Sensitive Issues Research Articles

Detecting muscle fatigue among community-dwelling senior adults with shape features of the probability density function of sEMG

BackgroundPhysical exercise is an important method for both the physical and mental health of the senior population. However, excessive exertion can lead to increased risks of falls, severe injuries, and diminished quality of life. Therefore, simple and effective methods for fatigue monitoring during exercise are highly desirable, particularly in community settings. The purpose of this study was to explore the possibility of real-time detection of exercise-induced fatigue using surface Electromyogram (sEMG) features, including the kurtosis and skewness of the Probability Density Function (PDF) in the community settings to solve the issues of low sensitivity and high computational complexity of commonly used sEMG features.MethodssEMG signals from six forearm muscles were recorded during hand grip tasks at 20% maximal voluntary contraction (MVC) task-to-failure contractions from 30 healthy community-dwelling elders at their respective community centers. PDF shape features of the sEMG, namely kurtosis and skewness, were computed from 25 s of non-fatigue stable phase and 25 s of fatigue data for comparison. Statistical tests were conducted to compare and test for the significance of these features. We further proposed a novel fatigue indicator, Temporal-Mean-Kurtosis (TMK) of channel-averaged kurtosis, to detect fatigue with relatively low computational complexity and adequate sensitivity in community settings. ANOVA and post-hoc analyses were performed to examine the performance of TMK.ResultsStatistically significant differences were found between the non-fatigue period and the fatigue period for both kurtosis and skewness, with increasing values when approaching fatigue. TMK was shown to be sensitive in detecting fatigue with respect to time with lower computational complexity than the Sample Entropy.ConclusionThis study investigated PDF shape features of sEMG signals during a handgrip exercise to identify muscle fatigue in older adults in community experiments. Results revealed significant changes in kurtosis upon fatigue, indicating that PDF shape features were suitable convenient detectors of muscle fatigue in community experiments. The proposed indicator, TMK, showed potential sensitivity in tracking muscle fatigue over time in community-based settings with limited computational complexity, highlighting the promise of sEMG’s PDF features in detecting muscle fatigue among the elderly.

Association between human blood metabolome and risk of myocarditis: a mendelian randomization study

Myocarditis is a common disease of the cardiovascular and immune systems, but the relationship between relevant blood metabolites and the risk of myocarditis has not been well-established. To identify potential biometabolic markers associated with myocarditis, we conducted a two-sample Mendelian randomization (MR) study. We performed preliminary MR analysis using the inverse variance weighted (IVW) method, supplemented by MR-Egger, weighted median, and weighted mode methods to adjust for false discovery rate (FDR). Confounders were screened using the GWAS Catalog website. Sensitivity analyses included Cochrane Q-test, Egger regression, Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO), scatterplots, funnel plots, and forest plots. For genetic and directional analysis, we employed co-localization analysis and the Steiger test. MR analysis was performed using the FinnGen database and meta-analysis was performed using the IEU database. MR analysis identified significant correlations for five metabolic biomarkers after FDR correction. These included four known metabolites: kynurenine, 1-stearoyl-GPE (18:0), deoxycarnitine, and 5-acetylamino-6-formylamino-3-methyluracil, as well as one unknown metabolite, X-25,422. Among these, kynurenine (OR = 1.441, 95%CI = 1.089–1.906, p-value = 0.018) and 1-stearoyl-GPE (18:0) (OR = 1.263, 95%CI = 1.029–1.550, p-value = 0.029) were identified as risk factors for myocarditis, while deoxycarnitine (OR = 0.813, 95%CI = 0.676–0.979, p-value = 0.029), 5-acetylamino-6-formylamino-3-methyluracil (OR = 0.864, 95% CI = 0.775–0.962, p-value = 0.018), and X-25,422 (OR = 0.721, 95%CI = 0.587–0.886, p-value = 0.009) were found to be protective factors. No evidence of heterogeneity, horizontal pleiotropy, or sensitivity issues was observed, and no shared genetic factors between exposure and outcome were detected. The causality was in the correct direction. Meta-analysis further confirmed the causal relationship between the five metabolites and myocarditis. This study identifies a causal relationship between five circulating metabolites and myocarditis. Kynurenine, 1-stearoyl-GPE (18:0), deoxycarnitine, X-25,422, and 5-acetylamino-6-formylamino-3-methyluracil may serve as potential drug targets for myocarditis, providing a theoretical basis for the prevention, diagnosis, and treatment of the condition.

