scHyper: reconstructing cell-cell communication through hypergraph neural networks.

Cell-cell communications is crucial for the regulation of cellular life and the establishment of cellular relationships. Most approaches of inferring intercellular communications from single-cell RNA sequencing (scRNA-seq) data lack a comprehensive global network view of multilayered communications. In this context, we propose scHyper, a new method that can infer intercellular communications from a global network perspective and identify the potential impact of all cells, ligand, and receptor expression on the communication score. scHyper designed a new way to represent tripartite relationships, by extracting a heterogeneous hypergraph that includes the source (ligand expression), the target (receptor expression), and the relevant ligand-receptor (L-R) pairs. scHyper is based on hypergraph representation learning, which measures the degree of match between the intrinsic attributes (static embeddings) of nodes and their observed behaviors (dynamic embeddings) in the context (hyperedges), quantifies the probability of forming hyperedges, and thus reconstructs the cell-cell communication score. Additionally, to effectively mine the key mechanisms of signal transmission, we collect a rich dataset of multisubunit complex L-R pairs and propose a nonparametric test to determine significant intercellular communications. Comparing with other tools indicates that scHyper exhibits superior performance and functionality. Experimental results on the human tumor microenvironment and immune cells demonstrate that scHyper offers reliable and unique capabilities for analyzing intercellular communication networks. Therefore, we introduced an effective strategy that can build high-order interaction patterns, surpassing the limitations of most methods that can only handle low-order interactions, thus more accurately interpreting the complexity of intercellular communications.

A Tunable Diffusion-Consumption Mechanism of Cytokine Propagation Enables Plasticity in Cell-to-Cell Communication in the Immune System.

Immune cells communicate by exchanging cytokines to achieve a context-appropriate response, but the distances over which such communication happens are not known. Here, we used theoretical considerations and experimental models of immune responses in vitro and in vivo to quantify the spatial extent of cytokine communications in dense tissues. We established that competition between cytokine diffusion and consumption generated spatial niches of high cytokine concentrations with sharp boundaries. The size of these self-assembled niches scaled with the density of cytokine-consuming cells, a parameter that gets tuned during immune responses. In vivo, we measured interactions on length scales of 80-120 µm, which resulted in a high degree of cell-to-cell variance in cytokine exposure. Such heterogeneous distributions of cytokines were a source of non-genetic cell-to-cell variability that is often overlooked in single-cell studies. Our findings thus provide a basis for understanding variability in the patterning of immune responses by diffusible factors.

From genetic mosaicism to tumorigenesis through indirect genetic effects.

Genetic mosaicism has long been linked to aging, and several hypotheses have been proposed to explain the potential connections between mosaicism and susceptibility to cancer. It has been proposed that mosaicism may disrupt tissue homeostasis by affecting intercellular communications and releasing microenvironmental constraints within tissues. The underlying mechanisms driving these tissue-level influences remain unidentified, however. Here, we present an evolutionary perspective on the interplay between mosaicism and cancer, suggesting that the tissue-level impacts of genetic mosaicism can be attributed to Indirect Genetic Effects (IGEs). IGEs can increase the level of cellular stochasticity and phenotypic instability among adjacent cells, thereby elevating the risk of cancer development within the tissue. Moreover, as cells experience phenotypic changes in response to challenging microenvironmental conditions, these changes can initiate a cascade of nongenetic alterations, referred to as Indirect non-Genetic Effects (InGEs), which in turn catalyze IGEs among surrounding cells. We argue that incorporating both InGEs and IGEs into our understanding of the process of oncogenic transformation could trigger a major paradigm shift in cancer research with far-reaching implications for practical applications.

Sex pheromone communication in an insect parasitoid, Campoletis chlorideae Uchida.

