning, and DL-based CAD approaches for the diagnosis of BC is presented in detail. A comparative study on techniques, datasets, and performance metrics used in state-of-the-art literature in BC diagnosis is also summarized. The proposed work provides a review of recent advancements in DL techniques for enhancing BC diagnosis.
The Impact of COVID-19 on Male Semiprofessional Cricket Player’s Mental Health and Performance Following the Resumption of Sporting Events
Authors: Malele Lesego S. , Noorbhai Habib
Published: June 2023

The ability of a cricket player to manage their mental health helps them to perform optimally. This study investigated how mental health is related to performance of male cricket players during the resumption of sporting events after coronavirus disease 2019 (COVID-19) restrictions. Mental health profiles were established using the Depression, Anxiety, Stress Scale-21 (DASS-21), Athlete Burnout Questionnaire (ABQ), and Satisfaction with Life Scale (SWLS) instruments among male semiprofessional cricket players ( n = 63). Performance metrics included: body fat percentage (BF%), range of motion (ROM), push-abdominal test, crazy catch test, t-test, 40-m sprint, and Cooper’s test. Inferential statistics included Spearman’s correlations with a significance level set at α < .05. Spearman’s correlation reported a statistically significant relationship for SWLS and body mass index (BMI) ( r = −0.263; p = .037) as well as between stress and abdominal test ( r = 0.355; p = .004); crazy catch test ( r = 0.249; p = .049); Cooper’s test ( r = 0.335; p = .009), VO2max ( r = 0.308; p = .014), stress and abdominal test ( r = −0.313; p = .012); as well as anxiety and 40-m sprint ( r = 0.488; p = .027). This study provides an important snapshot of how symptoms of mental health are associated with performance. Further research should investigate the relationship between mental health and performance parameters among male players at varied skill levels.
Examining Child-Led Tours and Child Standpoint Theory as a Methodological Approach to Mitigate Asymmetrical Adult-Child Power Dynamics in Ethnographic Research: A Child-Led Tour of Elfish Antics and Sensorial Knowledge
Authors: McFadden Alysha , Varcoe Colleen , Brown Helen
Published: June 2023

Child-led tours alongside intersectional feminist theory and child standpoint theory provide promising methodological insights regarding meaningful engagement and research approaches with young children that can inform intersectoral pediatric healthcare practice and policy. However, research has paid little attention to the dynamics between children and adults during research and promising methods and theories that may mitigate asymmetrical relationships of power. The authors describe lessons learned from a child-led tour through the lens of an intersectional feminist, child standpoint theoretical orientation regarding child assent, power, and control. The strength of a child-led tour coupled with a reflexive intersectional, child standpoint theoretical orientation is that it can make explicit adult epistemological biases and the tensions between children’s and adult’s interactions and collaborations. Further, this framing may make medicalized and taken-for-granted scientific assumptions of childhood and children explicit and allow for the reimaging of children’s agency, power, and capacity for knowledge generation in situ. Child-led tours coupled with an adult researcher’s commitment to anti-oppressive practice through methodological accountability and frameworks have the promise of eliciting rich, embodied, sensorial data in pursuit of knowledge mobilization for and with children. Child-led tours as an ethnographic, qualitative interview method are proposed to be child-friendly, enabling meaningful knowledge gathering concerning children’s perspectives, ideas, and experiences. More research on the potential for a child-led tour combined with an intersectional, child standpoint praxis is needed to prevent tokenistic methodological strategies that reproduce asymmetrical power relations and dynamics.
Infectious disease and political violence: Evidence from malaria and civil conflicts in Sub-Saharan Africa
Authors: Chen Haohan , Wang Zifeng , Han Enze
Published: June 2023

