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Implementing a Chatbot to Promote Hereditary Breast & Ovarian Cancer Genetic Screening in Women\u27s Health: Identifying Barriers and Facilitators to Screening Adoption
No full textBackground
To promote genetic screening among women at risk for hereditary breast and ovarian cancer (HBOC), the American College of Obstetricians and Gynecologists recommends that risk assessment be integrated into practice. Chatbots like the Genetic Information Assistant (Gia®) are increasingly implemented to expand access to hereditary genetic screening. Factors that impact chatbot implementation for HBOC risk screening and women\u27s uptake are not fully realized. To refine implementation strategies prior to full scale implementation, we sought to identify women\u27s perceived facilitators/barriers to adopting Gia screening in a rural population within a large healthcare system in the southern United States.
Methods
We recruited both women who agreed to screen using Gia (and then recommended for genetic testing based on National Comprehensive Cancer Network guidelines) as well as women who opted not to do the screen from three Women\u27s Health clinics (OB/GYN) in a northern rural region of Florida. We conducted in-depth, semi-structured interviews with 17 women (nine adopted the screen, eight did not). We conducted a thematic analysis to identify and further define barriers/facilitators to women\u27s uptake of Gia for HBOC cancer risk screening in obstetrics/gynecology care.
Results
Women identified six factors that inhibited and/or facilitated their willingness to use Gia for screening: 1) cancer risk perception, 2) communication with their clinician, 3) feasibility of screening, 4) fiscal and insurance concerns, 5) technology trust/distrust, and 6) previous genetic testing experience. Findings illustrate how each factor functioned as a facilitator and/or barrier in women\u27s uptake (e.g., technology being trusted for accuracy versus concerns for data privacy and security).
Conclusions
While chatbots can extend women\u27s cancer risk screening access, particularly in rural regions and with college-educated women, systems-level (cost) and individual-level factors (perceived risk, misconceptions about repeating genetic testing) should be addressed to promote adoption. Women\u27s interaction with a clinician may be a key implementation strategy for addressing these factors to personalize the screening opportunity and promote their chatbot screening adoption
Molecular Imprinting and Nanomaterial Synergy for Lactate Detection
No full textMolecularly imprinted polymer (MIP)-based electrochemical sensors have emerged as promising non-enzymatic platforms for the selective and stable detection of clinically and environmentally relevant biomarkers. This review provides a critical, comprehensive analysis of recent advances in MIP-based lactate sensing, with particular emphasis on hybrid systems that integrate conductive nanomaterials including gold and silver nanoparticles, laser-induced graphene, and reduced graphene oxide. These synergistic combinations leverage enhanced surface area, electrical conductivity, and molecular recognition to improve sensor sensitivity, selectivity, and long-term operational stability. Key fabrication strategies, such as electropolymerization, green nanomaterial synthesis, and surface imprinting, are critically examined for their roles in optimizing imprinting sensitivity and electron transfer efficiency. Application areas span real-time lactate monitoring in wearable health devices to environmental surveillance in complex matrices. Despite significant progress, challenges related to reproducibility, template removal efficiency, fouling resistance, and scalable manufacturing persist. The review concludes by outlining future directions, including integration into flexible and paper-based platforms, and the development of smart, implantable systems. With continued innovation, MIP-based lactate sensors are poised to become essential components in next-generation point-of-care diagnostics and environmental monitoring technologies
A Diagnostic Dilemma Due to a Large Chiari Network
No full textINTRODUCTION: Chiari networks are reticulated networks of fibers that result from incomplete reabsorption of the right valve of the sinus venosus. While the true clinical significance of these is currently unknown, there are associations with dysrhythmias, paradoxical emboli, and thrombi formation. Here, we describe a large, incidentally found Chiari network which encompasses most of the right atrium.
CASE: A 42-year-old female with a past medical history of obesity (BMI 58) and well-controlled asthma presented to the emergency department in respiratory distress with hypercapnia and hypoxemia. Computed tomography (CT) with angiography of the chest was performed and did not show a pulmonary embolism, but an abnormal filling defect was seen in the right atrium. She was intubated due to worsening respiratory failure and admitted to the intensive care unit. While undergoing empiric treatment for asthma exacerbation, a transthoracic echocardiogram was performed and demonstrated an enlarged right atrium with a mobile structure that was absent on previous echocardiograms. The patient was liberated from the ventilator and transferred out of the intensive care unit. A cardiac magnetic resonance imaging (cMRI) scan was done and showed evidence of a dense filamentous mass in the right atrium consistent with a Chiari network. Unfortunately, she was not able to tolerate the contrast portion of the cMRI to better visualize the findings. She was discharged from the hospital with plans for routine follow up.