Sex pheromones are pivotal for insect reproduction. However, the mechanism of sex pheromone communication remains enigmatic in hymenopteran parasitoids. Here we have identified the sex pheromone and elucidated the olfactory basis of sex pheromone communication in Campoletis chlorideae (Ichneumonidae), a solitary larval endoparasitoid of over 30 lepidopteran pests. Using coupled gas chromatography-electroantennogram detection, we identified two female-derived pheromone components, tetradecanal (14:Ald) and 2-heptadecanone (2-Hep) (1:4.6), eliciting strong antennal responses from males but weak responses from females. We observed that males but not females were attracted to both single components and the blend. The hexane-washed female cadavers failed to arouse males, and replenishing 14:Ald and 2-Hep could partially restore the sexual attraction of males. We further expressed six C. chlorideae male-biased odorant receptors in Drosophila T1 neurons and found that CchlOR18 and CchlOR47 were selectively tuned to 14:Ald and 2-Hep, respectively. To verify the biological significance of this data, we knocked down CchlOR18 and CchlOR47 individually or together in vivo and show that the attraction of C. chlorideae to their respective ligands was abolished. Moreover, the parasitoids defective in either of the receptors were less likely to court and copulate. Finally, we show that the sex pheromone and (Z)-jasmone, a potent female attractant, can synergistically affect behaviors of virgin males and virgin females and ultimately increase the parasitic efficiency of C. chlorideae. Our study provides new insights into the molecular mechanism of sex pheromone communication in C. chlorideae that may permit manipulation of parasitoid behavior for pest control.

Overcoming the EQE × Li-Fi Frequency Constraint by Modulating the PbS CQDs Distribution in Perovskite Film.

Advanced photodetectors are crucial for high-fidelity optical communication. However, the tradeoff between high external quantum efficiency (EQE) and high light fidelity (Li-Fi) frequency often limits data transmission accuracy and timeliness. Here, we report a photodetector consisting of lead sulfide (PbS) colloidal quantum dots (CQDs) with near-infrared responsiveness and perovskite frameworks responsible for the charge transport to overcome the EQE × Li-Fi constraint. Optimizing the PbS CQDs distribution and trap depth in the perovskite layer enhances charge injection, achieving a device gain of 11892% for 1200 nm photons and a response frequency of 24 kHz at -2 V. The device exhibits a record EQE × Li-Fi frequency product of 106 Hz. We have applied the detector to near-infrared optical communications at a data transfer rate of 2000 bits per second (2 kbps) to demonstrate the advances in high fidelity, the device retains over 98% of the original waveform information in its output.

Broken Symmetry Optical Transitions in (6,5) Single-Walled Carbon Nanotubes Containing sp3 Defects Revealed by First-Principles Theory.

We present a first-principles many-body perturbation theory study of nitrophenyl-doped (6,5) single-walled nanotubes (SWCNTs) to understand how sp3 doping impacts the excitonic properties. sp3-doped SWCNTs are promising as a class of optoelectronic materials with bright tunable photoluminescence, long spin coherence, and single-photon emission (SPE), motivating the study of spin excitations. We predict that the dopant results in a single unpaired spin localized around the defect site, which induces multiple low-energy excitonic peaks. By comparing optical absorption and photoluminescence from experiment and theory, we identify the transitions responsible for the red-shifted, defect-induced E11* peak, which has demonstrated SPE for some dopants; the presence of this state is due to both the symmetry-breaking associated with the defect and the presence of the defect-induced in-gap state. Furthermore, we find an asymmetry between the contribution of the two spin channels, suggesting that this system has potential for spin-selective optical transitions.

Representation Matters: Trust in Digital Health Information Among Black Patients With Prostate Cancer.

PURPOSE: Although the majority of US adults obtain health information on the internet, the quality of information about prostate cancer is highly variable. Black adults are underrepresented in online content about prostate cancer despite a higher incidence of and mortality from the disease. The goal of this study was to explore the perspectives of Black patients with prostate cancer on the importance of racial representation in online content and other factors influencing trust. MATERIALS AND METHODS: We conducted 7 virtual focus groups with Black patients with prostate cancer in 2022 and 2023. Participants completed an intake questionnaire with demographics followed by a group discussion, including feedback on purposefully selected online content. Transcripts were independently analyzed by 2 investigators experienced in qualitative research using a constant comparative method. RESULTS: Most participants use online sources to look for prostate cancer information. Racial representation is an important factor affecting trust in the content. A lack of Black representation has consequences, including misperceptions about a lower risk of prostate cancer and discouraging further information-seeking. Other key themes affecting trust in online content included the importance of a reputable source of information, professional website structure, and soliciting money. CONCLUSIONS: Underrepresentation of Black adults in prostate cancer content has the potential to worsen health disparities. Optimal online communications should include racially diverse representation and evidence-based information in a professional format from reputable sources without financial conflict.

