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Interpretation Challenges in Healthcare Settings as Experienced by Refugees and Healthcare Providers in the United States
Get PDFBackground: Language and interpretation barriers are significant challenges for refugees receiving healthcare in the United States. Both providers and refugee patients associate effective communication with a positive healthcare experience. Therefore, it is important to identify themes in interpretation barriers to promote productive communication between providers and refugee patients.
Purpose: To identify themes in literature surrounding interpretation challenges between refugees and healthcare workers in the United States and compare them to lived experience in a clinic in Northwest Arkansas.
Methods: Several databases were searched, including CINAHL, Medline, HealthSource, and Google Scholar, and articles were chosen with the inclusion criteria being research articles with studies related to interpretation challenges in healthcare settings with refugee patients in the United States published in the last seven years. Exclusion criteria included the research setting being in other countries, patient populations that were not refugees, and articles published prior to seven years.
Results: There were several themes identified from the literature, including linguistic barriers, time constraints, competence of interpreter and healthcare worker, and benefits of in-person or remote interpretation.
Conclusion: The themes identified were consistent with personal experience. Implications include advocating for a greater amount of time during appointments, exploring the option of using appropriately trained in-person interpretation, and assisting providers to grow in competence using interpretation services
At-Risk and Online: Parent Perceptions of At-Risk Learner\u27s Supports in a Fully Online School
Get PDFAt-risk students face a variety of challenges that encompass cultural, social and environmental contexts and identities. Full time virtual schools offer help for at-risk students through the provision of a personalized learning option where students can catch up with past work or complete school work in a non-traditional environment. The purpose of this study was to understand parent perceptions of at-risk learner’s affective, behavioral, and cognitive engagement supports in a fully online school. Although research exists on at-risk learners in blended environments, this topic has not yet been fully explored for fully online schools. We need a much fuller understanding of at-risk learners’ supports in online schools. These data are critical for the future success of at-risk students who are increasingly enrolling in full time online schools. Results showed that parents of at-risk students enrolled in a virtual school described affective engagement in terms of relationships, communication with teachers, and communication with students. Interestingly, parents emphasized that the structure of the traditional in-person schooling experience hindered long term relationships. Parents saw behavioral engagement in terms of learning expectations, help with technological issues, and self regulation skills. Parents of at-risk students enrolled in the virtual school also described cognitive engagement opportunities in the areas of teaching and tutoring of academic content, co-learning with students, and collaboration between students. Discussion focused on how virtual schools could embrace innovative staffing models to better support at-risk students who are enrolled in a virtual school as their ‘last resort’
Identifying and Training Deep Learning Neural Networks on Biomedical-Related Datasets
Get PDFThis manuscript describes the development of a resources module that is part of a learning platform named \u27NIGMS Sandbox for Cloud-based Learning\u27 https://github.com/NIGMS/NIGMS-Sandbox. The overall genesis of the Sandbox is described in the editorial NIGMS Sandbox at the beginning of this Supplement. This module delivers learning materials on implementing deep learning algorithms for biomedical image data in an interactive format that uses appropriate cloud resources for data access and analyses. Biomedical-related datasets are widely used in both research and clinical settings, but the ability for professionally trained clinicians and researchers to interpret datasets becomes difficult as the size and breadth of these datasets increases. Artificial intelligence, and specifically deep learning neural networks, have recently become an important tool in novel biomedical research. However, use is limited due to their computational requirements and confusion regarding different neural network architectures. The goal of this learning module is to introduce types of deep learning neural networks and cover practices that are commonly used in biomedical research. This module is subdivided into four submodules that cover classification, augmentation, segmentation and regression. Each complementary submodule was written on the Google Cloud Platform and contains detailed code and explanations, as well as quizzes and challenges to facilitate user training. Overall, the goal of this learning module is to enable users to identify and integrate the correct type of neural network with their data while highlighting the ease-of-use of cloud computing for implementing neural networks.
