Potential Access Research Articles

Ensuring Access to Opioid Treatment Program Services Among Delawareans Vulnerable to Flooding.

To quantify potential flood-related access disruptions to medication-assisted treatment for opioid use disorder (OUD) among Delawareans. Spatial flood risk maps and infrastructure, services, and hazard risk, transportation networks, opioid treatment programs (OTPs) for the State of Delaware were integrated to visually display the relationship between these layers. A complex network theory-based simulation model was used to assess both direct (e.g., inundation with flood water) and indirect (e.g., isolation) impacts of floods. Delaware is at increasing risk from flooding associated with storms and sea-level rise, which can lead to sunny day flooding during high tides. Of the 18 OTPs in Delaware, 4 are expected to be flooded in a 100-year flood and 7 are expected to be severely disrupted, increasing to 9 by 2035 and to 10 by 2050, with service reachability less than 15 square miles due to flood-induced isolation. Individuals utilizing OTPs for OUDs must be able to access treatment programs regardless of external disruptors like floods. Because these programs require consistent treatment adherence and in-person oversight by clinicians, timely restoration of services and continuity of operations for treatment facilities in post-disaster settings is critical for treatment compliance. The State of Delaware has the third highest rate of drug overdose mortality in the U.S., with three-quarters of all drug-related deaths involving opioids. Impeded access to opioid treatment during a flood disaster can lead to relapse, overdose, and death. Hazard planning must develop policies and practices to address these risks.

Neuroprotective Potential and Underlying Pharmacological Mechanism of Carvacrol for Alzheimer's and Parkinson's Diseases.

The phytochemicals have antioxidant properties to counter the deleterious effects of oxidative stress in the central nervous system and can be a promising drug candidate for neurodegenerative diseases. Among various phytochemicals, constituents of spice origin have recently received special attention for neurodegenerative diseases owing to their health benefits, therapeutic potential, edible nature, and dietary accessibility and availability. Carvacrol, a phenolic monoterpenoid, has garnered attention in treating and managing various human diseases. It possesses diverse pharmacological effects, including antioxidant, anti-inflammatory, antimicrobial and anticancer. Alzheimer's disease (AD) and Parkinson's disease (PD) are major public health concerns that place a significant financial burden on healthcare systems worldwide. The global burden of these diseases is expected to increase in the next few decades owing to increasing life expectancies. Currently, there is no cure for neurodegenerative diseases, such as AD and PD, and the available drugs only give symptomatic relief. For a long time, oxidative stress has been recognized as a primary contributor to neurodegeneration. Carvacrol enhances memory and cognition by modulating the effects of oxidative stress, inflammation, and Aβ25-35- induced neurotoxicity in AD. Moreover, it also reduces the production of reactive oxygen species and proinflammatory cytokine levels in PD, which further prevents the loss of dopaminergic neurons in the substantia nigra and improves motor functions. This review highlights carvacrol's potential antioxidant and anti-inflammatory properties in managing and treating AD and PD.

A fitting program for structural determination of molecular clusters from rotational spectroscopy

The characterization of the structures of molecular clusters, which serve as building blocks for bulk substances, provides crucial insight into the interactions between constituent units. Chirped-pulse Fourier transform microwave (CP-FTMW) spectroscopy, combined with state-of-the-art quantum chemical calculations, is a powerful tool for characterizing the structures of molecular clusters, as the rotational spectra are directly related to the mass distribution of a molecule or cluster. However, determining the structures of large or complex clusters from experimental rotational spectra remains challenging due to their structural flexibility. Ab initio and density functional theory calculations for searching their stable structures could be significantly time-consuming and method-dependent. To address these challenges, we have developed an approach that relies on the experimental rotational constants to search for potential molecular structures without quantum chemical optimization. Our approach involves creating an initial set of conformers through either a semi-empirical sampling program or the quasi-Monte Carlo method. After-ward, the trust region reflective algorithm is utilized for structure fitting. This procedure enables us to quickly generate potential conformers and gain access to precise structural information. We apply our fitting program to water hexamer and benzaldehyde-water clusters, and the resulting topological structures align extremely well with the experimental results.

