An empirical analysis of American Passenger's willingness to fly in commercial airplanes after vaccination against COVID-19.

Although several studies have explored the effects of the pandemic on aviation, little remains known about whether members of the public are willing to fly again after they have been vaccinated. The current study uses the Health Belief Model (HBM) to fill this missing gap by manipulating the following variables: 1) whether or not the participant is vaccinated; 2) whether or not airlines require that all passengers and crew receive vaccinations; 3) length of flight; 4) destination; and 5) the number of passengers. The data from 678 participants revealed that willingness to fly is much higher if the participants themselves have been vaccinated, if the airlines require all passengers to be vaccinated, if the flight is short, if the destination is domestic, and if the number of passengers is low. These findings did not appear to differ as a function of flying business versus pleasure. We discuss the practical implications of these data as airlines struggle to bring back their customer base.

Building a predictive model of U.S. patient willingness to undergo robotic surgery.

Prior research regarding robotic surgery (RS) has largely focused on the engineering or medical aspects of these tools. A few studies have examined consumer opinions toward, or willingness to use, robotic surgeons; however, no study to date has examined what type of person would be willing to undergo RS. Across two studies, the current research fills this gap by building both a descriptive and predictive regression model used to predict what type of user would be willing to undergo RS. To build the descriptive model, 1324 potential patients were asked a series of questions about demographics, attitudes, opinions, and personalities. Results indicate that perceived value, familiarity, wariness of new technologies, fear of surgery, openness, anger, fear, and happiness are all significant predictors of willingness to undergo RS. A regression equation was developed and then used to predict scores in a second study with 1335 potential patients. The scores from both studies were compared for model fit. Several methods were used to validate the regression model, including correlational analyses, a t test, and calculation of the cross-validity coefficient. All three stringent tests showed strong model fit, explaining 62% of the variance in the model. These findings have both practical and theoretical values to the field and can be used to identify early adopters of this advanced medical technology.

A qualitative analysis of social and emotional perspectives of airline passengers during the COVID-19 pandemic.

Background: Fear of illness, economic damage, and stigma have had a devastating impact on the travel industry and have caused a significant reduction in both business and leisure travel. This study examines passengers' social and emotional perspectives during and after the COVID-19 pandemic, building on a prior quantitative study that identified factors that predict a person's willingness to fly during the COVID-19 pandemic. Methods: This study used a qualitative method with a phenomenological perspective and hermeneutic design. Fifteen adults from the United States participated in a personal interview designed to capture demographics, individual safety measures, feelings, and concerns involving air travel during the pandemic. Personal interview transcripts were then inspected by the researchers using a constant comparison method. Results: The personal experiences of participants were dominated by projections of trust issues and emotional heuristics, protective behaviors, and fear of confrontations with others, and a fear of the unknown. These themes emerged even in participants who continued to fly during the pandemic. Conclusion: Insights into travelers' emotions, trust, and fears may help airlines and other segments of the travel industry to develop targeted messaging that supports the trust and safety issues confronted by frequent travelers.

Factors that predict passengers willingness to fly during and after the COVID-19 pandemic.

BACKGROUND: Prior research has examined consumer willingness to fly in a variety of situations, including during disease outbreaks. However, to date, no study that we know of has identified what type of person is willing to fly during the COVID-19 pandemic. METHODS: Six hundred and thirty-two participants from the United States were asked to complete a survey designed to capture demographics, personality measures, emotional states and travel purposes. The data were collected in two stages in order to both develop a descriptive regression equation and a predictive model. RESULTS: Regression equations were created for both business and pleasure travel, and the following predictors were significant for both scenarios: perceived threat from COVID-19, agreeableness, affect, and fear. These models accounted for 66-67% of the variance in willingness to fly. CONCLUSION: Airlines and governments could use these findings to help control the message to potential passengers on actions being taken to provide a safe flying experience, such as mask wearing policies and aircraft disinfectant procedures.

Autopilots in the Operating Room: Safe Use of Automated Medical Technology.