Is plant acoustic communication fact or fiction?

In recent years, the idea has flourished that plants emit and perceive sound and could even be capable of exchanging information through the acoustic channel. While research into plant bioacoustics is still in its infancy, with potentially fascinating discoveries awaiting ahead, here we show that the current knowledge is not conclusive. While plants do emit sounds under biotic and abiotic stresses such as drought, these sounds are high-pitched, of low intensity, and propagate only to a short distance. Most studies suggesting plant sensitivity to airborne sound actually concern the perception of substrate vibrations from the soil or plant part. In short, while low-frequency, high-intensity sounds emitted by a loudspeaker close to the plant seem to have tangible effects on various plant processes such as growth - a finding with possible applications in agriculture - it is unlikely that plants can perceive the sounds they produce, at least over long distances. So far, there is no evidence of plants communicating with each other via the acoustic channel.

Exploring the Telephone Call Experience of Patients with Non-English Language Preference in Primary Care vs. Specialty.

BACKGROUND: Latine people, comprising 18.5% of the US population, constitute the largest ethnic minority group, with nearly one-third self-identifying as having non-English language preference (NELP). Despite the importance of the telephone in health care access, there is limited understanding of how NELP patients navigate telephone calls with primary and specialty care clinics. OBJECTIVE: This qualitative study aims to capture how Spanish speakers with NELP characterize their telephone call experiences with primary and specialty care clinics. DESIGN: Semi-structured interviews were conducted with 24 Spanish-speaking participants from primary care clinics with a sizeable proportion of patients who prefer to communicate in a language other than English at an urban academic medical center in Boston, MA. PARTICIPANTS: Participants were selected from primary care clinics that were well-equipped to serve Spanish-speaking patients. A total of 24 Spanish-speaking patients with NELP, mainly women (83%), with a mean age of 55.8 years, participated. They represented diverse countries of origin, with an average length of time in the USA of 21.7 years. APPROACH: Interview questions prompted participants to describe their telephone call experiences with front desk staff, with attention to interpreter availability, ancillary assistance, health outcomes stemming from a lack of language services, and emotional consequences of language discordance on calls. KEY RESULTS: Patients perceived primary care clinics as providing familiarity and language concordance during telephone interactions, contrasting with specialty care clinics, seen as sources of monolingual English communication. Participants utilized various strategies, such as requesting interpreters, using concise English phrases, or seeking assistance from acquaintances, relatives, or primary care clinic staff, to mitigate language barriers. CONCLUSIONS: The findings underscore significant challenges faced by Spanish-speaking patients with NELP in ambulatory specialty care telephone calls. The study emphasizes the importance of creating inclusive multilingual telephone environments, standardizing interpreter access, and reflecting the diversity of the communities served.

Cell-cell communication characteristics in breast cancer metastasis.

Breast cancer, a highly fatal disease due to its tendency to metastasize, is the most prevalent form of malignant tumors among women worldwide. Numerous studies indicate that breast cancer exhibits a unique predilection for metastasis to specific organs including the bone, liver, lung, and brain. However, different types of, The understanding of the heterogeneity of metastatic breast cancer has notably improved with the recent advances in high-throughput sequencing techniques. Focusing on the modification in the microenvironment of the metastatic organs and the crosstalk between tumor cells and in situ cells, noteworthy research points include the identification of two distinct modes of tumor growth in bone metastases, the influence of type II pneumocyte on lung metastases, the paradoxical role of Kupffer cells in liver metastases, and the breakthrough of the blood-brain barrier (BBB) breach in brain metastases. Overall, this review provides a comprehensive overview of the characteristics of breast cancer metastases, shedding light on the pivotal roles of immune and resident cells in the development of distinct metastatic foci.

Randomized controlled trial of twin-twin transfusion syndrome laser surgery: the sequential trial.