NEW GUIDELINES FOR THE APPLICATION OF INTERNATIONAL ACCOUNTING AND REPORTING STANDARDS AFTER BREXIT

The UK’s exit from the EU is currently being studied not only as a major change in geopolitics, but also as a precursor to economic factors that create many accounting and taxation issues between Dublin, London and Brussels. The paper aims to review, identify and predict new guidelines for the application of International Financial Reporting Standards (IFRS) after the UK’s exit from the EU. Three possible benchmarks for the development of British accounting and auditing system after Brexit are identified. The article makes a significant contribution to the research by analytically assessing the UK’s accounting regulations after its exit from the EU, and comparing the functions of the new financial accounting board in London with those of the previous board. The study helps to define the guidelines for the further application of accounting standards in the UK and to highlight the prospects for the development and application of IFRS, both in the short and long term. For Ukraine, at a time of potential accession to the EU in 2024-2025, these issues are also relevant, as the UK, in addition to the EU, has become a significant economic partner for Ukraine during the war.

The impact of supply chain drivers on the performance of Ministry of Health pharmacies in Jordan

For most companies, supply chains have become the most crucial factor in their competition rather than individual competition, enabling any company to gain a competitive advantage against another organization through efficient and effective supply chain management. Supply chain drivers have become one of the most critical potential valuable access to a competitive advantage by enhancing and improving organizational performance. This study aims to explore the impact of the drivers of the supply chain on the performance of pharmacies of the Ministry of Health in Jordan. The study used the descriptive analytical approach and simple random sampling. 300 electronic questionnaires were designed via Google Sheets and sent via email and social media to employees in the Jordanian Ministry of Health pharmacies. The study retrieved 252 questionnaires valid for analysis. SPSS was employed to analyze the data and test the hypotheses. The results showed that the Beta-value is 0.849, T-value is 25.370, at a significance value of 0.000, which means that supply chain drivers affected the Ministry of Health pharmacy’s performance. The estimated regression equation means that any one-unit increase in the level of supply chain drivers will lead to an increase in Ministry of Health pharmacies’ performance by 0.789. Furthermore, the performance of the supply chain drivers was moderate, and the general performance was high. The study recommended that pharmacies focus on employing software and modern technology in inventory control.

Patient-centered outcomes of telehealth for the care of rural-residing patients with urologic cancer.

Patients residing in rural areas with urologic cancers confront significant obstacles in obtaining oncologic care. In the Pacific Northwest, a sizeable portion of the population lives in a rural county. Telehealth offers a potential access solution. Patients receiving urologic care through telehealth or an in-person appointment at the Fred Hutchinson Cancer Center in Seattle, Washington, were surveyed to assess appointment-related satisfaction and travel costs. Patients' residences were classified as rural or urban based on their self-reported ZIP code. Median patient satisfaction scores and appointment-related travel costs were compared by rural versus urban residence within telehealth and in-person appointment groups using Wilcoxon signed-rank or χ2 testing. A total of 1091 patients seen for urologic cancer care between June 2019 and April 2022 were included, 28.7% of which resided in a rural county. Patients were mostly non-Hispanic White (75%) and covered by Medicare (58%). Among rural-residing patients, telehealth and in-person appointment groups had the same median satisfaction score (61; interquartile ratio, 58, 63). More rural-residing than urban-residing patients in the telehealth appointment groups strongly agreed that "Considering the cost and time commitment of my appointment, I would choose to meet with my provider in this setting in the future" (67% vs. 58%, p=.03). Rural-residing patients with in-person appointments carried a higher financial burden than those with telehealth appointments (medians, $80 vs. $0; p <.001). Appointment-related costs are high among rural-residing patients traveling for urologic oncologic care. Telehealth provides an affordable solution that does not compromise patient satisfaction.

