Contact Points Research Articles

Taking the Piss? Using Lean to Review the Process for Provision & Delivery of Continence Disposable Products

Abstract Background Urinary incontinence (UI) is the unintentional passing of urine. Its impact on older people varies from a diminished quality of life, to social isolation and frailty. Pads or diapers are commonly employed tools in the care of older people with incontinence. Incontinence is largely underreported and poorly managed among older people in community care settings (Yan et al., 2022). This work reviews the process map of the provision and delivery of continence disposable products in the community by the Health Service Executive in Ireland. Methods Lean is a quality improvement approach that consists of the elimination of waste to improve the flow of people, information or goods. We reviewed the process map baseline assessment; captured steps that added value to the patient and the impact on staff in the community. Results The initial assessment tool consists of five pages. There are 28 possible steps presented in the process map. There is a gap in the presentation on connectors to associated processes. Eight people are involved in the ordering, approval and delivery process to the older person. The initial assessment and education add value to the patient. If adverse skin or complaints arise an older person can be referred to a continence advisor or the ADPHN. The patient feedback loop is missing following delivery no check-in for education is provided following initial use. Unclear who is the point of contact for the patient to raise issues. The only noted key performance indicator is the processing of a request to order is inputted in one working day. Objectives are not SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound.) Conclusion Further in-depth research is required to review if the right staff are making the approvals. Need to review KPIs throughout to improve process and SMART objectives. Perspectives of older people and GP supports require further investigation.

Community Specialist Teams: Are We Making an Impact? Insights from General Practitioners

Abstract Background Within our catchment area, General Practitioners (GPs) are the primary source of referral to community specialist teams (CSTs) for older adults and are key stakeholders in supporting the integrated care pathway. We sought to evaluate their experience to inform service development. Methods GPs across four healthcare networks were invited to complete an online questionnaire evaluating their experience of the CSTs for older adults. Results Twenty-eight GPs responded. Of these, 85.7% (24) found the referral criteria clear, and 89.3% (25) reported ease of access to the service. However, 50% (14) were uncertain about when to refer patients to primary care alone versus the CST. A significant majority, 96.5% (27), felt the service positively impacted the health and well-being of referred patients, and 92.9% (26) were satisfied with communication regarding patient care plans and progress. Identified strengths of the service included the multidisciplinary approach to providing comprehensive, patient-centered care and effective communication with both GPs and patients. Areas for improvement included enhancing access for specialist teams to community radiology and increasing staffing levels to ensure timely assessments. Regarding the impact on unscheduled and emergency care, 71.4% (20) reported a reduced need to refer to the acute medical unit, and 35.7% (10) reported a reduced need to refer to the emergency department due to the ability to refer to CSTs. Conclusion GPs value the CST service for the quality of assessment and intervention their patients receive. Targeted areas for operational and clinical improvement include provision of diagnostics and role distinction from primary care teams. This survey also suggests CSTs are providing an alternative care pathway and point of contact for older patients in crisis, resulting in a reduction in unscheduled and emergency care utilisation. The role of the CSTs should be supported and enhanced and warrants more detailed exploration.

Exploring Port City Porosity and Flows within Port Regions: The Case Study of Port of Malaga and Port of Beirut

The term “porosity” refers to the idea of interconnectedness between the spaces and institutions of ports, cities, and their surrounding areas. While porosity refers to the overall interconnectedness between different entities, an interface specifically refers to the point of contact and interaction between the same two entities. This paper goes beyond the idea of an interface and emphasizes a continuous network of port-related spaces and practices that shape the port cityscape. It also provides a historical perspective on the evolution of port/city boundaries. Additionally, this paper explores maps and conceptualizes port city porosity on both sea and land sides, measures, and reconsiders porosity in these regions. The thematic issue opens questions for further research such as: Can the interconnectedness between port and city areas, along with maritime pockets in the city and surrounding territory, enhance the resilience of port city activities? Does the existence of porous borders between port and city allow for easier transitions? The idea of transitions is particularly relevant in the context of the dynamic and ever-changing nature of port and city activities. As economic, social, or environmental conditions shift, there may be a need for both the port and city to adapt and evolve. The degree of porosity between them can play a role in facilitating or hindering these transitions.