BACKGROUND: Intraoperative blood transfer between twins during laser surgery for twin-twin transfusion syndrome can vary by surgical technique and has been proposed to explain differences in donor twin survival. OBJECTIVE: This trial compared donor twin survival with 2 laser techniques: the sequential technique, in which the arteriovenous communications from the volume-depleted donor to the volume-overloaded recipient are laser-occluded before those from recipient to donor, and the selective technique, in which the occlusion of the vascular communications is performed in no particular order. STUDY DESIGN: A single-center, open-label, randomized controlled trial was conducted in which twin-twin transfusion syndrome patients were randomized to sequential vs selective laser surgery. Nested within the trial, a second trial randomized patients with superficial anastomoses (arterioarterial and venovenous) to ablation of these connections first (before ablating the arteriovenous anastomoses) vs last. The primary outcome measure was donor twin survival at birth. RESULTS: A total of 642 patients were randomized. Overall donor twin survival was similar between the 2 groups (274 of 320 [85.6%] vs 271 of 322 [84.2%]; odds ratio, 1.12 [95% confidence interval, 0.73-1.73]; P=.605). Superficial anastomoses occurred in 177 of 642 cases (27.6%). Donor survival was lower in the superficial anastomosis group vs those with only arteriovenous communications (125 of 177 [70.6%] vs 420 of 465 [90.3%]; adjusted odds ratio, 0.33 [95% confidence interval, 0.20-0.54]; P<.001). In cases with superficial anastomoses, donor survival was independent of the timing of ablation or surgical technique. The postoperative mean middle cerebral artery peak systolic velocity was lower in the sequential vs selective group (1.00±0.30 vs 1.06±0.30 multiples of the median; P=.003). Post hoc analyses showed 2 factors that were associated with poor overall donor twin survival: the presence or absence of donor twin preoperative critical abnormal Doppler parameters and the presence or absence of arterioarterial anastomoses. Depending on these factors, 4 categories of patients resulted: (1) Category 1 (347 of 642 [54%]), no donor twin critical abnormal Doppler + no arterioarterial anastomoses: donor twin survival was 91.2% in the sequential and 93.8% in the selective groups; (2) Category 2 (143 of 642 [22%]), critical abnormal Doppler present + no arterioarterial anastomoses: donor survival was 89.9% vs 75.7%; (3) Category 3 (73 of 642 [11%]), no critical abnormal Doppler + arterioarterial anastomoses present: donor survival was 94.7% vs 74.3%; and (4) Category 4 (79 of 642 [12%]), critical abnormal Doppler present + arterioarterial anastomoses present: donor survival was 47.6% vs 64.9%. CONCLUSION: Donor twin survival did not differ between the sequential vs selective laser techniques and did not differ if superficial anastomoses were ablated first vs last. The donor twin's postoperative middle cerebral artery peak systolic velocity was improved with the sequential vs the selective approach. Post hoc analyses suggest that donor twin survival may be associated with the choice of laser technique according to high-risk factors. Further study is needed to determine whether using these categories to guide the choice of surgical technique will improve outcomes.

Role of national regime ideology for predicting biodiversity outcomes.

The rapid decline of global biodiversity has engendered renewed debate about the social, economic, and political factors contributing to it. Specifically, there is little understanding of the role that political ideology within a country (e.g., nationalism, conservatism, socialism) plays in determining biodiversity outcomes. We used negative binomial generalized linear models to investigate the importance of national regime ideology in predicting threatened animal species and protected area establishment compared with other factors that affect biodiversity outcomes, such as gross domestic product, inequality, and democracy. For threatened animals, the model with the highest Akaike weight suggested adverse biodiversity outcomes arose from larger gross domestic product (ß = 0.120, p < 0.001). However, nationalism (ß = 0.371, p < 0.01) and socialism (ß = 0.293, p < 0.05) were also significantly associated with increased proportions of threatened species. For protected areas, the model with the highest Akaike weight suggested increases in democracy (ß = 0.880, p < 0.001) led to a rise in relative protected area estate. Conservative regime ideology was also associated with greater protected area estate, although this did not increase the weight of evidence in support of the best models. These findings highlight the relevance of political ideology for predicting biodiversity outcomes at a national scale and illustrate opportunities to tailor policies and advocacy to promote biodiversity conservation more effectively. By targeting appropriate messaging and political advocacy, conservationists can improve the likelihood that politicians and their nations will participate in positive biodiversity actions.

