Geographic Barriers Research Articles

The Impact of Telemedicine on Chronic Disease Management: A Post-Pandemic Analysis of Patient Outcomes and Accessibility

This study explores the impact of telemedicine on chronic disease management, focusing on patient outcomes and healthcare accessibility in the post-pandemic context. Using a qualitative research approach, the study examines how telemedicine has transformed the management of chronic conditions, especially for patients facing geographical or mobility barriers. Data were collected through in-depth interviews with patients, healthcare providers, and policy experts to gain insights into the experiences and challenges associated with telemedicine for chronic care. The findings reveal that telemedicine has improved patient accessibility to healthcare services, enabling consistent monitoring and timely interventions, which positively impact patient health outcomes. However, the study also identifies challenges, including technological barriers and limitations in patient-provider communication, that may affect care quality and patient satisfaction. Despite these issues, telemedicine is seen as a valuable supplement to traditional healthcare, enhancing healthcare access, especially for underserved populations. This research provides key insights for healthcare policymakers and practitioners in improving telemedicine practices, ensuring that they address accessibility gaps without compromising quality. The study concludes that, with strategic improvements, telemedicine holds significant potential to transform chronic disease management and make healthcare more equitable.

Genomic Architecture Underlying the Striking Colour Variation in the Presence of Gene Flow for the Guinan Toad-Headed Lizard.

How divergence occurs between closely related organisms in the absence of geographic barriers to gene flow stands as one of the long-standing questions in evolutionary biology. Previous studies suggested that the interplay between selection, gene flow and recombination strongly affected the process of divergence with gene flow. However, the extent to which these forces interact to drive divergence remains largely ambiguous. Guinan toad-headed lizards (Phrynocephalus guinanensis) in the Mugetan Desert exhibit striking colour differences from lizards outside the desert and provide an excellent model to address this question. Through extensive sampling and whole genome sequencing, we obtained genotypes for 191 samples from 14 populations inside and outside the desert. Despite the colour differences, continuous and asymmetric gene flow was detected across the desert border. More importantly, 273 highly diverged regions (HDRs) were identified between them, accounting only for 0.47% of the genome but widely distributed across 20 (out of the total 24) chromosomes. Strong signatures of selection were identified in HDRs, and local recombination rates were repressed. Furthermore, five HDRs exhibited significantly higher divergence, which contained key genes associated with crucial functions in animal coloration, including pteridine and melanocyte pigmentation. Genes related to retinal cells and steroid hormones were identified in other HDRs, which might have also contributed to the formation of colour variation in the presence of gene flow. This study provided novel insights into the understanding of the evolutionary mechanisms of genetic divergence in the presence of gene flow.

The Promise of Remote Patient Monitoring.

The promise of remote patient monitoring (RPM) lies in its ability to revolutionize health care delivery by enabling continuous, real-time tracking of patient health outside traditional clinical settings. The COVID-19 pandemic accelerated the adoption of RPM, particularly in underserved and rural populations, highlighting both its potential and the persistent barriers that limit its widespread use. This paper explores the critical role of technological advancements-such as wearables, artificial intelligence (AI), and broadband expansion-in sustaining and optimizing RPM in the postpandemic era. We examine Michigan as a microcosm of national health care challenges, focusing on its diverse population and geographic barriers, and propose condition-specific RPM protocols to address these inequities. Key facilitators and barriers to RPM implementation are discussed, with a focus on AI integration, community engagement, and digital infrastructure. We also explore the role of policy reform and public-private partnerships in supporting RPM's scalability and long-term sustainability. Our findings suggest that while RPM offers a powerful tool for improving health care access and outcomes, especially for chronic conditions and rural maternal health, sustained investment in technology and infrastructure is critical. By addressing these challenges, RPM can become a cornerstone of modern health care, reducing disparities and improving care delivery for underserved populations.