Spotting the unthinkable. Tips for detecting incest

Identifying the signs that an infant, child or adolescent is a victim of incest is a complex process. Contradictory psychic mechanisms can interfere with the professional's position: how to think about the unspeakable and the unthinkable in a confused and confusing context? Faced with this sensitive issue, it's important to offer some food for thought on how to tackle it. Children speak to us, with words but above all with their bodies. It's up to us to listen carefully.

Quality of Life among Men and Women Diagnosed with Infertility in Khyber, Pakhtunkhwa

Background: Infertility is a sensitive global issue, characterized by a couple's inability to conceive or maintain a pregnancy. Infertility is classified into two types: primary infertility, where a couple has never achieved pregnancy, and secondary infertility, where a couple cannot conceive or maintain a pregnancy after engaging in unprotected intercourse. Objective: This study aimed to evaluate the quality of life among men and women diagnosed with infertility in Khyber Pakhtunkhwa. Methodology: The study used a cross-sectional design and was conducted in outpatient clinics in Khyber Pakhtunkhwa with a sample of infertile individuals (n=377). Quality of life among infertile couples was assessed using the standardized FERTIQOL instrument, with additional variables relevant to the study context. Results: The results showed that the average quality of life score for infertile couples was 63.84 out of a possible 120. According to the FERTIQOL assessment, the emotional wellbeing score was low at 14.29, and the mind-body score was also poor at 15.49. The relational score, at 18, was considered average, while the social domain score of 16.05 indicated a poor quality of life. The study also examined associations between quality of life and various sociodemographic factors, including age, gender, education, income, and type of infertility. Although most of these variables were not statistically significant, gender and education were found to be significantly associated with quality of life, with p-values of 0.00 and 0.16, respectively. Conclusion: Based on these findings, it can be concluded that infertile couples experience a low quality of life.

To Size Up the Serenissima Sposa: A Full-Length Portrait of Marguerite-Louise of Orléans by Henri and Charles Beaubrun

Summary This article identifies the subject and date of a full-length portrait attributed to Henri and Charles Beaubrun, previously housed at the Uffizi Galleries and currently displayed at the Villa Medicea La Petraia in Castello, near Florence. Iconographical analysis, corroborated by new archival findings, establishes that the sitter is Marguerite-Louise of Orléans, Grand Duchess of Tuscany. The first section situates this painting within the early iconography of the French-born princess, drawing comparisons with an original corpus of painted and engraved likenesses. The second section discusses the significance of this artwork within the negotiations of her marriage with Grand Prince Cosimo de’ Medici between 1658 and 1661. The diplomatic correspondence preserved at the Archivio di Stato in Florence shows that the full-length likeness was commissioned in November 1660 to provide reliable and final evidence of the prospective bride’s size, which had emerged as a sensitive issue during the negotiations. The final section considers the painting’s influence on the later iconography of the Grand Duchess, comparing an extant half-size version at the Uffizi Galleries with a hitherto unpublished copy in a private collection.

Mining PANI/Ti3AlC2/CeO2 ternary composite CO sensor: Material synthesis, gas sensing performance and mechanism research

