Mobility Issues Research Articles

Mobility restriction and barrier-reduced housing among people aged 65 or older in Germany: Do those who need it live in barrier-reduced residences?

Older people spend a lot of time at home and in the area near where they live. Housing conditions ensure their ability to participate in social life, especially when they suffer from mobility restrictions. Barrier-free access to the residence and to rooms within the residence is a key condition for their everyday mobility. As a result, this is what we define as minimal criteria for barrier-reduced residences. This article examines the extent to which people aged 65 and over (including people with mobility issues) live in barrier-reduced housing and what factors influence the chance of living in such residences. Cross-sectional data from the German Ageing Survey (DEAS) 2020/21 (persons aged 65 and over, n = 2,854) were used. The DEAS is a representative cross-sectional and longitudinal survey of the population aged 40 and over in Germany. In our analyses, we used logistic regression models to investigate the probability of living in a barrier-reduced residence. We defined housing as barrier-reduced when the apartment/house and the rooms inside it can be reached without steps or stairs. As explanatory variable, we considered mobility restrictions, defined as limited ability to climb a flight of stairs. In addition, the model includes other individual factors (age, gender, equivalized household income), regional factors (living in East vs. West Germany, in urban vs. rural region) and moving to the current residence after the age of 65. Of all individuals aged 65 or older, 19.3 percent live in a barrier-reduced residence. Also, of mobility-restricted elders, only 21.4 percent have such residences. The logistic regression results show that mobility restrictions are associated with a higher probability of living in a barrier-reduced residence. Compared to the lowest income group, older people in the highest income group are more likely to live in barrier-reduced housing. East Germans and people in urban areas are less likely to live in a barrier-reduced home. The likelihood of barrier-reduced living is higher among seniors who moved into their current residence after age 65. No significant differences were found for age groups and gender. The findings show that not enough seniors have barrier-reduced access to their homes and rooms, even if they suffer from mobility restrictions. Preventing functional restrictions must therefore also include improvements in the residential environment, especially in disadvantaged residential areas.

The role of governance models in the development of transport infrastructure megaprojects in Greater Montreal: The case of the Réseau express métropolitain

This article focuses on mobility issues in Montreal, whose metropolitan transportation policies are presented as one of the major ambitions of large North American metropolitan areas. Empirically, we are interested in a recent transportation megaproject: the Réseau express métropolitain (REM) in Montreal, an electric light-rail transit network spanning 67 kilometers in the Greater Metropolitan Area. These types of megaprojects involve significant governance challenges and certain criticisms due to the involvement of several actors from different backgrounds and defending different interests, which places. This is why we believe that it is important to address this issue from the point of view of metropolitan governance through the agenda-setting of urban megaprojects. The originality of this article is that it demonstrates how presenting the REM project as a public-public partnership, between the Caisse de dépôt et placement du Québec (CDPQ) and the Government of Québec, opened the door to favoritism for the Caisse which influenced the choice of a political solution in Greater Montreal. By mobilizing Kingdon's model, we conclude that windows of opportunity cannot open without choosing a governance model during the agenda-setting phase.

Exploring the life experiences of stroke survivors in Nigeria using the interpretive phenomenological analysis

BackgroundThe consequence of living as a stroke survivor has received significant attention in literature from different parts of the world. Enriching social relations and other factors are reported to influence the post-stroke experience. Differences in health systems, cultural factors and available resources have made it apt to explore the experience of life after a stroke in Nigerian stroke survivors. This study explored the lived experiences of Nigerian adult stroke survivors, with a focus on their concerns, hopes, dreams and daily routine experiences.MethodsThis qualitative study employed a phenomenological approach based on in-depth interviews with stroke survivors. Interpretative phenomenological analysis was used to analyse the in-depth exploration of the personal experiences of these stroke survivors and the meanings they attached to that experience.ResultsThe participants in this study described their experiences, emphasising both the visible loss of mobility and emotional issues related to their condition. Three superordinate themes were identified: (1) stroke presentation; (2) affect, coping, and adaptation; and (3) social supports.ConclusionThe study concluded that the experience of Nigerian stroke survivors is unique as it is a blend of supportive and non-supportive care scenarios, which is greatly associated with environmental and other intrinsic variables. Post-stroke mobility strongly influences the overall stroke experience.