Abstract 4137823: Influence of Hospital and Cardiac Rehabilitation Facility Proximity on Enrollment Rates Among Medicare Beneficiaries

Background: Participation in cardiac rehabilitation (CR) is enhanced by proximity to CR facilities and communication between inpatient and outpatient settings but may become fragmented when patients are distant from their discharging hospital and nearest CR facility. Research Question: This study investigates how patient distance to both hospitals and CR facilities impacts the rates of CR participation. Methods: This study included 100% Medicare fee-for-service claims for beneficiaries with 12 months of continuous Part A/B coverage who had coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or surgical or transcatheter aortic valve replacements (SAVR or TAVR) between 07/2016-12/2018, excluding patients discharged to hospice or died within 30 days. Google Maps defined travel distances from the patient to hospital and CR facility locations using geographic centroids of ZIP codes, which were then categorized into quartiles. CR enrollment was defined as attending at least one session within one year of discharge. Logistic regression models estimated marginal CR enrollment rates across both hospital and CR facility distance categories adjusting for patient, hospital, and regional factors. Results: The study included a total sample of 501,049 beneficiaries undergoing PCI (62%), CABG (19%), SAVR (7%), and/or TAVR (15%). The median travel distance to the hospital was 18.6 miles (IQR 8.2-43.3 miles) and to the CR facility was 7.7 miles (IQR 2-15.3 miles). A total of 188,963 (37.7%) beneficiaries attended at least one CR session, which varied across categories of distance to hospital (Q1: 36.8% to Q4: 37.5%) and CR facility (Q1: 44.7% to Q4: 30.0%, p<0.01). Adjusted CR enrollment rates improved when beneficiaries lived farther from their admitting hospitals but closer to CR facilities (Figure 1), with the highest enrollment for those located farthest from their admitting hospital but closest to the CR facility (47.5%) and lowest enrollment among those closest to the hospital but farthest from the CR facility (20.6%). Conclusions: Greater distance to the admitting hospital was associated with higher CR enrollment, while greater distance to the CR facility was associated with lower enrollment among eligible Medicare beneficiaries. Addressing geographic barriers to CR participation may require tailored solutions based on patient proximity to hospitals and CR facilities.

How Online Learning Has Changed the Accessibility of Higher Education

It has become more accessible, flexible, and affordable than ever before as it completely does away with geographical and time barriers as have persisted in traditional education. This aspect accelerated not just in presence but also with identifying strengths and weaknesses in online learning during the pandemic. An advantage of online education has been low cost, based on reduced physical infrastructure. Another is flexibility in learning that learners enjoy as it balances personal responsibilities with their educational needs. Additionally, access for disabled students exists through assistive technologies. Many institutions have embraced this hybrid model where both the traditional learning experience and the online learning experience can give personalized educational experiences. On the other hand, it has posed such problems as the digital divide: students from lower-income backgrounds and those residing in rural areas often cannot access the internet and its other technological tools, which remain inaccessible to a high number of students with disabilities. This contributes to the isolation and disengagement of the online learners, who feel much more at home within the face-to-face learning setting. A further drawback relates to the issue of academic integrity in an online virtual learning environment, where there are no guarantees that students would be self-regulatory.The study examines how these challenges affect the accessibility of higher education and explores gaps in current research, such as the digital divide, inclusion of marginalized students, and the emotional and social impact of online learning. Online education has broadened access to higher education, but there is a need to ensure that all barriers are addressed so that equitable, high-quality learning opportunities are offered to all students.