Opening of Lymphatic Outflow after Traumatic Cyclodialysis

After blunt trauma, a 24-year-old man presented with an inferior cyclodialysis cleft (A) and hypotony. Indocyanine green angiography (PMID: 28461013) on FLEX Spectralis revealed dilated, irregular, blind-tipped channels with variegated contrast (B, arrow), akin to lymphatics reported on angiographic imaging after trabeculectomy (PMID: 35005679). This was contrary to the traditional aqueous (PMIDs: 28461013, 35005679) outflow channels that are seen as acutely branching, more uniform, and narrower in width (C, arrow). As a result, after cyclodialysis, tracer imaging in this patient shows potential access to ocular lymphatics, most likely through the uveo-lymphatic pathway (PMID: 19729007), which could contribute to hypotony. Subconjunctival lymphatic trypan blue-assisted staining in the cleft region has previously shown lymphatic over-drain after cyclodialysis (PMID: 31090997) (Magnified version of Figure A-C is available online at www.aaojournal.org).

Sharing the Sidewalk: Observing Delivery Robot Interactions with Pedestrians during a Pilot in Pittsburgh, PA

Sidewalk delivery robots are being deployed as a form of last-mile delivery. While many such robots have been deployed on college campuses, fewer have been piloted on public sidewalks. Furthermore, there have been few observational studies of robots and their interactions with pedestrians. To better understand how sidewalk robots might integrate into public spaces, the City of Pittsburgh, Pennsylvania conducted a pilot of sidewalk delivery robots to understand possible uses and the challenges that could arise in interacting with people in the city. Our team conducted ethnographic observations and intercept interviews to understand how residents perceived of and interacted with sidewalk delivery robots over the course of the public pilot. We found that people with limited knowledge about the robots crafted stories about their purpose and function. We observed the robots causing distractions and obstructions with different sidewalk users (including children and dogs), witnessed people helping immobilized robots, and learned about potential accessibility issues that the robots may pose. Based on our findings, we contribute a set of recommendations for future pilots, as well as questions to guide future design for robots in public spaces.

Enhanced Diffusion and Confusion Based Encryption Algorithm Using Differential Evolution and Chaotic Mapping

Encryption is critical to protecting sensitive data, especially images, against potential illegal access and breaches. The use of chaotic maps for image encryption is widespread among researchers. However, it is necessary to set up initial parameters for chaotic maps to generate random sequences. These parameters need to be selected with care. To determine the optimal initial parameters for image encryption, evolutionary optimization techniques have been used. In this paper, we propose a secure image-based communication system based on an optimized image encryption algorithm. This approach uses differential evolution optimization, which is an ideal solution for reducing convergence time when optimizing chaotic map parameters. Furthermore, the security parameters of these techniques are evaluated, including entropy, Number of Pixel Change Rate (NPCR), Unified Average Changed Intensity (UACI), and correlation coefficients. The simulation results of the proposed encryption approach by combining Arnold’s cat map, chaotic logistic map and optimization method show that the encrypted image is safe against attacks.

Trends and Characteristics of Blood Pressure Prescription Fills Before and During the COVID-19 Pandemic in the United States.

The COVID-19 pandemic disrupted healthcare in the United States and raised concerns about certain antihypertensives, and may have impacted both prescribing practices and access to blood pressure (BP) medications. We assessed trends in BP prescription fills before and during the first year of the COVID-19 pandemic, using cross-sectional data for BP fills and tablets in the IQVIA (IMS Health) National Prescription Audit® database. Drugs filled via retail (92% coverage), mail-order (78% coverage), and long-term care (72% coverage) channels from January 2018 through December 2020 were included. Data were projected nationally and by state. Between 2.9 and 3.4 billion BP tablets were dispensed monthly until February 2020, increasing sharply to 3.8 billion in March 2020 and declining to 3.5 billion in April, then increasing at 3-month intervals until December 2020. The number of tablets per fill increased slightly over time, with the largest increase (from 66.7 to 68.6) during February-March, 2020. Tablets were dispensed through retail channels (99.7 billion), mail-order (14.7 billion), and long-term care (5.3 billion). Rates of patients initiating new medications decreased during 2020 compared to prior years. Fills did not vary significantly by drug class. A sharp increase in BP fills occurred with COVID-19 emergence, suggesting patients may have secured medications in preparation for potential access limitations. A decrease in new fills, indicating decreased initiation and/or modification of treatment regimens, suggests need for efforts to re-engage patients in the healthcare system and provide alternative ways to obtain medication refills and adjustments.