Analysis of the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on fracture healing, mobility and nutritional status of elderly patients with vertebral or hip fractures

ABSTRACT Hip fractures (VOHF) are a type of bone fracture that occurs in the hip bone, typically affecting older adults. Recovery from hip fractures in older adults can be challenging due to factors such as decreased mobility, weakened bones, and other health issues. This paper intends to determine the effect of mini-nutrition nursing plus Baduanjin rehabilitation exercise on postoperative rehabilitation of elderly patients with vertebral or hip fractures (VOHF). 106 senile VOHF patients were chosen for the study between May 2020 and May 2022. The research group (RG) consisted of 60 patients who received mini-nutrition nursing + Baduanjin rehabilitation exercise, while the control group (CG) had 46 patients who received mini-nutrition nursing + routine rehabilitation training. The study compared the fracture healing effect, MAMC, CC, and MNA-SF scores. The rehabilitation status of patients was evaluated using FMA, BI, BBS, and VAS. Adverse reactions during hospitalization and SF-36 scores were also recorded. Better fracture healing efficacy and higher MAMC, CC, and MNA-SF scores were determined in RG versus CG (P < 0.05). Elevated FMA, BI and BBS scores were observed in both groups after rehabilitation training, with more evident elevations in RG; while the VAS score reduced markedly and was lower in RG compared with CG (P < 0.05). In addition, RG was observed with fewer adverse reactions and higher SF-36 scores (P < 0.05). Mini-nutrition nursing + Baduanjin rehabilitation exercise can effectively accelerate the postoperative rehabilitation of elderly patients with VOHF, improve mobility, and enhance their quality of life.

Reducing unnecessary handovers and improving ranking abnormality based on multi‐attribute decision making graph theory and matrix approach with Euclidean distance in heterogeneous wireless networks

SummaryNew mobile devices offer multiple network interfaces to allow the users to connect to the best available network. The heterogeneous networks can provide better internet connectivity to the users by means of vertical handover. The handover must be triggered at a suitable point of time to avoid mobility issues such as unnecessary handovers and handover ping‐pongs. The network selection during handover is usually done using classical multi‐attribute decision making (MADM) methods. However, ranking abnormality is one of the prominent issues of the classical MADM methods. To address these challenges, a graph theory and matrix approach (GTMA) with Euclidean distance is proposed for vertical handover in wireless networks. GTMA is used for the selection of the appropriate network and Euclidean distance is utilized for the handover triggering. The simulation results reveal that the proposed method has eliminated the ranking abnormality issue. This proposed technique without triggering has also reduced the number of handovers up to 75.61%, 85.71%, and 66.67% as compared to the traditional MADM methods such as AHP, GRA, and TOPSIS respectively. The use of Euclidean distance for handover triggering has further reduced the number of handovers of the proposed technique as well as traditional techniques for all the traffic types.

Mobility and Security Aware Real-Time Task Scheduling in Fog-Cloud Computing for IoT Devices: A Fuzzy-Logic Approach

Abstract This paper aims to improve the overall task processing time of mobile real-time Internet of Things (IoT) applications in fog-cloud computing, considering the various resource and security requirements along with the time constraints of the task. Fog computing extends the cloud resources to serve the IoT devices at the network edge. In such a scenario, deciding whether the tasks should be processed at the fog layer or submitted to the cloud is critical. Moreover, for real-time applications, the mobility of IoT devices and the limited bandwidth available at the edge devices endanger the low processing time of the task. Besides, the security demands of some IoT applications (i.e. healthcare) require processing the tasks by specific fog or cloud servers to assure confidentiality of information, which may also delay the task processing time. Therefore, we first address the mobility issue by proposing three different algorithms that work on allocating the mobile IoT device to the appropriate edge device (i.e. fog gateway), considering the distance and bandwidth load factors. Then, we offer a novel task scheduling algorithm that uses fuzzy logic to optimize the distribution of tasks between the fog and cloud layers, considering the task security requirements. The algorithm selects the proper processing unit to execute the task in the fog layer by exploiting the task demands (i.e. computation, storage, bandwidth, security) and deadline. Results demonstrate that considering the factors of distance and available bandwidth load while allocating the IoT device to the fog gateway improves the task processing time better than adopting one aspect. Results also show that our proposed scheduling algorithm outperforms other existing algorithms regarding makespan, turnaround time, success ratio and processing time metrics.