Mathematical model and generation analysis for crossed helical gear system

Purpose Crossed helical gears have point contact and their surfaces are subject to high surface stress. Contact stress and root tooth stress are the most common sources of failure in crossed helical gear. This paper aims to study the load-carrying capacity and performance of crossed helical gear teeth with different gear tooth profiles. To overcome defects and reduce the sensitivity to small shaft angle changes. The combined tooth profile is designed to reduce the bending stresses, contact stresses and tooth deflection, and prevent pinion failure in the gearbox. Design/methodology/approach The principle of the method is a line contact is introduced instead of a point contact between two teeth in mesh with each other. The tooth surface of the helical gear is designed and cut by a modified tool. Higher normal pressure angles like 25° and 35° are used. The modified involute is accomplished to eliminate interference between the teeth. Engineering software packages have been applied to generate all crossed helical gears gear profiles. The modification is compounding curves consisting of an epicycloid-involute-hypocycloid gear teeth profile generated by the cutter modified. Findings The stresses in the crossed helical gear teeth profile were reduced by increasing the normal pressure angle values. Using a 35° pressure angle the enhancement percentage in contact stress and teeth fillet region will be about 29.345% and 15.421%, respectively. The best enhancement in a gear’s resistance is the epicycloid-involute-hypocycloid gear teeth profile. The enhancement was 32.610% and 18.588%. The skew in line of action in skewed helical gear will be sensitive when the crossing angles are small. Their teeth surface tends to be easily worn out; however, the wearing process will be reduced by using a proposed gear teeth profile. Practical implications The gear teeth to be modified are cut by a shaper process. The modifying rack cutter of this study can be used as a reference for creating a different helical gears sample. The helical teeth surface is modified to become an envelope of the other. This makes an original point contact change into a line contact. The epicycloid-involute-hypocycloid gear teeth profile is preferred for a higher contact ratio and a large load capacity. This work explicitly introduces a new method of kinematic consideration to improve the load capacity of crossed helical gear. Originality/value This paper showed some novel results by the unique shape of the rack-cutter designed to generate different helical angles and different gear positions. In the future, it will make valuable contributions to the further development of the dynamic performance of a crossed helical gear system through the study in the field of using asymmetric teeth profiles of helical gears with tip relief as the manner to enhance the crossed helical gear performance. Investigation of crossed helical gear by applying a predesigned parabolic function of transmission error enables the absorption of linear discontinuous functions caused by misalignment.

Путешествие между каналами: формирование клиентского опыта в цифровой среде

In modern marketing, researchers are focused on the omnichannel approach due to the growing number of communication channels and sources of consumer information about brands. This paper examines the complexity and multifactorial nature of the omnichannel approach in the formation of customer experience and marketing communications in the digital environment. The article discusses the concept of a “Consumer Journey Map”, which reflects the stages of making a purchase decision, after-sales interaction and the customer experience formed within this path. This approach allows you to define and analyze the touchpoints with the consumer and information messages at each stage of the consumer journey in order to create a positive brand image. The consumer’s journey is formed by the sequential passage of a number of points of contact, which may belong to the brand, its partners or be independent. This affects the degree of brand control over the information at each of these points. Particular attention is paid to the complexity of tracking the entire variety of contact points through which the customer passes on the way to making a purchase. The management of this variety of points from the standpoint of a single communication environment of brand and consumer interaction is the subject of omnichannel marketing research. Within the framework of this study, the author considers the evaluation of the effectiveness of marketing channels at the stage of preparation for purchase. These channels may be underestimated, since in terms of direct return on marketing investments, they lose to the final pre-purchase channels, but they play a key role in shaping the customer experience leading to subsequent purchases. The article presents the results of a study of online communication based on a company providing educational services. This study demonstrates the relationship between the volume of investments in paid promotion channels and the total revenue from online channels. The results of the study emphasize the importance of the omnichannel approach in modern communication, where the buyer interacts with the brand in various channels and perceives communication as a single continuous process, even when switching from one channel to another.