As an infectious disease, malaria consumes around 250 million yearly clinical cases and with more than half a million annual deaths. It has shown tremendous burden for the economic and social life of many countries around the world, particularly in the tropical and developing nations. The conventional wisdom claims that the prevalence of malaria infection either prolongs or should be positively correlated with outbreaks of civil conflicts. We contend that malaria infection should deter civil conflict occurrences because warming parties should avoid engaging each other in areas with rampant malaria infection. We test the hypothesis with 20 years of geo-referenced panel data of conflict event and malaria risk from Sub-Sahara Africa. Our result renders strong support for our hypothesis that areas with more malaria infection tends to have less civil conflicts.
Role of Internet of things in diabetes healthcare: Network infrastructure, taxonomy, challenges, and security model
Authors: Farooq Muhammad Shoaib , Riaz Shamyla , Tehseen Rabia , Farooq Uzma , Saleem Khalid
Published: June 2023

The Internet of things (IoT) is an emerging technology that enables ubiquitous devices to connect with the Internet. IoT technology has revolutionized the medical and healthcare industry by interconnecting smart devices and sensors. IoT-based devices and biosensors are ideal to detect diabetes disease by collecting the accurate value of glucose continuously. Diabetes is one of the well-known and major chronic diseases that has a worldwide social impact on community life. Blood glucose monitoring is a challenging task, and there is a need to propose a proper architecture of the noninvasive glucose sensing and monitoring mechanism, which could make diabetic people aware of self-management techniques. This survey presents a rigorous discussion of diabetes types and presents detection techniques based on IoT technology. In this research, an IoT-based healthcare network infrastructure has been proposed for monitoring diabetes disease based on big data analytics, cloud computing, and machine learning. The proposed infrastructure could handle the symptoms of diabetes, collect data, analyze it, and then transmit the results to the server for the next action. Besides, presented an inclusive survey on IoT-based diabetes monitoring applications, services, and proposed solutions. Furthermore, based on IoT technology the diabetes disease management taxonomy has also been presented. Finally, presented the attacks taxonomy as well as discussed challenges, and proposed a lightweight security model in order to secure the patient's health data.
Prospective mixed-methods study evaluating the potential of a voicebot (CovBot) to relieve German health authorities during the COVID-19 infodemic
Authors: Voelskow Vanessa , Meßner Claudia , Kurth Tobias , Busam Amelie , Glatz Toivo , Ebert Natalie
Published: June 2023

Background

During the COVID-19 pandemic, telephone hotlines of local health authorities in Germany were overloaded due to information requests by the public.

Objective

Evaluating the use of a COVID-19-specific voicebot (CovBot) in local health authorities in Germany during the COVID-19 pandemic. This study investigates the performance of the CovBot by assessing a perceptible relief of staff in the hotline service.

Methods

This prospective mixed-methods study enrolled local health authorities in Germany from 01 February 2021 to 11 February 2022 to deploy the CovBot, which was mainly designed to answer frequently asked questions. To capture the user perspective and acceptance, we performed semistructured interviews and online surveys with their staff, conducted an online survey among callers, and analyzed the performance metrics of the CovBot.

Results

The CovBot was implemented in 20 local health authorities serving 6.1 million German citizens and processed almost 1.2 million calls during the study period. The overall assessment was that the CovBot contributed to a perceived relief of the hotline service. In a survey among callers, 79% indicated that a voicebot could not replace a human. The analyzed anonymous metadata revealed that 15% of calls hung up immediately, 32% after hearing an FAQ answer, and 51% of calls were forwarded to the local health authority offices.

Conclusions

A voicebot primarily answering FAQs can provide additional support to relieve the hotline service of local health authorities in Germany during the COVID-19 pandemic. For complex concerns, a forwarding option to a human proved to be an essential functionality.
Everything, Everywhere, All at Once: Apprehending the Climate Crisis
Authors: Aronczyk Melissa , Russell Adrienne
Published: June 2023

The major challenge for us as communication researchers is to recognize and center climate change in the choices we make as scholars and educators, and to normalize ways of talking about climate change.
Neuromechanical Properties of the Vastus Medialis and Vastus Lateralis in Adolescents With Patellofemoral Pain
Authors: Crouzier Marion , Hug François , Sheehan Frances T. , Collins Natalie J. , Crossley Kay , Tucker Kylie
Published: June 2023

Background:

An alteration in the force distribution among quadriceps heads is one possible underlying mechanism of patellofemoral pain. However, this hypothesis cannot be directly tested as there are currently no noninvasive experimental techniques to measure individual muscle force or torque in vivo in humans. In this study, the authors considered a combination of biomechanical and muscle activation measures, which enabled us to estimate the mechanical impact of the vastus medialis (VM) and vastus lateralis (VL) on the patella.