MP52-05 BLADDER MANAGEMENT IS THE TOP HEALTH CONCERN AMONG ADULTS WITH A SPINAL CORD INJURY

You have accessJournal of UrologyCME1 Apr 2023MP52-05 BLADDER MANAGEMENT IS THE TOP HEALTH CONCERN AMONG ADULTS WITH A SPINAL CORD INJURY John P. Ratanawong, Christopher J. Loftus, Jeremy B. Myers, Sara M. Lenherr, John T. Stoffel, Blayne Welk, and Sean P. Elliott John P. RatanawongJohn P. Ratanawong More articles by this author , Christopher J. LoftusChristopher J. Loftus More articles by this author , Jeremy B. MyersJeremy B. Myers More articles by this author , Sara M. LenherrSara M. Lenherr More articles by this author , John T. StoffelJohn T. Stoffel More articles by this author , Blayne WelkBlayne Welk More articles by this author , and Sean P. ElliottSean P. Elliott More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder management has been shown to be the most important health concern for people with spinal cord injury (SCI), outranking even ambulation. Incontinence, urinary tract infections (UTI) and clean intermittent catheterization (CIC) compared to other bladder management methods, have been shown to predict poor urinary quality of life (QoL) in people with SCI. But, it is unclear if these factors impact ranking bladder management as a top health concern. Using the Neurogenic Bladder Research Group (NBRG) SCI registry, our objective was to confirm whether bladder management is the top health concern and whether this is associated with urinary incontinence, UTI, or CIC utilization. METHODS: Participants in the NBRG registry were asked: “What are the top 3 problems that affect you on a daily basis? (Rank top 3): bladder management/issues, bowel management/issues, pressure ulcer, mobility issues, autonomic dysreflexia, spasticity/stiffness, pain, depression/anxiety, heart problems, lung problems, sexual function, fertility, or other.” Incontinence and urinary QoL were assessed using the Neurogenic Bladder Symptom Score (NBSS). We performed a multivariate regression to identify factors related to their primary choice. RESULTS: Among our 1460 participants, 882 (60%) were men, mean age was 44.9 years, and mean time since injury was 14.4 years. 574 (39%) ranked bladder management as their primary issue, followed by pain and bowel management (Figure 1). Factors associated with choosing bladder as the top concern included more years since injury (OR 1.02 [1.00,1.03], p<0.02), worse NBSS incontinence domain score (OR 1.06 [1.02, 1.09], p<0.01), and worse NBSS QoL (OR 1.20 [1.04, 1.37], p=0.01); UTI≥1/year (OR 1.03 [0.70, 1.50], p=0.89) and CIC (OR 1.40 [0.92, 2.14], p=0.12) were not significant. CONCLUSIONS: In this group, bladder management was ranked as the top health issue, over other sequelae of SCI. The farther out from injury people are, the more important bladder management becomes. Bladder QoL and, in particular, incontinence also drive people to view bladder issues as their top health concern. By managing incontinence in people with SCI, urologists can impact the top health concern of people with SCI. Source of Funding: PCORI-1409-21348 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e704 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information John P. Ratanawong More articles by this author Christopher J. Loftus More articles by this author Jeremy B. Myers More articles by this author Sara M. Lenherr More articles by this author John T. Stoffel More articles by this author Blayne Welk More articles by this author Sean P. Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...