Cyclicity of slow–fast cycles with one self-intersection point and two nilpotent contact points*

Cyclicity of slow–fast cycles with one self-intersection point and two nilpotent contact points*

Bridging healthcare gaps: a scoping review on the role of artificial intelligence, deep learning, and large language models in alleviating problems in medical deserts.

"Medical deserts" are areas with low healthcare service levels, challenging the access, quality, and sustainability of care. This qualitative narrative review examines how artificial intelligence (AI), particularly large language models (LLMs), can address these challenges by integrating with e-Health and the Internet of Medical Things to enhance services in under-resourced areas. It explores AI-driven telehealth platforms that overcome language and cultural barriers, increasing accessibility. The utility of LLMs in providing diagnostic assistance where specialist deficits exist is highlighted, demonstrating AI's role in supplementing medical expertise and improving outcomes. Additionally, the development of AI chatbots offers preliminary medical advice, serving as initial contact points in remote areas. The review also discusses AI's role in enhancing medical education and training, supporting the professional development of healthcare workers in these regions. It assesses AI's strategic use in data analysis for effective resource allocation, identifying healthcare provision gaps. AI, especially LLMs, is seen as a promising solution for bridging healthcare gaps in "medical deserts," improving service accessibility, quality, and distribution. However, continued research and development are essential to fully realize AI's potential in addressing the challenges of medical deserts.

Transformation of Models of Interaction between Science and Society: From the Dialogical Model of Popularization to the Network Structure of Citizen Science

This article examines the transformation of models of interaction between science and society in the second half of the 20th century and the early 21st century, taking into account significant changes in communication between them and processes of deinstitutionalization characteristic of contemporary societies. The main attention is paid to the critical analysis of the processes of popularization of scientific knowledge and peculiarities of interaction between professional researchers and science enthusiasts under conditions of network communications. We have identified the main models of interaction between science and society, which include various features of communication between academics and the public. One of the main results of the study is the identification of points of contact between the interests of professional scientists and science enthusiasts. This can contribute to more effective cooperation and knowledge exchange between these groups.

A general mathematical model for manufacturing Roots pump rotors using conical milling cutters

The rotors are the key components in the Roots pump, and the rotor manufacture time will decide the pump price. In special cases, such as when one rotor shaft has two stages, respectively, with claw-type and Roots profiles, the traditional forming method is unsuitable for manufacturing the Roots rotor stage. Instead, more suitable manufacturing methods, such as planning or end-mill milling, can be applied. However, these two methods take time and effort. Therefore, this study proposes a general mathematical approach for Roots rotor manufacturing using the conical milling cutter as the key tool, which can reduce manufacturing time. The contact points and meshing angles between the rotor and the conical milling cutter can be calculated based on contact conditions. Then, a 3D conical milling cutter surface is obtained based on the cutter profile as a straight line, and the conical cutter is designed and considered to avoid undercutting in the rotor cutting process. The generated Roots rotor can be obtained by applying cutting simulation from the proposed mathematical model. The normal deviations of the rotor can be found by comparing the generated rotor profile to the datum rotor profile. In addition, the influence of axis errors of the conical milling cutter on the tooth profiles of the Roots pump rotor is investigated and discussed. The experimental results based on the proposed mathematical model are obtained and expressed to confirm the practicability of the proposed method.

Breton’s Hatchet: A Dream Simulation at the Confluence between Surrealism and AI

Many recent experiences done by AI in the fields of augmented creativity and computational art are full of unleashing the algorithms’ surrealist power. Surrealism, the avant-garde movement Breton launched in 1924 in Paris, combined his artistic needs with those of nascent psychoanalysis: so, dream stories, automatic writing and simulations of mental illnesses allowed historical surrealism to make a notable contribution to the development of psychoanalysis. Now that neuroscience and AI are joining both psychoanalysis and Surrealism, the absence of dream simulation in historical surrealism is even more striking. Dream Simulation is by now a new psychotherapeutic strategy, conceived in Italy by Dr. Francesca Vagnoni, which presents interesting points of contact with the experiments the French neurosurrealist group Obvious is carrying out by AI.