El papel de la ideología del régimen nacional para la predicción de resultados de biodiversidad Resumen El rápido declive de la biodiversidad mundial ha suscitado un renovado debate sobre los factores sociales, económicos y políticos que contribuyen a él. En concreto, se conoce poco el papel que desempeña la ideología política dentro de un país (por ejemplo, el nacionalismo, el conservadurismo o el socialismo) a la hora de determinar los resultados en materia de biodiversidad. Utilizamos modelos lineales generalizados binomiales negativos para investigar la importancia de la ideología del régimen nacional a la hora de predecir las especies animales amenazadas y el establecimiento de áreas protegidas en comparación con otros factores que afectan a los resultados de la biodiversidad, como el producto interno bruto, la desigualdad y la democracia. En el caso de los animales amenazados, el modelo con la mayor ponderación de Akaike sugirió que los resultados adversos para la biodiversidad se debían a un mayor producto interno bruto (ß = 0,120, p < 0,001). Sin embargo, el nacionalismo (ß = 0,371, p < 0,01) y el socialismo (ß = 0,293, p < 0,05) también se asociaron significativamente con una mayor proporción de especies amenazadas. En el caso de las áreas protegidas, el modelo con la mayor ponderación de Akaike sugirió que el aumento de la democracia (ß = 0,880, p < 0,001) conducía a un aumento de la extensión relativa de las áreas protegidas. La ideología conservadora del régimen también se asoció con una mayor superficie de áreas protegidas, aunque no aumentó el peso de la evidencia en apoyo de los mejores modelos. Estos resultados resaltan la importancia de la ideología política para predecir los resultados de la biodiversidad a escala nacional e ilustran las oportunidades de adaptar las políticas y la defensa para promover la conservación de la biodiversidad de manera más eficaz. Si se orientan los mensajes y la promoción política de forma adecuada, los conservacionistas pueden mejorar la probabilidad de que los políticos y sus naciones participen en acciones positivas para la biodiversidad.

Exploring factors affecting the acceptance of fall detection technology among older adults and their families: a content analysis.

BACKGROUND: This study conducted in-depth interviews to explore the factors that influence the adoption of fall detection technology among older adults and their families, providing a valuable evaluation framework for healthcare providers in the field of fall detection, with the ultimate goal of assisting older adults immediately and effectively when falls occur. METHODS: The method employed a qualitative approach, utilizing semi-structured interviews with 30 older adults and 29 families, focusing on their perspectives and expectations of fall detection technology. Purposive sampling ensured representation from older adults with conditions such as Parkinson's, dementia, and stroke. RESULTS: The results reveal key considerations influencing the adoption of fall-detection devices, including health factors, reliance on human care, personal comfort, awareness of market alternatives, attitude towards technology, financial concerns, and expectations for fall detection technology. CONCLUSIONS: This study identifies seven key factors influencing the adoption of fall detection technology among older adults and their families. The conclusion highlights the need to address these factors to encourage adoption, advocating for user-centered, safe, and affordable technology. This research provides valuable insights for the development of fall detection technology, aiming to enhance the safety of older adults and reduce the caregiving burden.

A scoping review of wildfire smoke risk communications: issues, gaps, and recommendations.

BACKGROUND: Wildfire smoke exposure has become a growing public health concern, as megafires and fires at the wildland urban interface increase in incidence and severity. Smoke contains many pollutants that negatively impact health and is linked to a number of health complications and chronic diseases. Communicating effectively with the public, especially at-risk populations, to reduce their exposure to this environmental pollutant has become a public health priority. Although wildfire smoke risk communication research has also increased in the past decade, best practice guidance is limited, and most health communications do not adhere to health literacy principles: readability, accessibility, and actionability. This scoping review identifies peer-reviewed studies about wildfire smoke risk communications to identify gaps in research and evaluation of communications and programs that seek to educate the public. METHODS: Four hundred fifty-one articles were identified from Web of Science and PubMed databases. After screening, 21 articles were included in the final sample for the abstraction process and qualitative thematic analysis. Ten articles were based in the US, with the other half in Australia, Canada, Italy, and other countries. Fifteen articles examined communication materials and messaging recommendations. Eight papers described communication delivery strategies. Eleven articles discussed behavior change. Six articles touched on risk communications for vulnerable populations; findings were limited and called for increasing awareness and prioritizing risk communications for at-risk populations. RESULTS: This scoping review found limited studies describing behavior change to reduce wildfire smoke exposure, characteristics of effective communication materials and messaging, and communication delivery strategies. Literature on risk communications, dissemination, and behavior change for vulnerable populations was even more limited. CONCLUSIONS: Recommendations include providing risk communications that are easy-to-understand and adapted to specific needs of at-risk groups. Communications should provide a limited number of messages that include specific actions for avoiding smoke exposure. Effective communications should use mixed media formats and a wide variety of dissemination strategies. There is a pressing need for more intervention research and effectiveness evaluation of risk communications about wildfire smoke exposure, and more development and dissemination of risk communications for both the general public and vulnerable populations.