Social Media Learning Lab to Offer Lessons in Twitter and TikTok

Back to table of contents Previous article Next article Annual MeetingFull AccessSocial Media Learning Lab to Offer Lessons in Twitter and TikTokJake Goodman, M.D., M.B.A.Jake GoodmanSearch for more papers by this author, M.D., M.B.A.Published Online:27 Mar 2023https://doi.org/10.1176/appi.pn.2023.04.3.55AbstractWith the use of social media platforms, psychiatrists can easily share information and resources with individuals who may not have access to traditional forms of education.iStock/PhotosbypatrikA panel of six psychiatrists (including two psychiatry residents) who are social media experts will lead a Learning Lab that will provide advice and insight into creating engaging and educational content on social media. The session is aptly titled “Using Social Media to Educate, Advocate, and Empower: A Panel of Social Media Experts in Healthcare.”The overwhelming majority of adolescents in the United States rely on social media for their news, entertainment, and education. If teenagers begin to experience the initial phases of a mental illness—from chronic insomnia, to periods of intense anxiety, to auditory hallucinations—where do they turn for answers? Odds are that they are not knocking on the doors of psychiatric practices and hospitals. Most will scroll social media to educate themselves, but they may not be able to distinguish between credible sources of information and misinformation.Where are the psychiatrists on social media? Where are the doctors with years of training in mental health who could share evidence-based practices and resources? They’re largely missing. If we don’t begin to make a serious effort to meet our patients where they are, we are failing them.As a psychiatry resident, I have built a community of over 2 million followers and supporters across social media, where I post videos educating the masses about mental health problems and treatment options. As of today, these videos have amassed over half a billion views. Every view is a chance to share what could be life-changing information with someone who may never sep foot in a psychiatric practice.With the use of platforms such as Facebook, Twitter, and Instagram, psychiatrists can easily share information and resources with individuals who may not have access to traditional forms of education. This can be particularly beneficial for those who live in rural or underserved areas, as well as for those who may have mobility or transportation issues. In addition to educating people in need, social media allow psychiatrists to connect with other mental health professionals, share the latest developments in the field, and help brand and market their practices to reach more patients.Here’s the elephant in the room: social media can be overwhelming and intimidating. Some of us don’t know the difference between a tweet and a TikTok. And that’s OK. We never had a lecture in medical school about how to create a video or write a tweet to educate the public about a new medical advancement. That’s where this session comes in—attendees will learn how to utilize social media to educate patients and the public, create engaging content, build a professional network, and brand one’s practice. These are essential skills for the future of psychiatry, so bring a phone and come to the session! ■Jake Goodman, M.D., M.B.A., is a psychiatry resident, mental health activist, and social media content creator. ISSUES NewArchived

SOCIAL INTEGRATION AND SOCIAL MOBILITY: AN EXAMPLE FROM HODÁSZ

The paper examines the social mobility process of Romani youngsters in a settlement that is in one of the most disadvantaged regions of Hungary. Hodász became the centre of interest due to the relevant research concerning the mobility issue, because here, just contrary to the communities have similar sociocultural features, there are number of young Romani who could stand out by learning. The author interprets in wider aspects the determinative local norms, and the scale of values of local Vlach Romani community make possible for lots of local youngsters, that they can be graduated. In the second part of the paper the reader can understand the intellectual career by three studies, and consequently the social integration doesn’t automatically yield social mobility. In the situational analyses of Hodász example can be circumscribed the specific preconditions of intellectual career in the case of the young Romani and disadvantageous.

Mobility program impact on the internationalization of higher education at The Faculty of Social and Psychological Education of Pavlo Tychyna Uman State Pedagogical University

The article deals with the issues of international academic mobility of students, teachingand research related to internationalization of higher education at the Faculty of Socialand Psychological Education of Pavlo Tychyna Uman State Pedagogical University.Given the ever-increasing requirements to quality of higher education, Ukrainianhigher education institutions (HEI) faced the problem of the need to increase competitivenesson the world market. All this indicates that international university cooperationis an integral part of the existence and development of Ukrainian higher educationinstitutions. International cooperation, academic mobility of students, participationin international educational programs and projects are the priority of today’s education development. Thanks to inter-university partnerships, young people study together withtheir peers from different countries of the world, develop intercultural understanding,and adapt to life and work in the global space.