THE IMPACT OF TELEMEDICINE ON ACCESS TO PRIMARY CARE

The COVID-19 pandemic has driven the implementation of telemedicine as a solution for maintaining access to healthcare, transforming the primary care landscape in many parts of the world. In Brazil, telemedicine has established itself as an essential tool for overcoming geographical and social barriers, facilitating access to basic care for populations that traditionally faced difficulties in accessing health services. This study seeks to investigate the impact of telemedicine on access to primary care, analyzing its main challenges and opportunities in the context of post-pandemic primary care. This study seeks to analyze the impact of telemedicine on access to primary care, exploring the main challenges and opportunities that arise with this modality of care. It also aims to identify practices and policies that can strengthen the implementation of telemedicine in Primary Care, ensuring that remote care is effective, safe and inclusive. This is a literature review, based on a qualitative approach, using the Scielo, Google Scholar and PubMed databases. To refine the research, the health descriptors “telemedicine”, “primary care”, “COVID-19”, and “equity in access to health” were selected, with a time frame between 2021 and 2023. Through a literature review, the study explores recent data on telemedicine in primary care, focusing on the main opportunities it offers, such as improved access and efficiency of services, as well as the challenges, including limited technological infrastructure in poor regions, privacy and confidentiality issues, and the need for adequate training for health professionals. Telemedicine enables more agile care and coverage of a larger population, but still faces obstacles related to digital accessibility and maintaining quality and continuity of care, especially for vulnerable groups. Telemedicine has therefore proved to be a strategic tool for expanding access to primary care, offering a viable alternative for reducing gaps in primary care. However, in order to maximize its impact, it is essential to overcome the technological challenges, guarantee information security and train health professionals in this new type of care. The continued use of telemedicine in the post-pandemic context presents an opportunity to strengthen the Unified Health System (SUS) in Brazil, expanding the reach of primary care and promoting greater equity in access to health.

News dissemination: a semantic approach to barrier classification

AbstractThe dissemination of information worldwide is significantly facilitated by the news media, with many events having global relevance across various regions. However, certain news events receive limited coverage restricted to specific geographic areas, due to the barriers that hinder the spread of information. These barriers can be attributed to political, geographical, economic, cultural, or linguistic factors. In this research, we propose an approach for classifying these barriers by extracting semantic information from news articles using Wikipedia-concepts. Our methodology involves the collection of news articles, each annotated to indicate the specific barrier types, leveraging metadata from news publishers. Subsequently, we employ Wikipedia-concepts, in conjunction with the content of the news articles, as features to determine the barriers to news dissemination. Our approach is then compared with traditional text classification techniques, deep learning methods, and transformer-based models. We have performed experiments on news articles from ten categories of topics including health, sports, business, etc. The findings indicate that 1) Utilizing semantic knowledge yields distinct concepts across the ten categories, thereby enhancing the effectiveness and speed of the classification model. 2) The proposed approach, incorporating Wikipedia-concepts-based semantic knowledge, leads to improved performance in barrier classification when compared to using solely the body text of news articles. Specifically, there is an increase in the average F1-scores for four out of five barriers, with the economic barrier rising from 0.65 to 0.68, the linguistic barrier from 0.71 to 0.72, the political barrier from 0.68 to 0.70, and the geographical barrier from 0.63 to 0.68.

From face-to-face to screen-to-screen: exploring the multifaceted dimensions of digital mental health care

BackgroundWith the onset of the COVID-19 pandemic, the world witnessed an unprecedented surge in the adoption of digital platforms across various sectors, including mental health care. In countries such as Pakistan, where traditional face-to-face therapy practices hold social and cultural significance, transitioning to digital therapeutic methods presents a range of unique opportunities and challenges.ObjectivesThis research aimed to explore the dynamics, implications, and perceptions surrounding digital therapeutic care within the Pakistani sociocultural context. Given the paucity of literature on this subject in the Pakistani context, this study aims to bridge the evidence gap between trends in digital therapy and localized practices. The main goal was to understand the benefits, issues, and challenges therapists and clients face when adopting digital modes for therapeutic care.MethodFor this study, primary data was gathered from counsellors and therapists using a qualitative in-depth interview guide. Using a thematic analysis approach, key themes were derived from the interviews that provided insights into the experiences and perceptions of the participants.ResultsThe study revealed that digital platforms have great potential in breaking down geographical barriers making therapeutic interventions more accessible to a wider demographic. This increased accessibility also brought about a level of comfort for clients as they could access therapy from their familiar surroundings. Among the challenges that needed attention, security and confidentiality stood out, requiring strict measures to safeguard client’s data. The shift also brought to light the diverse range of feedback from clients, which was influenced by factors like age and technological proficiency. Moreover, the digital transition posed challenges for both therapists and clients, with many facing an adjustment period as they transitioned from face-to-face to online sessions. One significant challenge was the perceived difficulty in fostering a deep interpersonal connection in a virtual environment. This was further compounded by the need for therapists to modify traditional therapeutic techniques to fit the online mode.Conclusion and implicationsThe study underscores the evolving nature of digital therapy in Pakistan, setting a foundation for further exploration in aligning technology with therapeutic needs, ensuring optimal benefits for clients while preserving the sanctity and efficacy of the therapeutic relationship.