This manuscript describes the development of a resource module that is part of a learning platform named NIGMS Sandbox for Cloud-based Learning https://github.com/NIGMS/NIGMS-Sandbox. The overall genesis of the Sandbox is described in the editorial NIGMS Sandbox [1] at the beginning of this Supplement. This module delivers learning materials on the analysis of bulk and single-cell ATAC-seq data in an interactive format that uses appropriate cloud resources for data access and analyses
Water Regime and Fertilizer-Phosphorus Source Effects on Greenhouse Gas Emissions from Rice
Get PDFGreenhouse gas (GHG) emissions from rice (Oryza sativa) systems have been correlated to water management practice, but to date, no study has directly evaluated three main GHGs (i.e., methane [CH4], nitrous oxide [N2O], and carbon dioxide [CO2]) under flood- and furrow-irrigated conditions at the same time as affected by various fertilizer-phosphorus (P) sources, in particular the reportedly slow-release struvite-P source. Therefore, the objective of this study was to evaluate the effect of water regime (flooded and furrow-irrigated) and fertilizer-P source (diammonium phosphate, chemically precipitated struvite, electrochemically precipitated struvite [ECST], triple superphosphate, and an unamended control) on GHG emissions and two- and three-gas global warming potentials (GWP* and GWP, respectively) in the greenhouse. Methane emissions were 10 times greater (p \u3c 0.05) under flooded (29.4 kg CH4 ha−1 season−1) than under furrow-irrigated conditions (2.9 kg CH4 ha−1 season−1), and four times lower (p \u3c 0.05) with ECST (3.4 kg CH4 ha−1 season−1) than other fertilizer-P sources, while CO2 emissions were three times greater (p \u3c 0.05) under furrow-irrigated (23,428 kg CO2 ha−1 season−1) than under flooded (8290 kg CO2 ha−1 season−1) conditions. The GWP* under furrow-irrigated conditions was almost 40% lower (p \u3c 0.05) than under flooded conditions. Although N2O emissions were unaffected by fertilizer-P source, the N2O contribution to GWP* was more than 80% under furrow-irrigated conditions. Flood- and furrow-irrigated water regimes require diversified approaches in GHG mitigation, where the best management for ECST needs to be more fully evaluated
Soil Profile Distribution of Nutrients in Contrasting Soils Amended with Struvite and Other Conventional Phosphorus Fertilizers
Get PDFPhosphorus (P) can be recovered from wastewater and used as an alternative fertilizer, namely, struvite [MgNH4PO4·6(H2O)]. However, the soil mobility of wastewater-derived P and other nutrients needs to be evaluated. The objective of this study was to compare the vertical distribution of water-soluble (WS) soil P and other nutrients from a synthetic-wastewater-derived electrochemically precipitated struvite (ECST) to that from a chemically precipitated struvite (CPST), triple superphosphate (TSP), monoammonium phosphate (MAP), and a control in six soils from Arkansas (AR; loam [L] and silt loam [SiL]), Missouri (MO; SiL 1 and SiL 2), and Nebraska (NE; sandy loam [SL] and SiL). A column-leaching experiment was conducted with the six soils and five fertilizer-P treatments. Water-soluble (WS) P from the two struvite materials generally did not differ (p \u3e 0.05) and was similar to that of MAP in the depths of 0–3, 3–6, and 6–10 cm, but was greater than that of TSP in the top 6 cm in four of the six soils. WS P from CPST in the MO-SiL 2 and NE-SL soils (6.6 and 12.7 mg kg−1, respectively) was larger than that from ECST, MAP, and TSP. In the AR-L and MO-SiL 1 soils, TSP was the only fertilizer-P source that had increased WS P concentrations in the top 6 cm relative to the other fertilizer-P sources. Results showed that ECST-derived, WS P had similar soil profile distributions in the top 10 cm, suggesting that ECST will be equally protective of environmental health and leachate quality across multiple soil textures as other common fertilizer-P sources
Oxyfluorfen Use in Combination with Clomazone or Quinclorac
Get PDFOxyfluorfen is a herbicide that inhibits protoporphyrinogen IX oxidase and has shown significant potential in its ability to control barnyardgrass. Oxyfluorfen is categorized as a Group 14 herbicide by the Herbicide Resistance Action Committee (HRAC)/Weed Science Society of America (WSSA). Despite its current lack of labeling for use on rice in the mid-southern United States due to its potential to cause crop injury, the introduction of a trait in rice that confers resistance to oxyfluorfen could provide producers with an effective alternative site of action for weed control. Field experiments were conducted during the 2021 and 2022 growing seasons near Stuttgart, AR, and near Lonoke, AR, to determine the optimum