Purpose/Hypothesis:

The purpose of this study was to determine whether the relative index of torque distribution for the VM and VL differs between adolescents with and without patellofemoral pain. It was hypothesized that, relative to the VL, the VM would contribute less to knee extension torque in adolescents with patellofemoral pain compared with controls.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Twenty adolescents with patellofemoral pain and 20 matched control participants were included (38 female; age, 15.3 ± 1.8 years; weight, 58 ± 13 kg; height, 164 ± 8 cm). Muscle volumes and resting moment arms were quantified from magnetic resonance images, and fascicle lengths were obtained from panoramic B-mode ultrasonography. Muscle activation was estimated using surface electromyography during submaximal isometric tasks (wall-squat and seated tasks). Muscle torque was estimated as the product of muscle physiological cross-sectional area (ie, muscle volume/fascicle length), muscle activation (normalized to maximal activation), and moment arm.

Results:

Across tasks and force levels, the relative contribution of the VM to the overall medial and lateral vastii torque was 31.0% ± 8.6% for controls and 31.5 ± 7.6% for adolescents with patellofemoral pain (group effect, P > .34).

Conclusion:

For the tasks and positions investigated in this study, the authors found no evidence of lower VM torque generation (relative to the VL) in adolescents with patellofemoral pain compared with controls.
What May Impact Trustworthiness of AI in Digital Healthcare: Discussion from Patients’ Viewpoint
Authors: Wang Bijun , Asan Onur , Mansouri Mo
Published: June 2023

The healthcare industry is undergoing a transformation of traditional medical relationships from human-physician interactions to digital healthcare focusing on physician-AI-patient interactions. Patients’ trustworthiness is the cornerstone of adopting new technologies expounding the reliability, integrity, and ability of AI-based systems and devices to provide an accurate and safe healthcare environment. The main objective of this study is to investigate the various factors that influence patients’ trustworthiness in AI-based systems and devices, taking into account differences in patients’ experiences and backgrounds. First, an exploratory conceptual framework inspired by the United Theory of Acceptance and Use of Technology (UTAUT) and Health Belief Model (HBM) is established to further explain the patients’ trust to support the adoption willingness of AI. Then a case study that includes 218 samples from chronic patients is conducted. The results of the study indicate that factors such as accountability, risk perception, facilitating conditions, and social influence play a significant role in determining a patient’s trust in AI-based healthcare devices, while ease of ease may not have a direct impact to trust. And among the demographic factors, only race showed a strong correlation with the level of patient trust in AI. The contributions of this study can provide a comprehensive understanding of patients’ trustworthiness and inform the development and deployment of the technology in a way that prioritizes patients’ interests.
Toward Joint Activity Design: Augmenting User-Centered Design with Heuristics for Supporting Joint Activity
Authors: Cochran Aaron , Rayo Michael F.
Published: June 2023

From their common roots in Human Factors Engineering, Human-Centered Design and Cognitive Systems Engineering have drifted into distinct fields over the past three decades, each developing beneficial heuristics, design patterns, and evaluation methods for designing for individuals and teams, respectively. GeoHAI, a clinical decision support application for preventing hospital-acquired infection, has yielded positive results in early usability testing and is expected to test positively in supporting joint activity, which will be measured through the novel implementation of Joint Activity Monitoring . The design and implementation of this application provide a demonstration of the possibilities and necessities to unify the work of Human-Centered Design and Cognitive Systems Engineering when designing technologies that are usable and useful to individuals engaged in joint activity with machine counterparts and other people. We are calling this unified process Joint Activity Design, which supports designing for machines to be good team players.
Conceptualization and iterative human-centered design of pharmacogenomic order checks
Authors: Kabel Margo , Arnold Tim , Chapman Jennifer , Voora Deepak , Bates Jill
Published: June 2023