Long term lithium availability and electric mobility: What can we learn from resource assessment?

A more sustainable global mobility system in which Internal Combustion Engine (ICE) vehicles are replaced by electric vehicles (EVs) powered by lithium-ion batteries (LiBs), taking into account the existing, or inferred, resource, is still possible? The present study aims at providing an answer to this question, through the design of an innovative compartmental model. Model scenarios have been considered accounting for three different estimates of the resource, i.e. the declared reserves, the hypothesized resources, and the full beneficiation of dissolved Li in the oceans. Input data were provided from the historical data of Li primary production, EVs production and recycling rates.The replacement of the ICE vehicles fleet appears possible only under extreme, unrealistic situations, unless the Li “stored” in the oceans is considered exploitable. The main viable policies, i.e. the optimisation of the resource share (almost entirely devoted to mobility issues) and of recycling strategies (pushed up to >90 %) have a modest effect on the achievement of fleet replacement. The total amount of geological lithium resources results as the main limiting factor for the complete transition to EVs. According to the developed model, the peak of production would occur between 2078 and 2130, unless seawater Li is accounted for.The future of the global mobility in a resource-constrained world should be driven toward a model based on the service rather than the individual property of vehicles. Planning a total number of electric vehicles able to assure long term sustainability will be also highly relevant.

Urban Quality of Life in Nasr City: An assessment of the reformation project of the built environment

Large-scale urban renewal initiatives are undertaken by governments in cities under pressure to improve residents' quality of life (QoL) and mitigate economic and environmental issues. In 2019, as a part of the Egypt 2030 vision, the government initiated a road network reformation project to solve mobility issues in the districts linking the east and west of Cairo, including Nasr City District. To investigate if the built environment of Nasr City District still meets residents' satisfaction, this research is being undertaken to examine residents' satisfaction with the reformation project, which had an impact on their QoL.

Identification and Incidence of Spina Bifida during Gestation and its Pregnancy Outcomes

Aim: To identify the incidence of spina bifida during gestation and its pregnancy outcomes. Study design: Cohort study Place and duration of study: Department of Radiology, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30th September 2022 Methodology: One thousand pregnant women who were screened for the identification of spina bifida. Doppler based ultrasonography was performed in each patient. The fetus body was examined during sonography Doppler between 18-24 weeks. The body of the fetus was focused and visualized longitudinally in midsagittal section. Spinal cord was traced from neck to sacral, cervical vertebra and thorax. A tram track appearance was observed. Spinal nerve positioning was also observed. In spina bifida nerve tethering was seen. The primary outcomes in reference to baby weight and maturity were recorded while secondary outcomes of the fetuses in terms of any disability were followed up to 12 months of age. Results: The mean age of the women was 25.6±5.6 years. The incidence of spina bifida was 1.1%. Within the primary outcomes observed birth weight ranged within 3.1-3.5kg. Around 81.81% cases were born full term while 18.18 were premature. On 06 months’ follow-up of the spina bifida cases it was observed that 45.45% of new born suffered from skin problems as sores, calluses or and blisters while 36.36% had hydrocephalus with excessive CSF which needed monitoring. Mobility issue and disability was observed in 27.27% cases. Conclusion: Spina bifida cases are identified successfully within gestational period. Prematurity can be significantly noticed in spina bifida cases. The lumbosacral and lumbar lesions are most common as well as skin conditions and hydrocephalus. Key words: Incidence, Spina bifida, Gestation, Outcome

Quality of life in patients with persistent postural-perceptual dizziness: results from a survey in hispanic patients