Leaving the profession as a medical assistant: a qualitative study exploring the process, reasons and potential preventive measures

BackgroundWorldwide growing shortages among health care staff are observed. This also holds true for medical assistants in Germany. Medical assistants mainly work in outpatient care and are the first point of contact for patients while performing clinical and administrative tasks. We sought to explore profession turnover among medical assistants, that is, in terms of the underlying decision-making process, the reasons for leaving the medical assistant profession and potential retention measures from the perspective of former medical assistants.MethodsFor this qualitative study, we conducted semi-structured telephone interviews with 20 former medical assistants between August and November 2023. Eligible for participation were medical assistants who (i) were of legal age, (ii) completed medical assistant vocational training and ii) were formerly employed as a medical assistant, but currently employed in another profession. The interviews were recorded, transcribed verbatim and content-analyzed.ResultsFormer medical assistants expressed various, often interrelated reasons for leaving the profession. These were changes in priorities throughout their career (e.g., in terms of working hours and salary), a constant high workload, barriers to further training, poor career prospects, and poor interpersonal relationships particularly with supervisors, but also within the team and with patients as well as the perception of insufficient recognition by politics and society. Suggestions of former medical assistants to motivate medical assistants to stay in their profession included amongst others higher salaries, more flexible work structures, improved career prospects, and more recognition from supervisors, patients, and society.ConclusionOur study provides insights into the complex decision-making process underlying ultimate medical assistant profession turnover. In light of an already existing shortage of medical assistants, we suggest to further explore how the suggested interventions that aim at retention of working medical assistants can be implemented.

Super‐Strong, Super‐Stiff, and Super‐Tough Fluorescent Alginate Fibers with Outstanding Tolerance to Extreme Conditions

AbstractThe combination of multiple physical properties is of great importance for widening the application scenarios of biomaterials. It remains a great challenge to fabricate biomolecules‐based fibers gaining both mechanical strength and toughness which are comparable to natural spider dragline silks. Here, by mimicking the structure of dragline silks, a high‐performance fluorescent fiber Alg‐TPEA‐PEG is designed by non‐covalently cross‐linking the polysaccharide chains of alginate with AIEgen‐based surfactant molecules as the flexible contact points. The non‐covalent cross‐linking network provides sufficient energy‐dissipating slippage between polysaccharide chains, leading to Alg‐TPEA‐PEG with highly improved mechanical performances from the plastic strain stage. By successfully transferring the extraordinary mechanical performances of polysaccharide chains to macroscopic fibers, Alg‐TPEA‐PEG exhibits an outstanding breaking strength of 1.27 GPa, Young's modulus of 34.13 GPa, and toughness of 150.48 MJ m−3, which are comparable to those of dragline silk and outperforming other artificial materials. More importantly, both fluorescent and mechanical properties of Alg‐TPEA‐PEG can be well preserved under various harsh conditions, and the fluorescence and biocompatibility facilitate its biological and biomedical applications. This study affords a new biomimetic designing strategy for gaining super‐strong, super‐stiff, and super‐tough fluorescent biomaterials.

Advancing the design of interspinous fixation devices for improved biomechanical performance: dual vs. single-locking set screw mechanisms and symmetrical vs. asymmetrical plate designs.