DISCUSSION: The Chiari Network, first described by Austrian pathologist Hans Chiari in 1897, is a mesh of thread-like strands which results from the failure of reabsorption of the sinus venosus. Developmentally, the right valve of the sinus venosus evolves into the Eustachian valve (valve of the inferior vena cava) and Thebesian valve (valve of the coronary sinus) and as these valves involute, the tissue undergoes fenestration which can leave a network of the remnants. Usually, they are first diagnosed by echocardiography, where the network presents as a mobile, highly reflective echotexture within the right atrium. On CT, Chiari networks may be visualized as a lace-like filling defect in the right atrium, however there is often diagnostic uncertainty due to heterogeneity of contrast enhancement in the right atrium as seen in our case. This is likely due to the atypical size and density of our patient’s Chiari network compared to the more usual, lace-like appearance. MRI is quickly becoming a complimentary method of differentiating types of right atrial pathologies. Typically, the Chiari network is discovered incidentally and itself does not pose major clinical significance aside from diagnostic challenges on imaging studies where misdiagnosis as thrombus, tumor, or vegetation can occur. The Chiari network has small associations with patent foramen ovales, thromboembolism formation, infective endocarditis, and supraventricular tachycardia. Rarely, the Chiari network can protrude into the right ventricle and cause clinically significant tricuspid regurgitation.
CONCLUSION: The Chiari network is an uncommon anatomical variant which should be recognized appropriately to prevent misdiagnosis. Diagnosis is most often made by echocardiography; however cardiac MRI can also be useful if there is uncertainty. While the Chiari network has no inherent clinical significance, clinicians must be aware of the associations with thromboembolism, infective endocarditis, and tachydysrhythmias
Challenges of the Opposition in Cameroon Multipartism
No full textThe main goal of this study was to explore the challenges faced by Cameroon opposition political parties and how these challenges affect presidential electoral outcomes since 1990. We employed both qualitative and quantitative methods to collect data for the study. The research design was the case study design, and the sampling technique was nonprobability sampling (precisely purposeful sampling). We employed the constructivist research philosophy to show that reality resides in the different views of people. Consequently, it finds out that the opposition in Cameroon lacks credibility and vision to achieve victory in presidential elections. They also face challenges of suppression, poor electoral conditions, lack of finances and the multiplicity of opposition parties, lack of internal democracy, and opposition consensus, broken alliance, inconsistency and lack of links with civil societies, funders and minorities like women, students. Finally, the study recommends first that electoral conditions be updated to ensure equality among parties while in the main time, opposition political parties in Cameroon be more democratic internally, create links with NGOs, civil societies and that the opposition in Cameroon should unite and fight for power alternation for the sake of the country and not to share the spoils
Inclusive Studies of Two- and Three- Nucleon Short-Range Correlations in ³H and ³He
No full textInclusive electron scattering at carefully chosen kinematics can isolate scattering from the high-momentum nucleons in short-range correlations (SRCs). SRCs are produced by the hard, short-distance interactions of nucleons in the nucleus, and because the two-nucleon (2N) SRCs arise from the same N-N interaction in all nuclei, the cross section in the SRC-dominated regime is identical up to an overall scaling factor. This scaling behavior has been used to identify SRC dominance and to measure the contribution of SRCs in a wide range of nuclei. We examine this scaling behavior over a range of momentum transfers using new data on ²H, ³H, and ³He, and find an expanded scaling region compared to heavy nuclei. Motivated by this improved scaling, we examine the ³H and ³He data in kinematics where three-nucleon SRCs may play an important role. The data for the largest struck nucleon momenta are consistent with isolation of scattering from three-nucleon SRCs, and suggest that the very highest momentum nucleons in ³He have a nearly isospin-independent momentum configuration
Developing Employability Skills: A Case Study of Synchronous and Asynchronous Modalities
No full textIn today\u27s workforce, soft skills such as communication and adaptability are increasingly critical for career success, yet many graduates lack these competencies. As online learning continues to expand, questions arise about its effectiveness in cultivating essential workplace skills. This mixed-methods case study examines how synchronous and asynchronous distance learning modalities support the development of soft skills, focusing on communication and adaptability. Drawing on data from two online courses, an asynchronous professional development course (n = 24 pre, n = 19 post) and a synchronous construction leadership course (n = 2), the study utilizes surveys, reflections, and assignments to assess student growth. Quantitative data analysis reveals moderate initial confidence in soft skills, with room for growth, particularly in self-reflection and time management. Thematic analysis of qualitative data highlights the importance of structured reflection, real-world application, and feedback. Findings underscore the need for intentional instructional strategies, including guided self-assessment and practical communication activities, to bridge the gap between virtual learning and workforce readiness. Implications for faculty, instructional designers, and institutions are discussed, along with recommendations for future research
Chesapeake Bay Water Clarity: Challenges and Successes
No full textThe Chesapeake Bay is a large estuarine system spanning multiple jurisdictions and serves as a model for estuarine health worldwide. Historically, nutrient loading degraded water quality, prompting the need for regulation. Water clarity, one component of water quality, is vital for benthic communities and serves as a key indicator of overall ecosystem health. Here, physical resuspension and salinity gradients, nutrient and sediment inputs, production of organic detritus by phytoplankton, and benthic communities all interact to drive clarity patterns, with high spatial variability. Trends over the last 50 years show improvement, though with a temporary increase in organic detritus in response to reduced sediment inputs and algal release from light limitation. Continued reductions in nutrient and sediment inputs have led to improved clarity across all metrics and a re-expansion of submerged aquatic vegetation. Future management should continue reductions in nutrient and sediment inputs while addressing climate-related shifts in estuarine dynamics