To address the issue of poor gas sensitivity in existing mining semiconductor CO sensor materials like PANI at room temperature, this study employed an ice-water bath in conjunction with an in-situ polymerization method to incorporate 2D sheet-like Ti3AlC2 and nano-CeO2 materials with oxygen vacancies into PANI. As a result, nanometer-sized PANI/Ti3AlC2/CeO2 ternary composite nanomaterial was synthesized. The morphology, synthesis mechanism, and thermal stability of the ternary composite material were investigated using scanning electron microscopy-energy dispersive analysis (SEM-EDS), transmission electron microscopy analysis (TEM), spectral analysis, and thermogravimetric methods. Furthermore, the CO gas sensing mechanism of the ternary composite material was also examined. The study discovered that the nano-PANI/Ti3AlC2/CeO2 ternary composite nanomaterial, when deposited on the Au interdigital electrode of the IDE substrate, exhibits superior gas transmission of 400 ppm CO compared to gas sensors based on nano-PANI, nano-PANI/Ti3AlC2, and nano-PANI/CeO2. The sensing response was enhanced by 1.75 times, 1.4 times, and 1.2 times, respectively. This improvement in sensing mechanism can be attributed to the pn heterojunction and interfacial interaction forces between the components. Hence, the nano-PANI/Ti3AlC2/CeO2 ternary composite nanomaterial holds potential as a high-performance CO detection sensing material at room temperature. Additionally, it can serve as a theoretical basis for further research on low-power, integrable sensor materials in coal mines.

Peace Brand Activism: Global Brand Responses to the War in Ukraine

Following the outbreak of the war in Ukraine in February 2022, many global brands took a stand on the crisis, which often elicited polarized consumer responses. This study explores this phenomenon—peace brand activism (PBA)—by conducting an inductive analysis of global brands’ responses to the Russia–Ukraine war as disclosed on social media channels across three different platforms: Facebook, Twitter, and Instagram. The analysis highlights the range of PBA tactics that global brands employ, revealing diverse action- and statement-based forms that they can adopt, including instances of pseudo-activism. In addition, this study identifies seven key characteristics of PBA: substantiality, nature, side-taking, location specificity, responsiveness, persistence, and diversity, each manifesting across spectra of differential ends. This work elucidates the evolving role of businesses in promoting peace and offers valuable guidance for managers navigating the complex terrain of PBA, emphasizing the importance of brands being cognizant of the various PBA options and thoroughly weighing the implications of taking a stand on sensitive geopolitical issues. The findings bear important policy implications, suggesting that policy makers must consider PBA's impact on bilateral relations and collaborate with brands to develop informed, strategic PBA initiatives. Finally, the authors outline important avenues for future research.

Nanoplasmonic microarray–based solid-phase amplification for highly sensitive and multiplexed molecular diagnostics: application for detecting SARS-CoV-2

A novel approach is introduced using nanoplasmonic microarray–based solid-phase recombinase polymerase amplification (RPA) that offers high sensitivity and multiplexing capabilities for gene detection. Nanoplasmonic microarrays were developed through one-step immobilization of streptavidin/biotin primers and fine-tuning the amplicon size to achieve high plasmon-enhanced fluorescence (PEF) on the nanoplasmonic substrate, thereby improving sensitivity. The specificity and sensitivity of solid-phase RPA on nanoplasmonic microarrays was evaluated in detecting E, N, and RdRP genes of SARS-CoV-2. High specificity was achieved by minimizing primer-dimer formation and employing a stringent washing process and high sensitivity obtained with a limit of detection of four copies per reaction within 30 min. In clinical testing with nasopharyngeal swab samples (n = 30), the nanoplasmonic microarrays demonstrated a 100% consistency with the PCR results for detecting SARS-CoV-2, including differentiation of Omicron mutations BA.1 and BA.2. This approach overcomes the sensitivity issue of solid-phase amplification, as well as offers rapidity, high multiplexing capabilities, and simplified equipment by using isothermal reaction, making it a valuable tool for on-site molecular diagnostics.Graphical abstract