Interspinous devices were introduced in the field of spine surgery as an alternative to traditional pedicle screw fixation in selected patients for treatment of spinal stenosis and fixation. These devices designs have evolved from non-fixated extension blocks to sophisticated interspinous fixation devices (IFDs). There is an absence of literature comparing the biomechanical fixation strength of different IFD plate designs and the role of set screw locking systems. The aim of this study was to evaluate fixation strengths by bench testing static disassembly and pullout strength of two dissimilar IFD designs and locking mechanisms. We hypothesized that the InSpan (InSpan LLC, Burlington, MA, USA) dual-locking symmetrically IFD plate designed will have stronger fixation than the Aspen (ZimVie, Parsippany, NJ, USA) single-locking asymmetric IFD plate design. We conducted two biomechanical bench tests to evaluate the load to failure locking characteristics of symmetrical InSpan and asymmetrical Aspen IFD designs. Static pullout testing involved locking each IFD to the stainless steel and 40 pcf cellular polyurethane foam and measuring pullout load and displacement six times. Seven InSpan and two Aspen IFDs (including the "used" IFDs from the pullout testing) underwent static disassembly tests using a pair of disassembly fixtures positioned between the IFD plates to measure disassembly force and displacement. All tests were performed under ambient conditions using an INSTRON 8874 Bi-Axial Tabletop Servohydraulic Dynamic Testing System (INSTRON, Norwood, MA, USA), and data was collected at a 0.2 mm/s displacement control rate until the test was stopped when there was a drop in the continuously increasing force against resistance (gross failure). The InSpan IFD experienced 94.81% higher resistance to pullout compared to the Aspen IFD in static pullout testing (P<0.05), owing to its notably larger footprint area of 69.8%. Gross failure for both IFD implant designs occurred at the foam block-block interface. In static disassembly testing, pristine InSpan required 60.7% higher force over pristine Aspen and 401.3% for "used" IFDs. Gross failure was characterized by the gradual distraction of the plates and material removal at the set screw contact points. Implant failure at the block-implant interface emphasized the pivotal role of teeth design and the contact surface area of the plates in ensuring stability. The dual-locking symmetrical InSpan IFD outperformed single-locking asymmetric Aspen IFD in both static disassembly and pullout bench tests. This highlights the benefits of InSpan's improved design and its potential for enhanced long-term stability in spinal fixation applications.

Validation of finite-element-simulated orthodontic forces produced by thermoplastic aligners: Effect of aligner geometry and creep

PurposeFinite element (FE) models for determining the orthodontic forces delivered by clear aligners often lack validation. The aim of this study was to develop and validate accurate FE models for clear aligners, considering the small but important geometrical variations from the thermoforming process and the creep behavior of the aligner material. Methods and materialsThe tooth misalignment considered was a 2.4° torque aberration (rotation about the mesial-distal axis at the level of the center of resistance) of the maxillary left central incisor. FE models were created from Micro-CT scans of a model dental arch and five nominally identical aligners with the aforementioned misfit. Fitting of the aligners onto the dental arch was simulated using Abaqus's Interference Fit function, followed by surface-to-surface frictional interaction. Stress relaxation of the aligner material was measured using double-cantilever beam bending and modeled with a Prony series. The assembled FE models were validated by comparing the predicted forces and moments delivered to the maxillary left central incisor with experimental data, obtained with a custom-built but fully calibrated apparatus. ResultsGood agreement between prediction and measurement was obtained for both the short- and long-term forces and moments. In the short-term, i.e., after 30 s, the dominant force in the labial-lingual direction had a maximum difference of 2.9% between experiment and simulation, and the dominant moment about the mesial-distal axis had a maximum difference of 8.3%. In the long-term, i.e., after 4 h, the experimental and numerical forces had a maximum difference of 8.4%. There were statistically significant differences in the forces delivered among the nominally identical aligners, which were predicted by the geometrically accurate FE models and attributed to the variations in the points of contact between the aligners and the dental arch. The decay in force applied was affected by both the viscoelastic material behavior and friction between the aligner and arch. ConclusionFor accurate prediction of the forces and moments delivered by thermoplastic aligners, FE models that can accurately capture the point contacts between the aligners and the underlying teeth are essential. Stress relaxation of the aligners could be adequately modeled using the Prony series to represent the temporal changes of their elastic modulus.