The usability of healthcare information systems is vital to providing safe, effective, and efficient patient care. In this paper, we describe human centered design of pharmacogenomic (PGx) clinical decision support (CDS) systems. Operationalizing PGx-based care is a relatively new endeavor, and the complexity of this clinical space requires adapting human factors techniques to fashion usable designs. We had to consider multiple design tradeoffs including whether to group medications by drug class. In this article, we provide additional design tradeoff considerations and lessons learned. Including embedded human factors practices early and throughout as a key consideration for maturing a learning health system.
Designing to Drive Practice Change: Automated Extraction of Resident Clinical Experiences
Authors: Fidel Alexander , Mai Mark , Muthu Naveen , Dziorny Adam
Published: June 2023

Exposure to patients and clinical diagnoses drives learning in graduate medical education (GME). However, variation exists in the breadth of experiences. Measuring such variation would provide practice data to inform residents’ understanding of the breadth of their patient experiences. We have developed an automated system to identify resident provider-patient interactions (rPPIs) and demonstrated accurate attribution at a single institution. The objective of this study was to understand the landscape of trainee planned learning, and iteratively design a tool to be used for this goal. To achieve these objectives at two institutions new to the AMA “Advancing Change” initiative, we used a mixed-methods approach to develop and evaluate a “mid-point report” of patients encounters. Qualitative outcomes include a guided exploration of usefulness, usability, and intent to use, as well as understanding the resources trainees would use for learning and how our system may deliver these resources. Quantitative outcomes from a summative usability test of the midpoint report will include time on task, task completion rate, and proportion of trainees who perceive the report to be useful to identify gaps in clinical experiences and guide learning.
Applying Human Factors to Reduce Healthcare-Associated Infections Caused by Face Touching
Authors: Henderson Kailyn , Hall Trevor , Farshait Nataly , Chignell Mark
Published: June 2023

Canada is currently facing a critical healthcare worker (HCW) shortage, in part resulting from absenteeism due to healthcare-associated infection (HAI). HCWs are at greater risk of infection and are among the most common sources of HAI transmission. Face touching is a behaviour that HCWs engage in on average 20-23 times per hour, and is one way for HCWs to infect themselves. While personal protective equipment (e.g., face masks) has been found to decrease face touching, the behaviour still occurs. We conducted a literature review on face touching, previously proposed solutions for addressing face touching, and the applications of human factors in mitigating face touching behaviours. We also conducted a pilot study of semi-structured interviews with three HCWs using the Lead User method to understand their needs and explore how best to decrease face touching, which resulted in several suggested interventions for reducing face touching.
Autoinjector Design Parameters: A Human Factors Perspective
Authors: Elkefi Safa , Foo Esther , Shen Jiaying
Published: June 2023

Subcutaneous drug delivery systems have evolved to include patient-operated devices such as pen injectors, autoinjectors, and on-body injectors. This evolution is driven by a rising need for devices that enable users across chronic disease states to routinely self-administer medications at home instead of going to a clinic. Convenient and easy-to-use autoinjectors are a primary target of interest due to its simplicity to operate. There is an anticipated substantial growth in the autoinjectors market, which is driven by many factors, such as the growing demand for home care due to the increased chronic diseases rate. Autoinjectors that are easy to operate may reduce users’ anxiety related to needle-related phobia, accidents, and errors. Human factors development work is critical since enhanced usability can increase patient acceptability, safety, and compliance. Human factors methodologies can be applied to not only evaluate the safe and effectiveness of a user interface, but also to optimize the design of user interface by considering the user population characteristics including physical, cognitive, and sensory abilities. In this investigation, we focus our efforts on user interface attributes relating to critical tasks in operating the autoinjector device, by consolidating information from successful autoinjector design published in literature and different anthropometric and ergonomic parameters, that could inform the user interface requirements that drive design specifications for autoinjectors.
Abstraction networks: adapting abstraction hierarchies to map important relationships for system design
Authors: Tewani Priyanka , Jefferies Christine M. , Reynolds Morgan , Segarra Gabriel , Rayo Michael F. , Catchpole Ken
Published: June 2023