Automated medical technology is becoming an integral part of routine anesthetic practice. Automated technologies can improve patient safety, but may create new workflows with potentially surprising adverse consequences and cognitive errors that must be addressed before these technologies are adopted into clinical practice. Industries such as aviation and nuclear power have developed techniques to mitigate the unintended consequences of automation, including automation bias, skill loss, and system failures. In order to maximize the benefits of automated technology, clinicians should receive training in human-system interaction including topics such as vigilance, management of system failures, and maintaining manual skills. Medical device manufacturers now evaluate usability of equipment using the principles of human performance and should be encouraged to develop comprehensive training materials that describe possible system failures. Additional research in human-system interaction can improve the ways in which automated medical devices communicate with clinicians. These steps will ensure that medical practitioners can effectively use these new devices while being ready to assume manual control when necessary and prepare us for a future that includes automated health care.

Patient Perceptions of New Robotic Technologies in Clinical Restorative Dentistry.

Patient perception research has failed to focus on burgeoning technology within the dental field. Specifically, researchers have yet to focus on developing robotic technologies which are being utilized by dentists to help perform certain procedures with added precision and route mapping. The current study attempts to fill the gap created by a lack of intersection between dental technology research, consumer perceptions research, and automation research. The current research takes a two-study approach, with study 1 investigating if gender or price of the procedure affects willingness to undergo a robotic dental procedure. Study 2 further investigates this phenomenon, identifying ten separate types of dental procedures (ranging from minimally invasive to extremely invasive) to further understand consumer perceptions. Results indicate that females are less willing to undergo a robotic dental procedure, and that participants in general are more willing to undergo a procedure if it is half price than if it full price. Willingness is influenced by gender and the type of procedure being performed - participants were less willing to undergo invasive procedures such as gum surgery than noninvasive procedures such as teeth whitening. These results, and their theoretical and practical significance are discussed.

Total testosterone and neuropsychiatric symptoms in elderly men with Alzheimer's disease.

INTRODUCTION: There has been a significant increase in the use of testosterone in aging men, but little investigation into its impact on men with Alzheimer's disease (AD). The findings of the few studies that have been done are inconsistent. In the present study, we investigated the relationship between total testosterone (TT) and neuropsychiatric symptoms (NPS) in a well-characterized sample of elderly men with mild to moderate AD. METHODS: The sample, which was drawn from the Texas Alzheimer's Research Care Consortium Longitudinal Research Cohort, included 87 men who met the criteria for mild to moderate AD. The occurrence of NPS was gathered from caregivers and/or family members with the Neuropsychiatric Inventory. TT was analyzed, and the sample was divided into a low-testosterone group (TT ≤2.5 ng/ml; n = 44) and a borderline/normal group (TT ≥2.6 ng/ml; n = 43). RESULTS: TT was correlated with symptoms of hallucinations, delusions, agitation, irritability and motor activity. The borderline/normal group was significantly more likely to have hallucinations (odds ratio (OR) = 5.56), delusions (OR = 3.87), motor activity (OR = 3.13) and irritability (OR = 2.77) than the low-testosterone group. Health status and apolipoprotein E ε4 status were not significant factors. CONCLUSIONS: The findings of the present study have implications for the use of testosterone replacement therapy in men with AD or the prodromal stage of the disease.

Inherited variation in miR-290 expression suppresses breast cancer progression by targeting the metastasis susceptibility gene Arid4b.