Freedom Fighter and Location: a Different Story of Partisan Commander Petras Bartkus

The subject of the research in this article is the locations of the partisan warfare determined by the historical events of mid-20th century. The main aim of the research is to highlight the diversity and abundance of the locations of the partisan warfare based on the field data, oral history, archival documents and historical literature. In order to outline the significance of these locations, the case of Petras Bartkus, member of the presidium of the Council of the Movement of the Struggle for Freedom of Lithuania, was selected. The story starts at his birthplace in Pakapurnys Village (Raseiniai District) in 1925 and ends in 1991 in the cemetery of the town of Radviliškis, where the remains of those who had perished in Užpelkių Forest on 13 August 1949 were buried. The partisan warfare theatre connects various locations of the partisan warfare and allows us to speak about a coherent and homogeneous theatre rather than its individual episodes (bunkers and individual locations of the battles, places of death, etc.). Within the area divided by the war, some locations with encoded values and memories about them emerged, which have been included in the general narrative of the fights for freedom and stand out as places of historical memory. Archival and field studies make it possible to expand and provide more details to the space in which Bartkus operated, and subsequently to bring people back into the coherent historical partisan warfare narrative. The text lists the locations visited by Bartkus (and there are certainly more of them) and their diversity and abundance supports the thought that the landscape of freedom fights has been unduly diminished. The text mentions 37 places which are better known or which have been identified and 10 more general places, most of which are directly linked to Bartkus’ activities. They can be allocated to 13 different groups, such as his birthplace, camps, bunkers, shelters, locations of the archives, farmsteads of supporters, contact points, places of meetings, battles, places of death and desecration of dead bodies, and places of burial. Bartkus’ case study brings back an important perception of space during the years of the partisan war, which, after the restoration of an independent state, was generally reduced to the perception consisting of the places of death and burial. A rather comprehensive discussion of Barkus’ life provides supporting details to the environment in which freedom fighters operated, diversity of locations, their change depending on the person’s rank and time of operational activities. Bartkus’ example shows that the perception of the locations of the partisan warfare, which have so far been described as possible locations, but not necessarily existing locations, should be reconsidered. Where possible, the priority should be given to partisan documents, oral history, and field studies, while the documents of the Soviet security structures must be used for the search of additional information.

A Thin Film Model for Meniscus Evolution

In this paper, we discuss a particular model arising from sinking of a rigid solid into a thin film of liquid, i.e. a liquid contained between two solid surfaces and part of the liquid surface is in contact with the air. The liquid is governed by Navier–Stokes equation, while the contact point, i.e. where the gas, liquid and solid meet, is assumed to be given by a constant, non-zero contact angle. We consider a scaling limit of the liquid thickness (lubrication approximation) and the contact angle between the liquid–solid and the liquid–gas interfaces close to π\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pi $$\\end{document}. This resulting model is a free boundary problem for the equation ht+(h3hxxx)x=0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h_t + (h^3h_{xxx})_x = 0$$\\end{document}, for which we have h>0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h>0$$\\end{document} at the contact point (different from the usual thin film equation with h=0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h=0$$\\end{document} at the contact point). We show that this fourth order quasilinear (non-degenerate) parabolic equation, together with the so-called partial wetting condition at the contact point, is well-posed. Furthermore, the contact point in our thin film equation can actually move, contrary to the classical thin film equation for a droplet arising from the no-slip condition. Additionally, we show the global stability of steady state solutions in a periodic setting.