The Role of Faith in Medical Decision-Making

Abstract Background Ultra-Orthodox Israeli Jews face complex decisions when their doctors’ instructions contradict their rabbis’ advice. This study examines how their belief system affects their trust and decision-making in such situations, using socio-economic club theory and Gilligan’s listening guide. Methods Excerpts from 16 focus groups with 128 ultra-Orthodox Jews were analyzed to understand their perspectives on the relationship between doctors and rabbis. The socio-economic approach of Berman’s club theory was applied to explain their behavior, and Gilligan’s listening guide was used to analyze the focus group results. Results The strict behaviors in the relationships between doctors, rabbis, and patients function as social capital, raising the status of ultra-Orthodox Jews as members of an exclusive club. They balance critical health decisions with the social demand to obey religious leaders. However, listening to different voices (‘I,’ ‘we,’ and ‘they’) provides nuanced insights into their decisions, revealing dynamic changes in the community’s perceptions of the doctor-rabbi relationship and varying perspectives within the heterogeneous ultra-Orthodox community. Conclusions Combining Berman’s theory with Gilligan’s listening guide is an effective method for conducting in-depth qualitative research on sensitive issues with religiously strict groups. Understanding the belief systems underlying healthcare decisions is essential for providing culturally sensitive medical care to religious communities and training medical staff serving these communities. Key messages • Ultra-Orthodox Jews balance complex health decisions with social demands, revealing nuanced perspectives through strict doctor-rabbi relationships. • Combining theories and qualitative methods effectively studies sensitive issues in religious groups, informing culturally sensitive healthcare.

Searching for an Optimal Model for the Renewal of the Constitutional Court to Avoid a Constitutional Crisis: Dream or Reality?*

The failed renewal of the Constitutional Court in Lithuania was not the first in Europe, and will not be the last. The appointment of constitutional judges, usually undertaken with the involvement of the political institutions, became a very sensitive issue closely linked to their independence. After a sequence of unsuccessful attempts to renew the composition of constitutional courts, some states fall into a deep democratic backsliding, while some take the initiative to reform the existing appointment procedure, seeking to prevent the politicisation of constitutional control institutions. A universal and standardised one-size-fits-all model does not exist, as each particular national context must be considered. However, certain lessons are to be learned and certain pitfalls to be avoided. Constitutional courts must correspond to the criteria of the tribunal established by law, as disclosed in international jurisprudence. For this purpose, the proper law is needed. This article analyses the advantages and shortcomings of some elements of the proposed and partly realised Slovak reform on the appointment of constitutional judges that Lithuania and other states could benefit from. This allows for the conclusion that the explicit criterion of professional reputation might prevent arbitrary nominations and ensure that the best judge for the court and the society would be appointed. Contrary to most convictions, a larger majority in the Parliament is not necessary to keep this procedure in line with the principle of the rule of law. The only requirement is that the law must be clear, unambiguous and provide for the steps to be taken if the rotation fails.

Music and the politics of famine: everyday discourses and shame for suffering.

Understanding the politics of famine is crucial to understanding why famines still occur. A key part of this is how famine is remembered, understood, and discussed. This paper focuses on songs popular among communities that have recently experienced deadly famine. Contemporary famines almost always manifest in armed conflict contexts, where there is limited political freedom. Here, songs and music can be an important way to debate sensitive political issues. This paper focuses on the way that songs and music shape 'regimes of truth' around famine, and who is shamed and held accountable for associated suffering. It is based on long-term ethnographic research, the recordings of famine-related songs, and collaborative analysis in Jonglei and Warrap States (South Sudan) in 2021-24. The paper shows how songs can mock soldiers for their seizing of assets during times of hunger and how they can create familial shame for famine suffering, shifting responsibility away from the real causes to family members.