Objective: Persistent postural perceptual dizziness (PPPD) is a common long-lasting cause of dizziness and/or vertigo. This condition is usually triggered by central, peripheral, or vascular injuries and may lead to physical disability and altered development of daily activities. Herein, we performed a cross-sectional in three clinical centers in Latin America using the EQ-5D questionnaire to study the quality of life (QoL) of patients diagnosed with PPPD. Method: Cross-sectional study in two centers in Mexico and one center in Colombia. A qualitative and quantitative analysis was performed using GraphPad 9.0 Results: 50 patients diagnosed with PPPD were included. Patients indicated that symptoms worsened while standing up (n=26), when walking (n=35) and during ground transportation. Specific events such as visual movements (n=26), walking (n=31), during home stay (n=16) and stay in open and public places (n=13) are associated with discomfort in patients with PPPD. 50% of patients indicated some problems in mobility, 28% some problems on self-care, 34% some problems while performing usual activities and only 10% moderate pain during the PPPD episodes. At least 50% of patients indicated that they were moderately anxious or depressed. Conclusions: Mobility, anxiety, depression, and social issues were reported in patients with PPPD. Other problems detected in this survey were fear of falling and fear of having an injury. Further multidisciplinary approach must be done for their treatment.

NOMA-Based VLC Systems: A Comprehensive Review.

The enhanced proliferation of connected entities needs a deployment of innovative technologies for the next generation wireless networks. One of the critical concerns, however, is the spectrum scarcity, due to the unprecedented broadcast penetration rate nowadays. Based on this, visible light communication (VLC) has recently emerged as a viable solution to secure high-speed communications. VLC, a high data rate communication technology, has proven its stature as a promising complementary to its radio frequency (RF) counterpart. VLC is a cost-effective, energy-efficient, and secure technology that exploits the current infrastructure, specifically within indoor and underwater environments. Yet, despite their appealing capabilities, VLC systems face several limitations which constraint their potentials such as LED's limited bandwidth, dimming, flickering, line-of-sight (LOS) requirement, impact of harsh weather conditions, noise, interference, shadowing, transceiver alignment, signal decoding complexity, and mobility issue. Consequently, non-orthogonal multiple access (NOMA) has been considered an effective technique to circumvent these shortcomings. The NOMA scheme has emerged as a revolutionary paradigm to address the shortcomings of VLC systems. The potentials of NOMA are to increase the number of users, system's capacity, massive connectivity, and enhance the spectrum and energy efficiency in future communication scenarios. Motivated by this, the presented study offers an overview of NOMA-based VLC systems. This article provides a broad scope of existing research activities of NOMA-based VLC systems. This article aims to provide firsthand knowledge of the prominence of NOMA and VLC and surveys several NOMA-enabled VLC systems. We briefly highlight the potential and capabilities of NOMA-based VLC systems. In addition, we outline the integration of such systems with several emerging technologies such as intelligent reflecting surfaces (IRS), orthogonal frequency division multiplexing (OFDM), multiple-input and multiple-output (MIMO) and unmanned aerial vehicles (UAVs). Furthermore, we focus on NOMA-based hybrid RF/VLC networks and discuss the role of machine learning (ML) tools and physical layer security (PLS) in this domain. In addition, this study also highlights diverse and significant technical hindrances prevailing in NOMA-based VLC systems. We highlight future research directions, along with provided insights that are envisioned to be helpful towards the effective practical deployment of such systems. In a nutshell, this review highlights the existing and ongoing research activities for NOMA-based VLC systems, which will provide sufficient guidelines for research communities working in this domain and it will pave the way for successful deployment of these systems.

Prostate cancer bone metastases biology and clinical management (Review).

Prostate cancer (PCa) is one of the most prominent causes of cancer-related mortality in the male population. A highly impactful prognostic factor for patients diagnosed with PCa is the presence or absence of bone metastases. The formation of secondary tumours at the bone is the most commonly observed site for the establishment of PCa metastases and is associated with reduced survival of patients in addition to a cohort of life-debilitating symptoms, including mobility issues and chronic pain. Despite the prevalence of this disease presentation and the high medical relevance of bone metastases, the mechanisms underlying the formation of metastases to the bone and the understanding of what drives the osteotropism exhibited by prostate tumours remain to be fully elucidated. This lack of in-depth understanding manifests in limited effective treatment options for patients with advanced metastatic PCa and culminates in the low rate of survival observed for this sub-set of patients. The present review aims to summarise the most recent promising advances in the understanding of how and why prostate tumours metastasise to the bone, with the ultimate aim of highlighting novel treatment and prognostic targets, which may provide the opportunity to improve the diagnosis and treatment of patients with PCa with bone metastases.