Online peer support: views and experiences of people with young onset dementia (YOD)

Objectives This study explores (1) which platforms people with YOD use for online peer support, (2) reasons for using or not using online peer support, and (3) how to optimise potential benefits and accessibility. Methods A mixed-methods online survey was conducted including fixed-choice and open questions. Participants were people with YOD recruited through dementia organisations, Join Dementia Research and the NHS using convenience sampling. Fixed-choice questions were analysed with Chi-square test of significance and free-text responses with thematic analysis. Results A total of 69 completed surveys were analysed. Zoom was most popular for online peer support, followed by Facebook and Twitter. Positives included sharing social support, joining from home, and the option to choose a preferred platform. However, it can be difficult to follow the conversation or understand others. Many were unaware about online peer support and some felt uncomfortable talking to strangers online. To improve access and benefits of online peer support organisations and healthcare professionals should advertise and signpost more and groups should have a clear description. Conclusion Online platforms facilitate social support and make peer support accessible to those who do not have access to in-person options. Future research and practice should focus on raising awareness about online peer support.

A random access channel resources allocation approach to control machine‐to‐machine communication congestion over LTE‐advanced networks

SummaryThe Internet of Things (IoT) is becoming a reality, and one of the core elements to make this reality come true is machine‐to‐machine (M2M) communication. With the fast‐growing rate in which devices are being deployed, communication among them has become crucial to support the development of IoT applications. The Long‐Term Evolution‐Advanced (LTE‐A) is a potential access network for these M2M devices. However, the LTE‐A inherited characteristics from older cellular network standards, which were designed for human‐to‐human (H2H) and human‐to‐machine (H2M) communication. Accordingly, supporting M2M communication poses some challenges to LTE‐A, with a highlight of the congestion and overload problems in the radio access network (RAN) during the random access channel (RACH) procedure. Such a problem arises due to the large number of devices sending access‐request messages to the network and the limited number of resources to satisfy this new demand. In this paper, we introduce a solution to mitigate the impact of M2M communication in the LTE‐A network. Precisely, we model how to divide the random access resources into different types of devices as a bankruptcy problem. Then, we propose two solutions: (i) A game theory approach to formulate the bankruptcy problem as a transferable utility game, and (ii) an axiomatic method where some elements are considered for judging the amount of resources each class should receive. The simulation results show that our approaches present improvements in terms of energy efficiency, impact control of M2M over H2H accesses, and priority respect among the different classes of devices.

Application of Ecotourism Principles in The Development of Marine Tourism in Sanur

The natural potential, strategic location and easy accessibility have made Sanur one of the most visited marine tourism areas. However, the development of marine tourism, in spite of having a positive impact, it also has negative ones, as it apparently harms the environment. This study aims to identify the extent to which ecotourism principles are applied in marine tourism product development efforts and programs in Sanur. This research is a descriptive qualitative research with the determination of informants through purposive sampling and snowball sampling techniques. Triangulation was also carried out as a test of data validity in this study.&#x0D; The results showed that overall the business and product development program of marine tourism in Sanur have implemented 5 principles of ecotourism according to Dowling. 3 principles that have been implemented well are Utilizing natural resources, Providing benefits to the community and Visitor satisfaction. However, the other 2 principles of ecotourism, namely nature-based and environmental education, still need to be improved in their application, in order to preserve nature which will ultimately establish sustainable tourism.