Racial biases in clinical practice and medical education: a scoping review

IntroductionHealth inequalities represent a major challenge in contemporary medicine, with some attributed to racial biases. Recently, in the United States, a call to combat discrimination in the field of health has resonated, particularly in the context of the COVID-19 crisis, in which minorities have been disproportionately affected. These calls echo recommendations from the Institute of Medicine dating back to 2001, urging the fight against inequalities in access to health care. In France, inequalities based on presumed origin persist, yet medical education on these issues is virtually nonexistent.Materials and MethodsWe conducted a scoping review literature review in accordance with the JBI recommendations for scoping review writing and applied the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist to explore existing conceptual and educational data on racial biases in medicine. The inclusion criteria were interventional studies or evaluations of existing educational programs in medical training addressing the fight against racial biases in clinical settings published in French or English between 2003 and 2023. Six databases were systematically consulted.ResultsOut of 748 initial studies, 28 were included in our study. The median number of participants in the studies was low, interventions were diverse, and participants were generally well received, most of whom were self-selected. No study has evaluated the clinical impact of these interventions. The highlighted concepts included levels of racism, cultural competence, cultural humility, and critical race theory.DiscussionThe authors most frequently referred to institutionalized racism, demonstrating the systemic nature of these issues. At an individual level, implicit and unconscious biases were most often emphasized. It appears that the concept of “race” is a sociopolitical construct without supporting biological determinants. Humility is central to this field of study, as it encourages questioning of individual or collective medical practices. In France, the context, including the prohibition of ethnic statistics, may hinder the objectification of discrimination. Immersion and virtual patient scenarios emerged as potential solutions for evaluating the clinical impact of interventions. A more horizontal medical pedagogy seems better suited to teach these sensitive issues.

Highly responsive gas sensors based on grain boundary–rich polycrystalline few-layer MoS2 films for NO2 detection

Abstract This study addresses the issues of insufficient sensitivity and poor reversibility for NO2 detection by successfully fabricating a sensor based on uniform and high-quality few-layer MoS2 polycrystalline material using chemical vapor deposition. This approach aims to improve the response of the sensor by exploiting the abundance of grain boundary (GB) defects in polycrystalline MoS2 membranes. Comprehensive surface morphology analysis of the few-layer MoS2 polycrystalline films was conducted using microscopy, Raman spectroscopy, and X-ray photoelectron spectroscopy to characterize their chemical composition and properties. Subsequently, evaluation of 1–100-ppm NO2 was conducted at room temperature (25°C). The results show excellent performance of the sensor, with a response range of 11–82.24. Notably, under ultraviolet excitation at room temperature, this sensor exhibits a response time of only 41 s to 50 ppm of NO2 with complete recovery and improved sensitivity, maintaining reliable stability over eight weeks. Furthermore, the findings reveal that the sensor demonstrates high selectivity toward NO2 gas with limit of detection and limit of qualification values of 10 and 34 ppb, respectively. Owing to the abundant adsorption sites provided by GB defects in polycrystalline thin films, the response performance of the sensor is effectively enhanced. This study provides valuable insights into the future design and development of high-performance NO2 gas sensors.

The impact of Covid-19 on recovery after sexual violence and abuse: Voices of help-seeking survivors and those individuals working within specialist support services in England

We examined the impact of Covid-19 on service delivery within specialist sexual violence services and the healing journeys of survivors of sexual violence and abuse through the experiences of 22 professionals and 221 service users in England. The pandemic posed challenges across all sectors and economies across the globe, but practices and innovations that emerged at that time could enhance future services and user experiences. Thematic analysis was used to identify key themes within the data. Overall, the negative impacts of Covid-19 outweighed the positive changes: survivors reported increased feelings of depression, anxiety, and worry, exacerbated by isolation and lost connections with friends and family, and access to strategies for managing their mental health. Difficulties/delays in accessing support, service provision, and disruptions to rapport, trust, and safety were widespread in participants’ reports. Conversely, for some, requirements to remain at home provided safety from the world, and space for healing, and even prompted survivors of non-recent abuse to seek help. Remote service delivery was beneficial where clients could be ‘at a distance’ in discussing sensitive issues. Together with insights from professionals about their own isolation, blurred boundaries, and concerns regarding client confidentiality and engagement, this research highlights an agile sector responding to an unprecedented situation. Moving forward, survivors’ preferences for flexible/remote support must be integrated into everyday delivery.