Telemedicine in Neuromuscular Diseases During Covid-19 Pandemic: ERN-NMD European Survey.

Telemedicine (TM) contributes to bridge the gap between healthcare facilities and patients' homes with neuromuscular disease (NMD) because of mobility issues. However, its deployment is limited due to difficulties evaluating subtle neurological signs such as mild weakness or sensory deficits. The COVID-19 pandemic has disrupted healthcare delivery worldwide, necessitating rapid measures implementation by health care providers (HCPs) to protect patients from acquiring SARS-CoV-2 while maintaining the best care and treatment. Given the challenges faced by remote healthcare assistance of NMD patients, we aim to evaluate the use of TM in NMD during the COVID-19 pandemic. Based on the Model for Assessment-of-Telemedicine-Applications (MAST), we conducted a survey amongst clinicians of the ERN EURO NMD (European-Reference-Network-for-Rare-Neuromuscular-Diseases). Based on 42 responses over 76 expected ones, our results show that the COVID-19 pandemic significantly increased the number of HCPs using TM (from 60% to 100%). The TM types most used during the COVID-19 period are teleconsultation and consultation by phone, particularly in the context of symptoms worsening in NMD patients with COVID-19 infection. Most European HCPs were satisfied when using TM but as a complementary option to physical consultations. Many responses addressed the issue of technical aspects needing improvement, particularly for elderly patients who need caregivers' assistance for accessing the TM platform. TM has been essential during COVID-19, but its use still presents some limitations for NMD patients with cognitive deficits or for first-time diagnosis. Thus, TM should be used as complement to, rather than substitute, for face-to-face consultations.

Impact of Platooning Connected and Automated Heavy Vehicles on Interstate Freeway Work Zone Operations

Work zones pose mobility issues to the traveling public and safety challenges to travelers and road maintenance workers. These safety and mobility issues may be exacerbated by the presence of heavy vehicles. Connected and automated vehicle (CAV) technologies have been identified as a potential solution for these issues. This paper investigates the operational impacts of connected and automated heavy vehicles (CAHV) on freeway work zone operations on interstate highways. A microsimulation model, calibrated to empirical work zone field data, was used to study the operational impacts of CAHV platoons under various work zone and traffic conditions. It was found that, as the CAHV market penetration rate increases, the average work zone delay and queue length decreases. In addition, as the demand and heavy vehicle percentage increases, so do the benefits of using CAHV technology. For example, it was found that, when all heavy vehicles are classified as CAHV, the average flow rate is approximately 67% higher, and the maximum queue size and average delay decrease by approximately 97%. The methodology used in this paper will help transportation agencies as they design work zones to accommodate heavy vehicles equipped with CAV technologies.