Abstract B121: Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network

Abstract Background: The Transformative Educational Advancement and Mentoring (TEAM) network is a program funded by the Center to Reduce Cancer Health Disparities (CRCHD) of the National Cancer Institute (NCI). In support of the NCI’s goal to reduce cancer health disparities, the CRCHD drives workforce diversity efforts by supporting trainees from backgrounds underrepresented (UR) in cancer biomedical and behavioral sciences research. The two TEAM programs launched at minority-serving institutions (MSIs) in 2023: The Southwest TEAM (STEAM) network and San Diego State University’s (SDSU) Advancing Cancer Careers for ExceLlence (ACCEL). Each program has a unique model designed to best serve trainees in their respective regions, but both provide: 1) Diverse Training Champions (TCs), role models and navigators who act as the primary point of contact for scholars, provide direct services to trainees, ascertain member needs, develop programmatic offerings, and connect trainees to program components; 2) a mentorship program for pre and postdoctoral scholars and early stage investigators (ESIs); 3) targeted recruitment and professional development of UR scholars; and 4) tailored linkages to professional development and employment opportunities, and NCI/CRCHD funding priorities. This work summarizes the strategies planned across both programs to promote recruitment and retention of investigators from UR backgrounds and cultivate professional development opportunities for students and ESIs. Approach: The STEAM network includes the University of New Mexico, New Mexico State University, Northern Arizona University, and Burrell College of Osteopathic Medicine and leverages the unique programs and expertise of these MSIs to collectively train diverse cancer health disparities researchers with interests in serving Native American, Hispanic and rural communities in the Southwestern United States. The ACCEL Program supports excellence, inclusion and transformation of the cancer research science force, expanding and strengthening the pipeline of UR scholars pursuing cancer research. SDSU, a Carnegie Foundation high activity research institution is one of few institutions to be both a Title Ill/Title V eligible institution for diversity. ACCEL works in close collaboration with the University of California San Diego Moores Cancer Center. We will discuss opportunities and approaches employed by each program in support of scholars to increase the number of diverse scholars in these research pipelines and demonstrate the effectiveness of such coordinated efforts. Conclusion: Supporting TCs to focus on scholars within regional programs will prove to be an efficient and effective way to increase recruitment and retention of diverse investigators in NCI research and community programs. Using novel strategies like TCs, the programs will support the attainment of career goals and enhance and diversify workforce capacity across the cancer research and care continuum. Citation Format: Dolores D. Guest, Martha M. Grimes, Andrew L. Sussman, Elizabeth Y. Jimenez, Graciela Unguez, Ahmed Mohammed, Naomi Lee, Jani Ingram, Krystal Charley, Kristin Gosselink, Jill Nery, Avesta Basraki, Natalie Gude, Rebecca Lewison. Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B121.

Abstract A158: Community-based lung cancer screening navigation for populations at high risk

Abstract Rationale: Lung cancer screening (LCS) can reduce mortality in individuals with a high-risk smoking history, but uptake has been uneven and suboptimal. In our catchment area of Washington state, urban American Indian/Alaska Natives (AI/AN) and sexual and gender minorities (SGM) have high rates of commercial tobacco use and lower uptake of LCS. Mixed-methods community-engaged formative research with both populations revealed barriers to LCS related to social determinants of health, and interest in identity-tailored approaches to LCS care. We used this to develop tailored navigation approaches to LCS. Our study objective was to pilot and evaluate patient navigation programs to facilitate LCS uptake and care completion for these community members. Methods: We conducted parallel LCS navigation pilot studies, with participants who self-identified as AI/AN or as a member of SGM communities and who were LCS screen eligible. Participants were recruited through referrals to our multi-site university-based LCS program, community-based organization partnerships, outreach, and social media. Dedicated patient navigators were trained on LCS processes, navigation, and community-specific best practices. Navigation was guided by handbooks with barrier-specific resources, standardized scripting for contact points, and community-based resources specific to the populations. Participants completed pre- and post-navigation (1-3 months after enrollment) surveys and were followed for LCS uptake, outcomes, and navigation activities through chart review. Results: Between July 1, 2023 and February 1, 2024, 40 participants were enrolled in the navigation pilot studies, 21 in the AI/AN arm and 19 in the SGM arm. The median age of participants was 65 (interquartile range (IQR): 59-69), 80% reported current smoking, and 65% reported a household income below $30,000. Most (55%) reported at least one barrier that delayed access to healthcare in the past year. After enrollment, 35% completed LCS within one month and 55% completed LCS to date. Participants who completed post-surveys (n=22, 55%) indicated that the patient navigator was helpful. Common navigation activities included scheduling assistance, understanding screening results, addressing financial issues, and smoking cessation. Overall, participants approved of navigation approaches with a median Acceptability of Intervention Measure score of 5/5 (IQR: 4.8-5) and a median Patient Satisfaction with Interpersonal Relationship with Navigator score of 44.5/45 (IQR: 39.3-45). Conclusion: These single-arm pilot trials suggest tailored navigation for LCS for AI/AN and SGM communities is a useful approach to engage patients and address barriers and appears acceptable and welcomed. However, substantial variation in LCS completion may reflect complex barriers not addressed through navigation. Community-based and tailored navigation offers a promising approach to address LCS disparities, though further bi-directional refinement of patient navigation is necessary to optimize engagement and LCS completion. Citation Format: Ursula Tsosie, Katie DeCell, Nicolas Anderson, Madison Snidarich, Brandon Omernik, Nicholas Murphy, Matthew Triplette. Community-based lung cancer screening navigation for populations at high risk [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A158.