An improved variant of quantitative randomized response techniques using forced responses

The randomized response technique has gained a wide popularity among survey researchers over the past few decades. Randomized response procedure is applicable in a variety of fields including sociology, psychology, business, and education, etc. It is a useful method which helps the researcher in dealing with the high non-response rates in sample surveys on sensitive issues such as monthly income, traffic rules violations, income tax amount, and expenditure on luxury items, etc. We introduce an optimal scrambling technique which uses forced responses. The algebraic properties of the estimator of population mean using the suggested technique have been derived. For the purpose of comparison with existing models, the different measures of model-evaluation have been obtained. Our analysis suggests that the new quantitative technique using forced responses is better than the available scrambling techniques not only in efficiency, but also in the combined metric of model’s efficiency and level of privacy, which make it more useful than the available models for practical problems. Using real-world example, we illustrate its practical implementation to sensitive sample surveys.

NDVI or PPI: A (Quick) Comparison for Vegetation Dynamics Monitoring in Mountainous Area

Cold ecosystems are experiencing a warming rate that is twice as fast as the global average and are particularly vulnerable to the consequences of climate change. In mountain ecosystems, it is particularly important to monitor vegetation to understand ecosystem dynamics, biodiversity conservation, and the resilience of these fragile ecosystems to global change. Hence, we used satellite data acquired by Sentinel-2 to perform a comparative assessment of the Normalized Difference Vegetation Index (NDVI) and the Plant Phenology Index (PPI) in mountainous regions (canton of Valais-Switzerland in the European Alps) for monitoring vegetation dynamics of four types: deciduous trees, coniferous trees, grasslands, and shrublands. Results indicate that the NDVI is particularly noisy in the seasonal cycle at the beginning/end of the snow season and for coniferous trees, which is consistent with its known snow sensitivity issue and difficulties in retrieving signal variation in dense and evergreen vegetation. The PPI seems to deal with these problems but tends to overestimate peak values, which could be attributed to its logarithmic formula and derived high sensitivity to variations in near-infrared (NIR) and red reflectance during the peak growing season. Concerning seasonal parameters retrieval, we find close concordance in the results for the start of season (SOS) and end of season (EOS) between indices, except for coniferous trees. Peak of season (POS) results exhibit important differences between the indices. Our findings suggest that PPI is a robust remote sensed index for vegetation monitoring in seasonal snow-covered and complex mountain environments.

Highly integrated, self-powered and activatable bipedal DNA nanowalker for imaging of base excision repair in living cells

DNA walkers have attracted considerable attention in biosensing and bioimaging. Compared with the conventional single leg-based DNA walker, the bipedal DNA walker has remarkable advantages, with improved sensitivity and fast kinetics, and can work efficiently in a crowded cellular environment. However, most reported bipedal DNA walkers are powered by exogenous supplementation, and elaborate DNA sequence designs, auxiliary additives or extra carriers are often needed. A highly integrated bipedal DNA walker that can address robustness, sensitivity and consistency issues in a single system is highly desirable but remains a great challenge. We herein report a novel bipedal DNA nanowalker system through simple assembly of a DNA substrate, hairpin functionalized-AuNPs (AuNPs-H2), and a blocked Mn2+-dependent DNAzyme hairpin (H1) on degradable MnO2 nanosheets, which holds great potential for living cell operation. Highly integrated features enable the simultaneous delivery of core components of the bipedal DNA walker, including a walking track (AuNPs-H2), a walking strand (H1 cleaved by APE1), and a driving force (Mn2+-dependent DNAzyme cleavage) as a whole, thereby enhancing the control of the spatiotemporal distribution of these components at the intracellular target sites. The redox reaction between the MnO2 nanosheets and GSH inside the cells not only consumed the intracellular GSH to improve the biostability of the walking track but also generated abundant Mn2+ as a cofactor of the DNAzyme. As a proof of concept, the developed nanowalker was demonstrated to work efficiently for monitoring base excision repair (BER)-related human apurinic/apyrimidinic endonuclease 1 (APE1) in living cells, highlighting the great potential of the bipedal DNA nanowalker in biological systems.Graphical abstract

Dynamic analysis and experimental study of direct-acting centrifugal speed limiter