rates of clomazone (280 or 336 g ha−1) and oxyfluorfen (673 or 840 g ha−1) to use in sequential preemergence (PRE) and postemergence (POST) applications on a silt loam soil and to assess the efficacy of oxyfluorfen when combined with clomazone and quinclorac applied PRE, followed by oxyfluorfen applied POST. No differences in barnyardgrass control were observed among treatments 14 d after emergence in 3 site years, as all control was ≥90%. By 35 d after the POST application, barnyardgrass control was ≥94% for all herbicide treatments in all site years. All herbicide treatments resulted in lower barnyardgrass seed production than a nontreated control in 2021. Contrasts revealed that oxyfluorfen applied PRE on a silt loam soil resulted in barnyardgrass control that was similar to that of clomazone or quinclorac applied alone at 14 d after emergence. Although oxyfluorfen combined with clomazone or quinclorac did not increase barnyardgrass control, an additional site of action for control of this weed could help reduce the evolution of resistance. Mixing oxyfluorfen with clomazone in a dry-seeded rice production system in the mid-southern United States would effectively control barnyardgrass and reduce the risk for resistance to both herbicides, further highlighting the potential of oxyfluorfen in rice production
Natural Panola Mountain Ehrlichia Infections in Cattle in a Longitudinal Study of Angus Beef Calves
Get PDFPanola Mountain Ehrlichia (PME) is an emerging zoonotic pathogen, transmitted by Amblyomma americanum ticks in the southeastern United States. It is closely related to Ehrlichia ruminantium, the causative agent of heartwater disease. Heartwater disease is an often-fatal illness of ruminant livestock present in Africa and the Caribbean. The taxonomic relationship between PME and E. ruminantium has raised concerns about the pathogenicity of PME in livestock. To determine whether cattle could be naturally infected with PME in an endemic area, we conducted a one-year longitudinal study of Angus-breed beef calves in Fayetteville, Arkansas. One hundred seventy-seven calves born between September and October 2022 were sampled for blood and ticks in February, May, and September 2023. Blood and ticks from each animal were tested for bacteria in the family, Anaplasmataceae using quantitative and conventional PCR, and positive samples were sequenced for species identification. Panola Mountain Ehrlichia was detected in 2.34 % of male A. americanum collected in February, and 1.27 % of female, 0.95 % of male, and 0.43 % of nymphal A. americanum collected in May. No PME-positive ticks were collected in September. Active PME infections were detected in two calves: one which tested positive in May 2023 and one which tested positive in September 2023. Neither animal exhibited any signs of disease, and the animal PME-positive in May tested negative in September. Cattle are susceptible to PME, but the pathogen does not appear to cause obvious disease. However, all animals in this study were under one year old, and older animals may be more susceptible. Cattle are at risk of tick-borne illness in the winter as well as spring, and off-season acaricide applications may improve disease management
Towards a New Urbanism- Using Artificial Intelligence to Reconcile Modernist Aesthetics with New Urbanist Principles
Get PDFAs urbanization and densification of cities have become undeniable trends of the past few centuries, designers have theorized ways of building the ideal environment for its inhabitants to thrive. These methods include the Garden Cities, Late Modern Housing Estates, and New Urbanism. This study will focus on New Urbanism. Known for its reluctance to embrace new architectural styles and ways of building, incorporating contemporary architectural styles presents a challenge to the future applicability of New Urbanism.
To analyze this issue, this study will leverage the ability of Artificial Intelligence image generation software to evaluate the compatibility of New Urbanism principles with modernist facades through a synthetic image generation process. This simulation will create an opportunity to assess how modernist principles may or may not align with New Urbanist architectural theory, particularly regarding social interaction, pedestrian experience, and neighborhood community building.
This research offers insight into the adaptability of New Urbanism to different architectural preferences while maintaining its comprehensive theory. By scrutinizing the interplay of urban form and façade treatment through AI modeling, this study tests the ability of New Urbanism to maintain its core principles when using contemporary design methods that are atypical in New Urbanist developments.