A cadaveric study of arteriovenous trigone of heart: the triangle of Brocq and Mouchet.

Left coronary artery divides into anterior interventricular branch and circumflex branch. As both the arteries run in their corresponding grooves, an arteriovenous trigone is formed between conus arteriosus and left auricle called triangle of Brocq and Mouchet. The triangle base is formed by great cardiac vein. This study aims to describe the frequency of triangle and its type and relationship between various boundaries and content of triangle and to supplement the existing knowledge of clinicians. This observational and descriptive study was conducted on 40 formalin fixed cadaveric hearts in department of anatomy, Kalpana chawla government medical college. The triangle was found in 92.5% of specimen with most common type being closed (51.3%) which is followed by inferiorly open in 35.1%, superiorly open in 8.1% and completely open in 5.4% hearts. Most frequent content of triangle was median artery followed by diagonal branches of anterior interventricular and circumflex branches. The mean area of the triangle was 246.3 mm2. Relationship of vein with two arterial branches was either superficial or deep. The knowledge of different patterns of existence will be required for angiographic procedures. Further the triangle is a potential epicardial access route to left fibrous ring. Thus detailed knowledge of variations will help cardiologist to achieve better outcome in interventional procedures with minimal complications.

Assessing the effects of the large‐scale road construction on the ethnic disparities of accessibility in Tibet from 2010 to 2020

AbstractTibet is the main consist of the Tibetan Plateau and also inhabited by minorities in China. How to promote its road accessibility and narrow the gap between different ethnic groups should draw more attention. This study analyzes both territorial accessibility (At) and potential accessibility (Ap) in Tibet from 2010 to 2020, as well as the disparities within and between main ethnic groups, exploring whether ethnic minorities undertook the accessibility disparity or loss. The findings are as follows: (1) At and Ap are characterized by a center‐periphery structure with a remarkably improvement and spatial difference from 2010 to 2020. The disparity between counties tends to widen slightly, whereas the increment of At shows the opposite feature. (2) The Hui and Han ethnic groups enjoy better accessibility than Tibetans, and the other ethnic minorities have insufficient accessibility, though with prominent improvement. The disparity in At within ethnic groups is smaller but tends to widen; by contrast, that of Ap is larger but tends to narrow. The Hui ethnic group enjoys relative equal accessibility, which tends to be more so, while Tibetans face unequal accessibility with no obvious improvement. (3) The proportion of Tibetans is negatively correlated with the improved accessibility, but those of the other ethnic minorities are positively correlated with the increment of At, indicating that the accessibility improvement in Tibet tilts to the ethnic minorities in remote areas. The overall spatial disparities in accessibility in Tibet tend to widen, but this does not totally apply to those between and within ethnic groups. Nonetheless, the construction of transport infrastructure alone may not be able to achieve equality. Above results may provide reference for related research and policy making for remote and minority areas in China and other similar regions.

Intercity accessibility and equity: Empirical study of high speed rail and air travel network in China

With the rapid increase of high speed rail (HSR) network and air travel network in China, the intercity accessibility is reshaped. This study aims to measure the intercity accessibility by considering the two modes. Based on the current networks, timetable and socioeconomic data, this study utilizes connectivity, cumulative opportunity accessibility and potential accessibility to calculate intercity accessibility in the network consisting of 36 major cities in China. Furthermore, the relative and weighted average intercity accessibility of the two modes are obtained to provide a comparison and overall evaluation. The results indicated that the selected indicators are effective to evaluate the accessibility from different perspectives. The intercity accessibility shows different spatial distributions in HSR and air travel. Besides, the air travel network has higher equity than the HSR network in all accessibility measures. Furthermore, it is found that the correlation between the potential accessibility and economic development is stronger than that of others. This study can provide some advices for the further development of the HSR and air travel.

Access Control Design Practice and Solutions in Cloud-Native Architecture: A Systematic Mapping Study.