Successfully Navigating the Disruption AI will Bring to Survey Research
No full textSurveys are a core methodological tool in government, industry, and academia, providing essential data for theory development and evidence-based decision-making. As artificial intelligence continues its rapid advancement, it stands to fundamentally transform the entire survey lifecycle - from design and administration to analytics and reporting. Previous transitions to new technologies, such as telephone, internet, and non-probability surveys, led to divisions within the survey research community with real consequences for both the trajectory of research and trust in the industry. We believe the survey community should take proactive steps now to avoid similar challenges with AI integration. Specifically, our paper examines the potential benefits and risks AI introduces to survey methodology. We first identify promising research opportunities and innovations that merit further exploration. We then outline strategic recommendations for the survey research community to navigate this transition effectively, including guidelines for publication standards and research prioritization. Finally, we propose collaborative initiatives between AI specialists and survey researchers that could yield mutual advantages. This paper aims to influence the trajectory of research and implementation during this critical early phase. By addressing these considerations now, we hope to facilitate a more efficient and constructive integration of AI into survey research practices
\u27Managed Hearts’ in Helper-Education: Gender Non-Binary Helper-Educators’ Experiences of Emotional Labor
No full textThe unique experiences of people who identify with a gender beyond the binary paradigm dominant in the Global West are not well understood. The literature provides little insight into the experiences and perspectives of these individuals in a variety of contexts, including in their workplaces. As various social movements collide, they bring amplified attention to the mental health of marginalized communities and to workers, as well as the dynamics of modern work environments, and the specific needs of certain individuals doing certain types of work. The current study explored the experiences of gender non-binary individuals (GNI) working as helper-educators engaged in the training of helping professionals within higher education employment settings. A phenomenological approach utilizing Moustakas’s Modified Stevick-Colaizzi-Keen Method of Qualitative Data Analysis (1994) was used to examine the experiences of respondents using the lens of Emotional Labor Theory, a sociological framework that attempts to understand the experience and impact of emotional regulation and performance as a requirement of one’s employment (2012). This inquiry revealed a community of scholars for whom authenticity is a core value, who perform significant amounts of emotional labor in their work settings, much of it invisible, and who engage with the hegemony of higher education at the intersection of personal identities that are not well understood. These disclosures led not only to a deepened understanding of these experiences but yielded suggested actions higher education settings can take to address these conditions
Governing Innovation: Antecedents, Composition, and Impact of Board Technology Committees
No full textThe Board of Directors (BOD) is at the apex of making strategic decisions, setting long-term objectives, and advising and monitoring management. However, scholars have begun to question the board’s ability to fulfill its roles and responsibilities effectively. Board members might lack the necessary expertise, making it challenging for them to navigate the complex and dynamic landscape in which the firm operates. This issue is particularly evident in the context of overseeing and steering the firm’s R&D and innovation strategies, a function that is inherently complex and difficult to comprehend. In response, there have been calls for boards to evolve and adapt their structure to provide more effective guidance to management regarding technology- and innovation-related initiatives.
One emerging approach that boards are using to address these concerns is the establishment of board-level technology committees. This dissertation aims to explore the role of these technology committees within the BODs of corporations. I am especially interested in understanding why BODs create these committees, how they choose which board members will serve on them, and the strategic implications of such committees. The research is timely, given the heightened importance of technology and innovation in firm strategies.
Paper I examines the antecedents of technology committee formation. I argue that the establishment of voluntary board committees results from a tradeoff. By institutionalizing specialized committees of experts with relevant experience focused on a narrow aspect of organizational strategy and operations, BODs can carry out their oversight and advisory responsibilities more effectively. However, these committees also introduce an additional layer of bureaucracy, which heightens communication and coordination challenges, as well as costs. I find that corporations are more likely to establish a board technology committee when their innovation strategies become more complex, specifically when they involve a greater diversity of technologies and products and are organized in less transparent ways.
Paper II examines the appointment of board directors to the technology committee at its inception. I utilize the conceptual quad model to explore whether directors who have the qualities considered necessary for effective board monitoring—independence, expertise, bandwidth, and motivation—are more likely to be assigned to the technology committee. I find strong evidence that directors with relevant, domain-specific expertise are more likely to be appointed. However, there is mixed or no support for the other elements of the quad model.
Paper III examines the strategic impact of adopting a technology committee within the board. Board committees can enhance efficiency through task division, promote specialization in knowledge, increase director accountability, and help alleviate the cognitive demands on individual directors. However, to what extent does this affect strategic decision-making? Using a two-stage Difference-in-Differences (DID) approach, I investigate whether and how the establishment of a board technology committee influences firms’ intellectual property (IP) strategy. The analysis reveals limited evidence that technology committees significantly shape IP creation, protection, and commercialization outcomes