Using this combination of Modernist facades and New Urbanist setting, this project takes advantage of the opportunity to scrutinize and re-envision the definition of New Urbanist Architecture. This project proposes changes in verbiage that reflect the changing reality of New Urbanist developments that incorporate these contemporary styles and offers ways to update the Congress for New Urbanism’s “building” points
Extraction of Anthocyanins from Purple Sweet Potato Using Supercritical Carbon Dioxide and Conventional Approaches
Get PDFThis research investigates the potential of supercritical carbon dioxide (SC-CO2) technology as a green and sustainable approach to improve anthocyanin extraction from purple sweet potatoes (PSP). The study explored different extraction parameters (i.e., temperatures of 35–55 °C, cosolvent concentrations of 10–30 % (w/w), ethanol ratios of 30–70 % (v/v), pressures of 30–40 MPa, extraction times of 120–180 min, and solvent: sample ratios of 25:1–45:1(v/w)), to optimize the total phenolic content (TPC), anthocyanin content (ANC), and antioxidant activity (AA). Additionally, conventional extraction methods using different solvent (ethanol and methanol) mixtures, solvent: sample ratios (15:1; 45:1; 6:1 (v/w)), temperatures (35–50 °C), and extraction times (50–60 min) were performed for the extraction of phenolic compounds from PSP. The highest TPC (340 mg GAE/g dry PSP), ANC (136 mg C3G/100 g dry PSP), and AA (ABTS (7.3 mg TEV/g dry PSP), DPPH (18.2 mg TEV/g dry PSP), and FRAP (1399 mg GAE/100 g)) were achieved with 30 MPa, 35 °C and 20 % cosolvent concentration operated for 180 min. These findings underscore the use of SC-CO2 extraction to obtain anthocyanin extracts that can potentially be used as a coloring agent in the food industry. The proposed SC-CO2 extraction method provides an eco-friendly alternative to conventional methods for extracting phenolic compounds
Statistical Analysis of Telehealth Use and Pre- and Postpandemic Insurance Coverage in Selected Health Care Specialties in a Large Health Care System in Arkansas: Comparative Cross-Sectional Study
Get PDFBackground:
The COVID-19 pandemic triggered policy changes in 2020 that allowed insurance companies to reimburse telehealth services, leading to increased telehealth use, especially in rural and underserved areas. However, with many emergency rules ending in 2022, patients and health care providers face potential challenges in accessing these services.
Objective:
This study analyzed telehealth use across specialties in Arkansas before and after the pandemic (2017-2022) using data from electronic medical records from the University of Arkansas for Medical Sciences Medical Center. We explored trends in insurance coverage for telehealth visits and developed metrics to compare the performance of telehealth versus in-person visits across various specialties. The results inform insurance coverage decisions for telehealth services.
Methods:
We used pre- and postpandemic data to determine the impacts of the COVID-19 pandemic and changes in reimbursement policies on telehealth visits. We proposed a framework to calculate 3 appointment metrics: indirect waiting time, direct waiting time, and appointment length. Statistical analysis tools were used to compare the performance of telehealth and in-person visits across the following specialties: obstetrics and gynecology, psychiatry, family medicine, gerontology, internal medicine, neurology, and neurosurgery. We used data from approximately 4 million in-person visits and 300,000 telehealth visits collected from 2017 to 2022.
Results:
Our analysis revealed a statistically significant increase in telehealth visits across all specialties (PMedicare, Blue Cross and Blue Shield, commercial and managed care, Medicaid, and Medicare Managed Care. In-person visits covered by Medicare and Medicaid decreased by 15%, from 313,196 in 2019 to 264,696 in 2022. During 2020 to 2022, about 22.84% (33,123/145,001) of total telehealth visits during this period were covered by Medicare and 53.58% (86,317/161,092) were in psychiatry, obstetrics and gynecology, and family medicine. We noticed a statistically significant decrease (Ppsychiatry telehealth visits was almost 50% shorter than that for in-person visits. These findings highlight the potential benefits of telehealth in providing access to health care, particularly for patients needing psychiatric care.
Conclusions:
Reverting to prepandemic regulations could negatively affect Arkansas, where many live in underserved areas. Our analysis shows that telehealth use remained stable beyond 2020, with psychiatry visits continuing to grow. These findings may guide insurance and policy decisions in Arkansas and other regions facing similar access challenges