Human Impacts on Great Lakes Walleye Sander vitreus Structure, Diversity and Local Adaptation.

Artificial propagation and wild release may influence the genetic integrity of wild populations. This practice has been prevalent in fisheries for centuries and is often termed 'stocking'. In the Laurentian Great Lakes (Great Lakes here-on), walleye populations faced declines from the 1950s to the 1970s, prompting extensive stocking efforts for restoration. By the mid-2010s, walleye populations showed signs of recovery, but the genetic legacy of stocking on population structure at the genomic level remains unclear. Using a dataset of 45,600 genome-aligned SNP loci genotyped in 1075 walleye individuals, we investigated the genetic impacts of over 50 years of stocking across the Great Lakes. Population structure was associated with both natural geographic barriers and stocking from non-native sources. Admixture between Lake Erie walleye and walleye from the re-populated Tittabawassee River indicate that stocking may have re-distributed putatively adaptive alleles around the Great Lakes. Genome scans identified FST outliers and evidence of selective sweeps, indicating local adaptation of spawning populations is likely. Notably, one genomic region showed strong differentiation between Muskegon River and walleye from the Tittabawassee River, which was re-populated by Muskegon strain walleye, suggesting admixture and selection both impact the observed genetic diversity. Overall, our study underscores how artificial propagation and translocations can significantly alter the evolutionary trajectory of populations. The findings highlight the complex interplay between stocking practices and population genetic diversity, emphasising the need for careful management strategies to preserve the genetic integrity of wild populations amidst conservation efforts.

Delineating genomic features for wild guanaco conservation

Abstract The South American fauna has endured challenges such as illegal hunting, cattle expansion, climate change, and landscape fragmentation. Despite ongoing conservation efforts that aim to address these issues, genetic diversity remains overlooked. We genotyped 126 Lama guanicoe individuals from an area of 2 million km2 in Patagonia and Cuyo using the 60K SNPs Axiom-Camelids, and we assessed population viability through genetic diversity, inbreeding, and population size. We then explored population connectivities through network analyses, genetic differentiation, and Bayesian approaches. Our findings reveal six genetic clusters: Cuyo, Somuncura, North Patagonia, Central Patagonia, South Patagonia, and Tierra del Fuego Island (TDFI). Cuyo and TDFI guanacos differed from others due to isolation-by-distance and geographical barriers, respectively. Cuyo exhibited the highest degree of allele conservation, but TDFI faced heightened vulnerability due to isolation and increased homozygosity. Sharp bottlenecks in Cuyo and North Patagonia coincided with the expansion of sheep farming, while bottlenecks in the other populations occurred during the Little Ice Age. North Patagonia acted as a probable contact zone, facilitating mixing of the Cuyo, Somuncura, and Central Patagonia populations. The Central and South Patagonian populations presented the highest gene flow. Thus, genomic advances help to define distinct conservation units (genetic stocks) to guide management practices and decisions.

Distance Education In The Legal Amazon

The expansion of Distance Education (DE) in the Legal Amazon represents an important advance for the democratization of higher education in a region marked by the vast territorial extension and the difficult accessibility to face-to-face educational services. This education model seeks to meet a pent-up demand from students who reside in isolated areas, offering a solution that circumvents geographical limitations and promotes inclusion. This article explores the expansion of Distance Education (DE) in Brazil's Legal Amazon, where educational provision faces socioeconomic and geographic barriers that make face-to-face access more challenging. This study reviews the literature on distance education in the region, analyzes the impact of public policies and discusses how Information and Communication Technologies (ICT) play a central role in the democratization of education.