"Build back the confidence": qualitative exploration of community experiences with polio vaccination in the Covid-19 context in Cameroon and Ethiopia.

BACKGROUND: In 2020, as the Global Polio Eradication Initiative worked to address outbreaks of vaccine-derived poliovirus Type 2, particularly in sub-Saharan Africa, the Covid-19 pandemic suspended routine immunization campaigns worldwide. There were concerns about how Covid-19 - and the introduction of Covid-19 vaccines - might influence uptake of the oral polio vaccine (OPV). To inform communications strategies, we conducted a qualitative study to explore insights from community stakeholders into how Covid-19 influenced perceptions of OPV and vaccination campaigns. METHODS: We conducted 32 focus group discussions with caregivers of children under 5 and polio frontline workers as well as 22 in-depth interviews with healthcare practitioners and social influencers in Cameroon and Ethiopia. In each country, we purposively sampled stakeholders per discrete eligibility criteria from one urban (Yaoundé and Addis Ababa) and one peri-urban site (Bafia and Adama). RESULTS: We found that the Covid-19 pandemic and related precautionary measures introduced new challenges for OPV campaigns in Cameroon and Ethiopia, including reduced caregiver confidence in routine immunizations and an erosion of trust between caregivers and frontline workers. A salient concern among caregivers was that Covid-19 vaccines might be delivered in place of OPV. When asked how to maximize community support for future OPV campaigns, stakeholders suggested to rebuild caregiver trust for frontline workers; use a variety of information sources to ensure consistent messaging on vaccination reaches caregivers in a timely manner; increase remuneration, resources, and training for frontline workers; and leverage existing community influencers and groups. CONCLUSIONS: Despite the challenges to vaccination campaigns experienced during the Covid-19 pandemic, it was anticipated that the Polio Programme would continue to experience community support for OPV with appropriate messaging and community coordination. These efforts would "build back the confidence" among caregivers and other community stakeholders regarding community-based vaccination campaigns. Social and behavior change approaches that leverage clear, consistent messaging from multiple trusted platforms could address caregiver trust and dismantle mis/dis-information that creates confusion surrounding vaccines.

Insights from a community-based survey on factors influencing acceptance and uptake of Paxlovid (nirmatrelvir and ritonavir) as a COVID-19 antiviral medication in Singapore.

INTRODUCTION: Antiviral treatment can reduce the burden of COVID-19. But utilisation can be suboptimal, even in a setting like Singapore where it is fully subsidized for those with selected medical conditions and older adults (≥ 50 years). We hence investigated the factors affecting awareness, acceptance, and initiative to request Paxlovid. METHODS: We assessed the Paxlovid awareness, factors impacting its uptake in a survey conducted from August 2022 to September 2022 through the SOCRATES cohort. Multivariable logistic regression was used to investigate associations between sociodemographics, perceptions, and attitudes with the key study outcomes. RESULTS: Among respondents to the Paxlovid survey, 54% were aware of Paxlovid. On being provided essential details about Paxlovid, 75% reported they would likely be receptive to taking it if prescribed, and 38% indicated the initiative to request for it if it was not suggested by their doctors. Factors associated with awareness of Paxlovid include aged 40 years old and above, higher education, citing websites as an information source, greater trust in healthcare providers (aOR: 1.65, 95% CI 1.26 - 2.15) and government communications (aOR: 0.69, 95% CI 0.55 - 0.86), and higher perceived risk of COVID-19 infection (aOR: 1.25, 95% CI 1.10 - 1.42). Factors associated with acceptance to take Paxlovid include male gender, citing trust in healthcare providers (aOR: 1.49, 95% CI 1.11 - 1.99) and government communications (aOR: 1.38, 95% CI 1.09 - 1.76), and higher perceived severity of COVID-19 (aOR: 1.23, 95% CI 1.07 - 1.42). Factors associated with initiative to request Paxlovid include male gender, having pre-existing diabetes and higher perceived severity of COVID-19 (aOR: 1.24, 95% CI 1.09 - 1.40). The most common reasons for why respondents might not take Paxlovid were concerns about side effects (64%), concerns about costs (29%), and the perception that COVID-19 is a mild (25%). CONCLUSION: The majority of our respondents would take Paxlovid if it was prescribed to them, but a much smaller proportion would have the initiative to request for this. Key factors that may influence uptake are COVID-19 threat perceptions, trust in healthcare and government, and perceptions of the drug's side effects and cost.