In response to the issues of significant braking error and low sensitivity associated with the ratchet-claw centrifugal speed limiters, this study proposes a direct-acting centrifugal speed limiter (DCSL) characterized by minimal braking error and heightened sensitivity. A triggering model for the DCSL has been established through dynamic analysis and simulated using MATLAB to elucidate the interrelationships between the total mass of the centrifugal blocks, the rigidity of the speed regulating spring (SRS), the pre-compression, and the release rotational speed of the speed limiter. A mathematical model of the speed limiter has been constructed by setting parameters. An experimental platform for speed limiter detection has been established, and MATLAB has been utilized to mathematically model the experimental data to verify the applicability and reliability of the mathematical model. The results indicate that the triggering system of the DCSL meets the characteristic that the greater the stiffness and pre-compression of the SRS and the smaller the total mass of the centrifugal blocks, the higher the release rotational speed of the speed limiter, which aligns with the expected design. The braking rotational speed error between the mathematical model and the experimental data ranges from 0.73% to 1.76%, meeting the requirements of engineering applications. Through multiple linear regression, the speed limitation range and capability of the speed limiter under the premise of achieving design requirements have been investigated. The error between the mathematical model values and the experimental values at different pre-compressions of the SRS is in the range from 0.01% to 2.66%, all within the specified error range. The DCSL boasts a fast start-up speed and a broad speed range, significantly enhancing the safety of elevator operation systems, reducing the risk of accidents, and providing robust assurance for the continuity and stability of elevator operations.

Examining use of telehealth in jails: linking women to community OUD services

BackgroundOpioid use disorder (OUD) remains a significant health care need for women, particularly those involved in the criminal legal system (CLS). There are no studies to date that focus on the utilization of telehealth as a platform for assessment and linkage to medications to treat opioid use disorder (MOUD) at community re-entry for women, despite the fact that women have unique risk factors that may contribute to opioid relapse in the community. The purpose of this mixed-methods study is to provide an overview of the innovative use of telehealth for linking incarcerated women to community MOUD treatment in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN).MethodsThis study incorporates qualitative and quantitative data collection with MOUD providers, recovery staff involved in peer navigation services, and women who are incarcerated to understand perceptions of the use of telehealth prior to jail release as a linkage to community services.ResultsFindings from this study suggest overall support for the use of telehealth between community MOUD treatment providers and women who are incarcerated using videoconferencing technology. On average, there was very little variation in provider favorable feedback related to clinical engagement or in face-to-face comparability, as well as how telehealth allowed the participant to discuss personal and sensitive issues during the clinical assessment.ConclusionsStudy findings suggest benefits associated with the use of telehealth in increasing access to treatment for women with OUD. Jails are critical venues for telehealth interventions because they provide the opportunity to reach women who have been actively using illicit substances, often have advanced-stage substance use disorders which have compromised their health and mental health, and often have not been previously identified as needing treatment.Trial registration: This study was originally registered on 8/23/19, ClinicalTrials.gov, #NCT04069624.

Trends and topics: Characterizing echo chambers’ topological stability and in-group attitudes

Nowadays, online debates focusing on a wide spectrum of topics are often characterized by clashes of polarized communities, each fiercely supporting a specific stance. Such debates are sometimes fueled by the presence of echo chambers, insulated systems whose users’ opinions are exacerbated due to the effect of repetition and by the active exclusion of opposite views. This paper offers a framework to explore how echo chambers evolve through time, considering their users’ interaction patterns and the content/attitude they convey while addressing specific controversial issues. The framework is then tested on three Reddit case studies focused on sociopolitical issues (gun control, American politics, and minority discrimination) during the first two years and a half of Donald Trump’s presidency and on an X/Twitter dataset involving BLM discussion tied to the EURO 2020 football championship. Analytical results unveil that polarized users will likely keep their affiliation to echo chambers in time. Moreover, we observed that the attitudes conveyed by Reddit users who joined risky epistemic enclaves are characterized by a slight inclination toward a more negative or neutral attitude when discussing particularly sensitive issues (e.g., fascism, school shootings, or police violence) while X/Twitter ones often tend to express more positive feelings w.r.t. those involved into less polarized communities.