Developing a cross-functional team coordination framework: A model for optimizing business operations

In today's complex business environment, effective cross-functional team coordination is crucial for optimizing operations and achieving organizational goals. This study introduces a comprehensive framework designed to enhance cross-functional team coordination through structured operational management strategies. By integrating key principles of collaboration, communication, and accountability, the framework aims to bridge departmental silos and promote a culture of teamwork. The proposed model is structured around three core components: communication channels, collaborative tools, and performance metrics. First, it emphasizes the establishment of robust communication channels that facilitate real-time information sharing and feedback among team members from diverse functions. This fosters transparency and aligns objectives, ensuring that all team members are on the same page. Second, the framework advocates for the implementation of collaborative tools that streamline project management and task allocation. These tools enable team members to track progress, manage workloads, and share resources effectively, thereby enhancing overall productivity. By utilizing technology that supports remote collaboration, organizations can also adapt to the increasing trend of virtual teams, ensuring that geographical barriers do not hinder coordination. Finally, the model incorporates performance metrics that allow teams to evaluate their effectiveness and make data-driven decisions. By establishing clear key performance indicators (KPIs) related to team outcomes, organizations can continuously monitor progress and identify areas for improvement. This iterative approach not only optimizes current operations but also fosters a culture of continuous improvement within cross-functional teams. The framework is designed for applicability across various industries, demonstrating its versatility in addressing the unique challenges faced by organizations. By adopting this structured approach to cross-functional coordination, businesses can enhance their operational efficiency, reduce project delays, and improve overall team morale. This study contributes to the existing literature on operational management by providing a practical model that organizations can implement to optimize their business operations through improved cross-functional teamwork.

Enhancing HIV/AIDS and TB medication logistics: A comprehensive approach to global healthcare distribution

The distribution of HIV/AIDS and tuberculosis (TB) medications is critical to the success of global healthcare initiatives, particularly in regions with limited infrastructure and resources. This review examines the logistical challenges hindering the efficient delivery of these life-saving medications, including supply chain inefficiencies, poor infrastructure, and geographical barriers. It also explores innovative approaches to optimizing logistics, such as the use of blockchain, drones, and artificial intelligence (AI), alongside public-private partnerships (PPPs) and supportive policy frameworks. These emerging technologies have the potential to enhance the availability and effectiveness of HIV/AIDS and TB treatments by improving supply chain transparency, reducing stockouts, and overcoming transportation challenges in remote areas. The paper further assesses the impact of these logistical improvements on healthcare outcomes, demonstrating how they contribute to improved patient adherence, reduced disease transmission, and cost savings. Finally, recommendations are provided for policymakers, healthcare organizations, and stakeholders to adopt these innovations, and future research directions are proposed to expand these models to other medications and diseases.

Digital Tele-Counseling for Sustainable Maternal Health Services in Indonesia Focus on Telelactation

Breastfeeding is essential for infant health and development, yet Indonesia faces challenges in meeting global breastfeeding targets. This review examines the potential of tele-counseling (telelactation) as a solution to improve breastfeeding support in the digital era, focusing on overcoming geographical and service delivery barriers. A systematic literature search covering PubMed, Scopus, Google Scholar, and local Indonesian journals identified 25 articles from 2019 to 2023, with 14 unique studies meeting inclusion criteria. Findings indicate that telelactation primarily utilizes WhatsApp groups, Androidbased apps, and online counseling sessions, resulting in improved breastfeeding techniques, increased exclusive breastfeeding rates, and enhanced maternal knowledge. However, privacy concerns and technological barriers persist, though these are addressed through specialized training and ongoing support for healthcare providers. Telecounseling demonstrates promise in supporting breastfeeding in Indonesia, though further research is needed to address geographical limitations and assess longterm impacts. Integrating telecounseling into national breastfeeding policies could significantly advance maternal and child health outcomes in Indonesia.