A Call to Action: Supporting Black Maternal and Infant Health Using the Collective Impact Model.

This commentary advocates for a comprehensive approach to addressing the Black maternal and infant health crisis, utilizing the collective impact model with health equity at its center. Black women in the United States face alarmingly high rates of maternal morbidity and mortality compared to white women. Black women are twice as likely to have premature and low birthweight babies than white women, exposing both the expectant woman and child to various health risks. This crisis stems from systemic racism, implicit bias in healthcare, and a lack of targeted health communications for pregnant Black women. The urgency of this situation requires a bold and unified response through collaboration and coordination among healthcare providers, local and grassroots community-based organizations (CBOs), and digital health communicators. A comprehensive Black maternal and infant health campaign embedded within the collective impact model and led by a dedicated backbone organization would facilitate the coordination and involvement of diverse stakeholders. Central to these efforts should be the acknowledgment that systemic racism perpetuates health inequities. Consequently, any initiatives to improve health outcomes should prioritize health equity by valuing and incorporating Black women's perspectives. This involves crafting a responsive strategy and placing Black women at the forefront of content creation, program strategy, and evaluation. Through a collaborative effort involving healthcare partners, CBOs, and health communicators, we can have an impact far more significant than any single initiative. Immediate action is needed to dismantle systemic barriers and ensure every Black woman and infant receives the care and support they deserve. Black maternal health disparities in the United States have been widely acknowledged and studied. It is well-established that Black women face significantly higher rates of maternal morbidity and mortality compared to their white counterparts, indicative of a severe healthcare crisis. This opinion piece contributes to the discourse by proposing a comprehensive solution grounded in the collective impact model, which emphasizes collaboration and coordination across various stakeholders. This approach represents a shift from past siloed efforts, aiming to tackle the urgent issue of Black maternal and infant health with a multidisciplinary approach centered on health equity.

Communication-efficient federated learning.

Federated learning (FL) enables edge devices, such as Internet of Things devices (e.g., sensors), servers, and institutions (e.g., hospitals), to collaboratively train a machine learning (ML) model without sharing their private data. FL requires devices to exchange their ML parameters iteratively, and thus the time it requires to jointly learn a reliable model depends not only on the number of training steps but also on the ML parameter transmission time per step. In practice, FL parameter transmissions are often carried out by a multitude of participating devices over resource-limited communication networks, for example, wireless networks with limited bandwidth and power. Therefore, the repeated FL parameter transmission from edge devices induces a notable delay, which can be larger than the ML model training time by orders of magnitude. Hence, communication delay constitutes a major bottleneck in FL. Here, a communication-efficient FL framework is proposed to jointly improve the FL convergence time and the training loss. In this framework, a probabilistic device selection scheme is designed such that the devices that can significantly improve the convergence speed and training loss have higher probabilities of being selected for ML model transmission. To further reduce the FL convergence time, a quantization method is proposed to reduce the volume of the model parameters exchanged among devices, and an efficient wireless resource allocation scheme is developed. Simulation results show that the proposed FL framework can improve the identification accuracy and convergence time by up to 3.6% and 87% compared to standard FL.

Comparing Federal Communications Commission and Microsoft Estimates of Broadband Access for Mental Health Video Telemedicine Among Veterans: Retrospective Cohort Study.