Introduction

Introduction Katherine Jellison (bio) As Midwesterners know all too well, Americans who live in other parts of the United States frequently refer to the Midwest as "flyover country." For many travelers, the vast twelve-state region is simply a geographic impediment between themselves and their ultimate destination. An airline passenger suffering through an uncomfortable flight might even curse the Midwest's very existence: "Why does New York have to be so damned far from Denver, anyway?" Before air travel became commonplace, however, Americans both inside and outside the Midwest viewed the region very differently. Far from being a place to fly over, it was a place to come together. Historically, the Midwest was the nation's crossroads, a place where people of diverse backgrounds were on the move and crossing paths. First traveling on the region's waterways and trails and later its railroads and highways, Indigenous fur traders, White farm families, enslaved Blacks and their descendants were among the varied groups who spent time in the Midwest. Even those who merely passed through the region without becoming permanent residents developed a very different perspective from today's air passenger. Their on-the-ground interactions with persons from different locations and cultural backgrounds had an impact on the ways travelers and residents in the Midwest thought about themselves, their communities, and their relationships with the midwestern landscape. As the articles in this special issue of the Middle West Review demonstrate, women were particularly affected by their experiences at the nation's crossroads. Building on important studies that have emerged in the past two decades, the articles in this issue center on the experiences of women of diverse backgrounds as they lived, worked, and traveled in the Midwest. In addition to issues of cultural diversity and geographic mobility, a third [End Page 15] major theme surfaces in these articles: political engagement. The politics of historical memory, women's educational and economic rights, women's citizenship, and racial justice receive significant examination in this issue.1 As Cynthia C. Prescott notes in the issue's opening article, Midwesterners initially failed to commemorate the diversity of their region even as they celebrated its identity as the nation's crossroads. In the late nineteenth century, when Midwesterners began to tell their history in the form of public sculpture, they remembered it almost exclusively as the story of White families crossing the region on their way to the Far West or perhaps settling to farm in the Midwest itself. Sculptures reflected the era's manifest destiny ideology as well as its White gender role prescriptions. Sculptors typically portrayed male figures as active conquerors of the frontier and women as docile helpmates and mothers. Examining sculptural tributes to midwestern history throughout all corners of the region, Prescott records the greater accuracy of commemorative statues in the twenty-first century. In contrast to public artwork of an earlier period, today's monuments are more likely to portray women of color—particularly Native American women—and to represent midwestern women as active participants in the history of their region. Following Prescott's overview of the midwestern landscape and its sculptural representations of women's history, Jenny Barker-Devine takes readers to a particular place and time in midwestern history—Jacksonville, Illinois, in the 1830s and 1840s. Here, middle-class Northeasterners promoted women's education as a means for controlling the chaos of frontier life. Like Prescott, Barker-Devine focuses her essay on the themes of movement and transition. She notes that White women from New England and the Mid-Atlantic initially sought to maintain their Yankee identities and values when they relocated to the former Northwest Territory. Over time, however, their educational mission in the Illinois wilderness caused them to adopt a distinctive new guise. They increasingly defined themselves as midwestern women. In her contribution to the special issue, Debra A. Reid reminds readers that midwestern women's history took place in cities as well as on the region's open prairies and plains and in its small towns. Reid examines the experiences of women who sold food at the central market in nineteenth-century Detroit. With its strategic location on the Detroit River and ready access to...

Partial ceratohyoidectomy as surgical treatment for horses with temporohyoid osteoarthropathy: 10 cases (2010-2021).

To describe outcomes of horses with temporohyoid osteoarthropathy (THO) treated with partial ceratohyoidectomy. 10 client-owned horses. Medical records from 2 institutions were examined for records of horses with THO treated with partial ceratohyoidectomy between 2010 and 2021. History, signalment, clinical signs, diagnostics, medications, and surgery-related details were recorded. Horses with a minimum of 6 months follow-up were recruited for neurologic and imaging examinations in the hospital or field where radiography of the basihyoid-ceratohyoid articulation were performed along with CT, when available. 10 horses with THO were included (9 unilateral; 1 bilateral). Nine planned partial ceratohyoidectomies were performed in 8 horses, whereas 2 horses had preoperatively planned complete ceratohyoidectomies transitioned to partial ceratohyoidectomies during surgery due to intraoperative complications. Postoperative complications occurred mostly in transitioned surgeries (obstructed airway, tongue mobility issues, and incisional hemorrhage), whereas only 1 horse with a planned ceratohyoidectomy had postoperative complication of rhabdomyolysis. All complications resolved before hospital discharge. Neurologic signs improved in all 10 horses, with 2 showing complete resolution. Nine horses were available for radiographic follow-up, 6 of which also had head CT scans. A space between the ceratohyoid and basihyoid bones was measurable on radiography in all 9 horses, and was confirmed on CT. Three horses demonstrated proliferation of either ceratohyoid or basihyoid bones. The 9 horses with unilateral disease returned to previous work, and the horse with bilateral disease was retired. Partial ceratohyoidectomy is a surgical option for treatment of THO that provides similar clinical outcomes to published reports on ceratohyoidectomy.