Innovating Community Engagement: The Role of Micro-Influencers in Promoting Sustainable Behaviors among Malaysian Millennials

Social Influencers as environmental leaders utilize social media platforms to enhance community engagement in advocating sustainability. This study explores the underexplored role of micro-influencers in fostering pro-environmental behaviors among Malaysian youths and innovating community engagement by employing a qualitative approach in conducting semi-structured interviews with five micro-influencers. Our findings indicate the critical role of micro-influencers in raising awareness and actively engaging communities in adopting sustainable practices. The findings reveal three key themes: leadership qualities, pro-environmental behaviors, and persuasive narrative strategies. Through the innovative use of social media, these influencers overcome linguistic and geographical barriers, fostering enhanced community engagement in the pursuit of environmental stewardship. However, the sample size of five micro-influencers may limit the generalizability of the findings, as it may only partially represent the diverse range of micro-influencers. The result of this research can be used as recommendations for organizations, non-governmental organizations and governmental bodies that can leverage the insights from this study to strategically engage micro-influencers in environmental campaigns, recognizing their unique ability to reach and resonate with specific communities, particularly Malaysian youths. This study offers a novel perspective on digital environmental leadership by uncovering the unique role of micro-influencers in fostering community engagement and cultivating a culture of sustainability. It provides original insights into how these emerging leaders not only inspire but also empower communities to take meaningful action toward environmental preservation. The study highlights the underexamined potential of micro-influencers in exceeding traditional barriers to community engagement, offering valuable implications for future strategies in environmental advocacy.

Youth mental health outreach interventions: lessons from an experience capitalisation process

Abstract Issue Young people face socioeconomic, geographical and cultural barriers to access care and support in mental health. Practitioners implement outreach initiatives to improve mental health and address health inequalities, mostly developed in a ‘no-request for care’ context. Methods To better understand the implementation mechanisms of these initiatives, Fondation de France commissioned the French Society for Public Health to carry out an experience capitalisation to inspire other professionals. Experience capitalisation method was used, based on in depth interviews with project stakeholders. Covered themes were: the description of history, strategies and activities; identification of key moment and key levers; skills and knowledge used. Results Nine mental health outreach projects implemented across regions of France were selected with the help of a multidisciplinary steering committee. Each project was synthetised in a capitalisation document and a cross-sectional analysis was undertaken. Lessons • A variety of outreach approaches were carried on: meeting adolescents in the street or at coffee shops; home-based interventions; consultations in converted van etc. • Outreach is not just a matter of physically moving outside health structures but requires non-judging and flexible stance to adjust to the youth’s pace and will. To extend their approach to mobility, professionals deepen their team’s multidisciplinarity, broaden cross-sector partnerships and mobilise new skills and creativity. • Adolescents’ participation to care or support plans was one of projects strengths, whether they suffer from anxiety or mental disorders. However, their participation in governance and decisions regarding global projects remained limited. Key messages • To reduce mental health inequalities and enhance youth participation in outreach interventions, empowerment and wellbeing of interventions practitioners should also be supported. • Capitalisation of experience in health promotion is a promising method contributing to professional acknowledgment and development of shared knowledge on interventions implementation.

Genetic polymorphism of merozoite surface protein 1 and merozoite surface protein 2 in the Vietnam Plasmodium falciparum population

BackgroundPlasmodium falciparum merozoite surface proteins 1 (PfMSP1) and 2 (PfMSP2) are potential candidates for malaria vaccine development. However, the genetic diversity of these genes in the global P. falciparum population presents a significant challenge in developing an effective vaccine. Hence, understanding the genetic diversity and evolutionary trends in the global P. falciparum population is crucial.MethodsThis study analyzed the genetic variations and evolutionary changes of pfmsp1 and pfmsp2 in P. falciparum isolates from the Central Highland and South-Central regions of Vietnam. DNASTAR and MEGA7 programs were utilized for analyses. The polymorphic nature of global pfmsp1 and pfmsp2 was also investigated.ResultsA total of 337 sequences of pfmsp1 and 289 sequences of pfmsp2 were obtained. The pfmsp1 and pfmsp2 from Vietnam revealed a higher degree of genetic homogeneity compared to those from other malaria-endemic countries. Remarkably, the allele diversity patterns of Vietnam pfmsp1 and pfmsp2 differed significantly from those of neighboring countries in the Greater Mekong Subregion. Declines in allele diversity and polymorphic patterns of Vietnam pfmsp1 and pfmsp2 were observed.ConclusionsThe Vietnam P. falciparum population might be genetically isolated from the parasite populations in other neighboring GMS countries, likely due to geographical barriers and distinct evolutionary pressures. Furthermore, bottleneck effects or selective sweeps may have contributed to the genetic homogeneity of Vietnam pfmsp1 and pfmsp2.