BACKGROUND: The COVID-19 pandemic highlighted the importance of telemedicine in health care. However, video telemedicine requires adequate broadband internet speeds. As video-based telemedicine grows, variations in broadband access must be accurately measured and characterized. OBJECTIVE: This study aims to compare the Federal Communications Commission (FCC) and Microsoft US broadband use data sources to measure county-level broadband access among veterans receiving mental health care from the Veterans Health Administration (VHA). METHODS: Retrospective observational cohort study using administrative data to identify mental health visits from January 1, 2019, to December 31, 2020, among 1161 VHA mental health clinics. The exposure is county-level broadband percentages calculated as the percentage of the county population with access to adequate broadband speeds (ie, download >25 megabits per second) as measured by the FCC and Microsoft. All veterans receiving VHA mental health services during the study period were included and categorized based on their use of video mental health visits. Broadband access was compared between and within data sources, stratified by video versus no video telemedicine use. RESULTS: Over the 2-year study period, 1,474,024 veterans with VHA mental health visits were identified. Average broadband percentages varied by source (FCC mean 91.3%, SD 12.5% vs Microsoft mean 48.2%, SD 18.1%; P<.001). Within each data source, broadband percentages generally increased from 2019 to 2020. Adjusted regression analyses estimated the change after pandemic onset versus before the pandemic in quarterly county-based mental health visit counts at prespecified broadband percentages. Using FCC model estimates, given all other covariates are constant and assuming an FCC percentage set at 70%, the incidence rate ratio (IRR) of county-level quarterly mental video visits during the COVID-19 pandemic was 6.81 times (95% CI 6.49-7.13) the rate before the pandemic. In comparison, the model using Microsoft data exhibited a stronger association (IRR 7.28; 95% CI 6.78-7.81). This relationship held across all broadband access levels assessed. CONCLUSIONS: This study found FCC broadband data estimated higher and less variable county-level broadband percentages compared to those estimated using Microsoft data. Regardless of the data source, veterans without mental health video visits lived in counties with lower broadband access, highlighting the need for accurate broadband speeds to prioritize infrastructure and intervention development based on the greatest community-level impacts. Future work should link broadband access to differences in clinical outcomes.

A Typology of Social Media Use by Human Service Nonprofits: Mixed Methods Study.

BACKGROUND: Nonprofit organizations are increasingly using social media to improve their communication strategies with the broader population. However, within the domain of human service nonprofits, there is hesitancy to fully use social media tools, and there is limited scope among organizational personnel in applying their potential beyond self-promotion and service advertisement. There is a pressing need for greater conceptual clarity to support education and training on the varied reasons for using social media to increase organizational outcomes. OBJECTIVE: This study leverages the potential of Twitter (subsequently rebranded as X [X Corp]) to examine the online communication content within a sample (n=133) of nonprofit sexual assault (SA) centers in Canada. To achieve this, we developed a typology using a qualitative and supervised machine learning model for the automatic classification of tweets posted by these centers. METHODS: Using a mixed methods approach that combines machine learning and qualitative analysis, we manually coded 10,809 tweets from 133 SA centers in Canada, spanning the period from March 2009 to March 2023. These manually labeled tweets were used as the training data set for the supervised machine learning process, which allowed us to classify 286,551 organizational tweets. The classification model based on supervised machine learning yielded satisfactory results, prompting the use of unsupervised machine learning to classify the topics within each thematic category and identify latent topics. The qualitative thematic analysis, in combination with topic modeling, provided a contextual understanding of each theme. Sentiment analysis was conducted to reveal the emotions conveyed in the tweets. We conducted validation of the model with 2 independent data sets. RESULTS: Manual annotation of 10,809 tweets identified seven thematic categories: (1) community engagement, (2) organization administration, (3) public awareness, (4) political advocacy, (5) support for others, (6) partnerships, and (7) appreciation. Organization administration was the most frequent segment, and political advocacy and partnerships were the smallest segments. The supervised machine learning model achieved an accuracy of 63.4% in classifying tweets. The sentiment analysis revealed a prevalence of neutral sentiment across all categories. The emotion analysis indicated that fear was predominant, whereas joy was associated with the partnership and appreciation tweets. Topic modeling identified distinct themes within each category, providing valuable insights into the prevalent discussions surrounding SA and related issues. CONCLUSIONS: This research contributes an original theoretical model that sheds light on how human service nonprofits use social media to achieve their online organizational communication objectives across 7 thematic categories. The study advances our comprehension of social media use by nonprofits, presenting a comprehensive typology that captures the diverse communication objectives and contents of these organizations, which provide content to expand training and education for nonprofit leaders to connect and engage with the public, policy experts, other organizations, and potential service users.