Protecting the resources of a cloud-native application is essential to meet an organization's security goals. Cloud-native applications manage thousands of user requests, and an organization must employ a proper access control mechanism. However, unfortunately, developers sometimes grumble when designing and enforcing access decisions for a gigantic scalable application. It is sometimes complicated to choose the potential access control model for the system. Cloud-native software architecture has become an integral part of the industry to manage and maintain customer needs. A microservice is a combination of small independent services that might have hundreds of parts, where the developers must protect the individual services. An efficient access control model can defend the respective services and consistency. This study intends to comprehensively analyze the current access control mechanism and techniques utilized in cloud-native architecture. For this, we present a systematic mapping study that extracts current approaches, categorizes access control patterns, and provides developers guidance to meet security principles. In addition, we have gathered 234 essential articles, of which 29 have been chosen as primary studies. Our comprehensive analysis will guide practitioners to identify proper access control mechanisms applicable to ensuring security goals in cloud-native architectures.

Determinants of maize farmers market participation in Southern Ethiopia: Emphasis on demographic, socioeconomic and institutional factors

Maize is the main cereal crop that supports the livelihoods of millions of smallholder farmers in Africa. However, one of the main bottlenecks for maize production is low market penetration. This study examined the factors influencing the likelihood of smallholder farmers taking part in maize trading in southern Ethiopia using cross-sectional data collected from 360 smallholder maize growers. The data were examined with inferential statistics and the Heckman two-stage sample selection econometric model. Household head age and sex, maize price, household size, farm experience, market distance, access to transportation, frequency of extension contact, land size, amount of credit received, market information, and off-farm income were all found to be significant factors that determine maize farmers’ market participation. Investment in road infrastructure in maize production potential areas and access to market information is mainly needed to increase maize trading.

New Transport Infrastructure and Regional Development of Central and Eastern Europe

The discussion about the impact of the construction of new transport infrastructure on economic growth has been going on in scientific journals for decades. The objective of the article is to assess the importance of the development of transport infrastructure for regional development in Central and Eastern European countries (CEEC). The analysis mainly concerns investments made with the support of European Union structural funds. Particular attention was paid to transport relations between the major metropolises. It is assumed that they perform the functions of growth poles and generate the diffusion of development processes also into the peripheral area. In addition, a study of changes in potential accessibility in road transport was carried out. The temporal scope of the study covers a period of 12 years, when the scale of new investment was greatest. The results thus obtained are set against a backdrop of economic development indices (changes in GDP over the period under study). The study confirmed that the impact on economic development mainly takes place at the beginning of the development of the transport infrastructure. On this basis, a dynamic spatial sequence proposal was formulated regarding the dependence between investments in infrastructure and the development of regions and metropolises.

Disparities in access to primary care, a key site for HIV prevention services, among gay and bisexual men in the United States

ABSTRACT U.S. HIV diagnoses disproportionately affect Non-Hispanic Black (NHB) and Hispanic gay and bisexual men. Using data from the National Health Interview Survey (2013-2018), we examined race and ethnicity and primary care access, an HIV prevention resource, among gay and bisexual men. The explanatory variable was NHB, Hispanic or Non-Hispanic White (NHW). Outcomes were primary care-specific usual place of care (potential access) and saw general doctor <12 months (realized access). We used multivariable logistic regression, adjusting for individual sociodemographic characteristics, health status, and care barriers. In sensitivity analysis, we examined general access (any place/doctor) and subgroups (1) NHB (2) has usual place of care. The sample included 1,858 adult, gay and bisexual men (unweighted). Nearly one-third self-identified as NHB or Hispanic. Compared to NHW men, NHB and Hispanic men were younger, with lower household income, and more care barriers (p < 0.05). NHB and Hispanic men had lower realized access (aOR 0.7058, p = 0.030) than NHW men. Potential access was lower for NHB only (versus NHW) and, among those with any usual place of care, NHB and Hispanic men versus NHW men. Lower primary care access for NHB or Hispanic, rather than NHW, gay and bisexual men, may reduce HIV prevention access.