Abstraction hierarchies (AHs) are essential to a work domain analysis (WDA), the “most important and unique” phase of cognitive work analysis (CWA) (Vicente, 1999). Although AHs have been the industry standard for assessing and describing work systems for several decades, they are not without limitations (Vicente, 2002). We have developed an evolution of AHs called Abstraction Networks (ANs) to address several of the limitations Vicente identified. ANs are designed to (1) improve engagement with practitioners, thereby facilitating greater shared understanding of the system, (2) better integrate with existing systems analysis tools, and (3) provide a more direct bridge between systems analysis and display design. We document a case study that uses ANs to better understand a sterile processing department (SPD) at a Southeastern tertiary care hospital, detailing the extent to which AN’s achieve these three goals.
Measures of Speech Understanding in Noise for Young Children with a Cochlear Implant in Mainstream and Special Education
Authors: Van den Borre Elien , Wouters Jan , Verhaert Nicolas , Boon Ellen , van Wieringen Astrid
Published: June 2023

The use of two types of speech-in-noise (SPIN) assessment, namely digits-in-noise self-tests and open-set, monosyllabic word tests, to assess the SPIN understanding performance of children with cochlear implants (CI) in mainstream and special education, was investigated. The tests’ feasibility and reliability and the influence of specific cognitive abilities on their results were studied. The results of 30 children with CIs in mainstream and special education were compared to those of 60 normal-hearing children in elementary school. Results indicate that the digit triplet test (DTT) was feasible for all children tested in this study, as seen by the familiarity of all the digits, the high stability of the test results (<3 dB SNR), and a small measurement error (≤2 dB SNR). Remembering full triplets did not form a problem and results did not show systematic attention loss. For children with CIs, the performance on the DTT was strongly related to the performance on the open-set monosyllabic word-in-noise task. However, small but significant differences were observed in the performance of children with CIs in mainstream and special education on the monosyllabic word test. Both tests showed little influence of cognitive abilities, making them both useful in situations where the bottom-up auditory aspect of SPIN performance needs to be investigated or in situations where sentence-in-noise tests are too challenging.
Civic Online Reasoning Across the Curriculum: Developing and Testing the Efficacy of Digital Literacy Lessons
Authors: McGrew Sarah , Breakstone Joel
Published: June 2023

Given the current threat posed by toxic digital content, preparing students to evaluate online sources cannot be relegated to a single subject area—this instruction should happen across the curriculum. This article focuses on materials designed to teach students to evaluate online information across subject areas. ninth-grade biology and world geography teachers taught a series of curriculum-embedded lessons based on the following design principles: (a) Focus on a core question and strategy; (b) engage students in evaluating real online content; (c) feature cognitive apprenticeship and formative assessment; and (d) support teacher learning. We examine whether these lessons helped students become more skilled evaluators of online content. Pretest/posttest data (N =574) showed statistically significant growth in students’ ability to evaluate the credibility of online content. We analyze the role played by the curriculum design principles in this interdisciplinary intervention and explore implications for future initiatives.
The “Good” Schools: Academic Performance Data, School Choice, and Segregation
Authors: Houston David M. , Henig Jeffrey R.
Published: June 2023

We examine the effects of disseminating school-level academic performance data—achievement status, achievement growth, or both—on parents’ school choices and their implications for racial, ethnic, and economic segregation. Many researchers consider growth to be a superior (if still imperfect) measure of school effectiveness relative to status. Moreover, compared to status, growth has weaker relationships with schools’ demographic compositions. We conduct an online survey experiment featuring a nationally representative sample of parents and caretakers of children ages 0–12. Participants choose between three randomly sampled elementary schools drawn from the same school district. The provision of status information guides participants toward schools with higher achievement status and fewer Black, Hispanic, and economically disadvantaged students. The provision of growth information and the provision of both types of academic performance data guide participants toward higher growth schools. However, only growth information—alone, and not in concert with status information—tends to elicit choices with desegregating consequences.