An atomistic and experimental approach to study the effect of water and nanofillers on the compressive strength of PEGDA hydrogels for cartilage replacement

Polyethylene glycol diacrylate (PEGDA) hydrogel is emerging as a potential candidate for biomedical applications, particularly cartilage replacement. However, due to weak mechanical strength, their applications are still in the infancy for cartilage replacement. In this article, authors have reported the compressive strength of hexagonal boron nitride (h-BN) reinforced PEGDA hydrogels in conjunction with different water content. A combined experimental and atomistic approach (Molecular Dynamics) was employed to explore the compressive strength of nanocomposite hydrogels. It was reported from the experimental analysis that h-BN acts as a superior reinforcement for the compressive strength at lower water content. The Molecular Dynamics (MD) based simulations also predict a similar trend with h-BN and water content. The MD-based study gives insight into scrutinizing the behavior of polymer chains and their entanglement and sheds light on microscale phenomena that are usually inaccessible through experiments alone. It can be concluded from the experiments in conjunction with MD simulations that at higher water content, the contact points between h-BN nanosheets and polymer chains decrease, mitigating the overall compressive strength of PEGDA hydrogels. In summary, this study enables us to obtain meaningful mechanical properties that mimic the strength of human articular cartilage.

The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review

BackgroundIn recent years, eHealth has received much attention as an opportunity to increase efficiency within healthcare organizations. Adoption of eHealth might consequently help to solve perceived health workforce challenges, including labor shortages and increasing workloads among primary care professionals, who serve as the first point of contact for healthcare in many countries.The purpose of this systematic review was to investigate the impact of general eHealth use and specific eHealth services use on general practice workload in the pre-COVID-19 era.MethodsThe databases of CINAHL, Cochrane, Embase, IEEE Xplore, Medline ALL, PsycINFO, Web of Science, and Google Scholar were searched, using combinations of keywords including ‘eHealth’, ‘workload’, and ‘general practice’. Data extraction and quality assessment of the included studies were independently performed by at least two reviewers. Publications were included for the period 2010 – 2020, before the start of the COVID-19 pandemic.ResultsIn total, 208 studies describing the impact of eHealth services use on general practice workload were identified. We found that two eHealth services were mainly investigated within this context, namely electronic health records and digital communication services, and that the largest share of the included studies used a qualitative study design. Overall, a small majority of the studies found that eHealth led to an increase in general practice workload. However, results differed between the various types of eHealth services, as a large share of the studies also reported a reduction or no change in workload.ConclusionsThe impact of eHealth services use on general practice workload is ambiguous. While a small majority of the effects indicated that eHealth increased workload in general practice, a large share of the effects also showed that eHealth use reduced workload or had no impact. These results do not imply a definitive conclusion, which underscores the need for further explanatory research. Various factors, including the study setting, system design, and the phase of implementation, may influence this impact and should be taken into account when general practices adopt new eHealth services.Study registration numberPROSPERO (International Prospective Register of Systematic Reviews) CRD42020199897; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199897.