TeleHelp Ukraine: A distributed international telemedicine response to the ongoing war.

Humanitarian crises frequently garner solidarity and robust volunteer recruitment among health care communities. However, a common obstacle is matching providers to those in need across geographic and other barriers. We examined the application of a decentralised governance strategy in establishing an emergency telemedicine response, TeleHelp Ukraine (THU). Using a case study approach, we explored how global networking and technological advancements empower organisations to generate, access, disseminate, and utilise knowledge for sustainable health care delivery. Preliminary results suggest that a non-profit, decentralised model strengthened by robust team dynamics may optimise the distribution of clinical workload and scheduling procedures. Institutional and cultural diversity among health care providers and volunteers fosters the mobilisation of knowledge resources, synergistic collaboration, and tailored care standards that align with both provider and patient expectations. By integrating these diverse, distributed networks, a synergistic effect is achieved, combining effective learning mechanisms with intellectual capital. Our study provides insights into the structure, implementation strategies, dissemination methodologies, and initial results of THU's operation. These findings may inform future emergency telemedicine responses in humanitarian scenarios, thereby reinforcing the practical implementation of health as a human right.

Telehealth to increase healthcare access; perspectives of people who use drugs.

People who use drugs (PWUD) often face restricted healthcare access despite their heightened healthcare needs. Factors such as stigma, mistrust of the healthcare system, competing priorities, and geographical barriers pose significant healthcare access challenges. Telehealth offers an innovative solution to expand healthcare access for better inclusion of underserved populations in healthcare. We aimed to explore PWUDs' perceptions of telehealth as a healthcare delivery modality. We utilized purposive sampling to recruit participants (N = 57) for nine focus group discussions (FGDs) in Athens, Greece. Eligibility criteria required participants to be at least 18years, with current or prior injection drug use, and current internet access. The FGDs followed a semi-structured interview guide, were audio recorded, transcribed verbatim, translated into English, and de-identified. We applied thematic analysis to analyze FGD transcripts. Participants' mean (standard deviation) age was 47.9 (8.9) years, 89.5% (51/57) were male, 91.2% (52/57) were of Greek origin, and 61.4% (35/57) had attended at least 10years of school. Three main themes emerged from the FGDs: (1) high internet utilization for healthcare-related purposes among PWUD, (2) highlighting telehealth benefits despite access obstacles and PWUDs' concerns about diagnostic accuracy, and (3) approaches to overcome access obstacles and build digital trust. Participants extensively used the internet for healthcare-related processes, such as accessing healthcare information and scheduling provider appointments. Despite being telehealth-inexperienced, most participants expressed a strong willingness to embrace telehealth due to its perceived convenience, time-saving nature, and trusted digital environment. Some participants recognized that the inability to conduct physical examinations through telehealth reduces its diagnostic accuracy, while others expressed concerns about digital literacy and technological infrastructure accessibility. Most participants expressed a preference for video-based telehealth encounters over audio-only encounters. To build trust in telehealth and promote patient-centeredness, participants recommended an initial in-person visit, virtual eye contact during telehealth encounters, patient education, and partnerships with PWUD-supportive community organizations equipped with appropriate infrastructure. PWUD frequently use the internet for health-related purposes and suggested several approaches to enhance virtual trust. Their insights and suggestions are practical guidance for policymakers seeking to enhance healthcare access for underserved populations through telehealth. NCT05794984.

Taxonomic revision and evolutionary history of the climbing mice in eastern Africa (Dendromus mystacalis clade): the role of elevation and geographical barriers in the speciation process

Taxonomic revision and evolutionary history of the climbing mice in eastern Africa (Dendromus mystacalis clade): the role of elevation and geographical barriers in the speciation process