The metastatic cascade is a complex and extremely inefficient process with many potential barriers. Understanding this process is of critical importance because the majority of cancer mortality is associated with metastatic disease. Recently, it has become increasingly clear that microRNAs (miRNA) play important roles in tumorigenesis and metastasis, yet few studies have examined how germline variations may dysregulate miRNAs, in turn affecting metastatic potential. To explore this possibility, the highly metastatic MMTV-PyMT mice were crossed with 25 AKXD (AKR/J × DBA/2J) recombinant inbred strains to produce F1 progeny with varying metastatic indices. When mammary tumors from the F1 progeny were analyzed by miRNA microarray, miR-290 (containing miR-290-3p and miR-290-5p) was identified as a top candidate progression-associated miRNA. The microarray results were validated in vivo when miR-290 upregulation in two independent breast cancer cell lines suppressed both primary tumor and metastatic growth. Computational analysis identified breast cancer progression gene Arid4b as a top target of miR-290-3p, which was confirmed by luciferase reporter assay. Surprisingly, pathway analysis identified estrogen receptor (ER) signaling as the top canonical pathway affected by miR-290 upregulation. Further analysis showed that ER levels were elevated in miR-290-expressing tumors and positively correlated with apoptosis. Taken together, our results suggest miR-290 targets Arid4b while simultaneously enhancing ER signaling and increasing apoptosis, thereby suppressing breast cancer progression. This, to the best of our knowledge, is the first example of inherited differences in miRNA expression playing a role in breast cancer progression.

Allelic variation and differential expression of the mSIN3A histone deacetylase complex gene Arid4b promote mammary tumor growth and metastasis.

Accumulating evidence suggests that breast cancer metastatic progression is modified by germline polymorphism, although specific modifier genes have remained largely undefined. In the current study, we employ the MMTV-PyMT transgenic mouse model and the AKXD panel of recombinant inbred mice to identify AT-rich interactive domain 4B (Arid4b; NM_194262) as a breast cancer progression modifier gene. Ectopic expression of Arid4b promoted primary tumor growth in vivo as well as increased migration and invasion in vitro, and the phenotype was associated with polymorphisms identified between the AKR/J and DBA/2J alleles as predicted by our genetic analyses. Stable shRNA-mediated knockdown of Arid4b caused a significant reduction in pulmonary metastases, validating a role for Arid4b as a metastasis modifier gene. ARID4B physically interacts with the breast cancer metastasis suppressor BRMS1, and we detected differential binding of the Arid4b alleles to histone deacetylase complex members mSIN3A and mSDS3, suggesting that the mechanism of Arid4b action likely involves interactions with chromatin modifying complexes. Downregulation of the conserved Tpx2 gene network, which is comprised of many factors regulating cell cycle and mitotic spindle biology, was observed concomitant with loss of metastatic efficiency in Arid4b knockdown cells. Consistent with our genetic analysis and in vivo experiments in our mouse model system, ARID4B expression was also an independent predictor of distant metastasis-free survival in breast cancer patients with ER+ tumors. These studies support a causative role of ARID4B in metastatic progression of breast cancer.

Adolescent mental health: Challenges with maternal noncompliance.

The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal-child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient's mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother's actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.

Mouse modifier genes in mammary tumorigenesis and metastasis.

Tumorigenesis and metastasis are complex multistep processes. In addition to the numerous somatic mutations that facilitate cancer progression, there is abundant evidence that an individual's genetic background not only contributes to overall cancer risk, but also specifically influences metastatic potential. The handful of human susceptibility genes that have been identified thus far do not fully account for hereditary cancer risk, and the discovery of additional susceptibility loci using population based studies is complex, time-consuming and expensive. Therefore, we and others have used a variety of mouse models to identify novel candidate susceptibility genes. Here we review how these mouse models have contributed to our understanding of the role of genetic background in modifying tumorigenesis and metastasis susceptibility.

Use of Magnetorheological fluid in a force feedback glove.

Magnetorheological fluid (MRF) is a smart material that has the property of changing its viscosity when exposed to a magnetic field. By placing this fluid into a sealed cylinder with an electromagnet piston as a core, a controllable resistance motion dampener can be created. A novel exoskeleton mechanical power transmission system was designed, utilizing rapid prototype parts, to transmit these resistive forces to the user's fingertips. A first iteration force feedback glove was developed and tested on human subjects for overall usability. The eventual goal of the system is to provide an alternative force producing system for exercises and rehabilitation. The entire system is lightweight, low power, and easily portable.

Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept.

Carpal tunnel syndrome is caused by the compression of the median nerve as it transits the carpal tunnel, with an incidence of about 1% of the population. If surgery is needed, the treatment involves decompression of the median nerve followed sometimes by musculoskeletal outpatient rehabilitation. This paper presents a proof-of-concept pilot clinical trial in which the Rutgers Masters II haptic glove was tested on five subjects, who were two weeks post-hand surgery. Subjects trained for 13 sessions, 30 min per session, three sessions per week, and had no conventional outpatient therapy. Computerized measures of performance showed group effects in hand mechanical energy (1200% for the virtual ball squeezing and DigiKey exercises and 600% for the power putty exercise). Improvement in their hand function was also observed (a 38% reduction in virtual pegboard errors, and 70% fewer virtual hand ball errors). Clinical strength measures showed increases in grip (by up to 150%) and key pinch (up to 46%) strength in three of the subjects, while two subjects had decreased strength following the study. However, all five subjects improved in their tip pinch strength of their affected hand (between 20%-267%). When asked whether they would recommend the virtual reality exercises to others, four subjects very strongly agreed and one strongly agreed that they would.

Functional neoangiogenesis imaging of genetically engineered mouse prostate cancer using three-dimensional power Doppler ultrasound.

We report the first application of high-frequency three-dimensional power Doppler ultrasound imaging in a genetically engineered mouse (GEM) prostate cancer model. We show that the technology sensitively and specifically depicts functional neoangiogenic blood flow because little or no flow is measurable in normal prostate tissue or tumors smaller than 2-3 mm diameter, the neoangiogenesis "switch-on" size. Vascular structures depicted by power Doppler were verified using Microfil-enhanced micro-computed tomography (micro-CT) and by correlation with microvessel distributions measured by immunohistochemistry and enhanced vascularity visualized by confocal microscopy in two GEM models [transgenic adenocarcinoma of the mouse prostate (TRAMP) and PSP94 gene-directed transgenic mouse adenocarcinoma of the prostate (PSP-TGMAP)]. Four distinct phases of neoangiogenesis in cancer development were observed, specifically, (a) an early latent phase; (b) establishment of a peripheral capsular vascular structure as a neoangiogenesis initiation site; (c) a peak in tumor vascularity that occurs before aggressive tumor growth; and (d) rapid tumor growth accompanied by decreasing vascularity. Microsurgical interventions mimicking local delivery of antiangiogenesis drugs were done by ligating arteries upstream from feeder vessels branching to the prostate. Microsurgery produced an immediate reduction of tumor blood flow, and flow remained low from 1 h to 2 weeks or longer after treatment. Power Doppler, in conjunction with micro-CT, showed that the tumors recruit secondary blood supplies from nearby vessels, which likely accounts for the continued growth of the tumors after surgery. The microsurgical model represents an advanced angiogenic prostate cancer stage in GEM mice corresponding to clinically defined hormone-refractory prostate cancer. Three-dimensional power Doppler imaging is completely noninvasive and will facilitate basic and preclinical research on neoangiogenesis in live animal models.

Identification of genes potentially involved in the acquisition of androgen-independent and metastatic tumor growth in an autochthonous genetically engineered mouse prostate cancer model.

BACKGROUND: A major focus of prostate cancer research has been to identify genes that are deregulated during tumor progression, potentially providing diagnostic markers and therapeutic targets. METHODS: We have employed serial analysis of gene expression (SAGE) and microarray hybridization to identify alterations that occur during malignant transformation in the Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) model. Many of these alterations were validated by real-time PCR (rtPCR). RESULTS: We identified several hundred mRNAs that were deregulated. Cluster analysis of microarray profiles with samples from various stages of the disease demonstrated that androgen-independent (AI) primary tumors are similar to metastases; 180 transcripts have expression patterns suggesting an involvement in the genesis of late-stage tumors, and our data support a role for phospholipase A2 group IIA in the acquisition of their highly aggressive characteristics. CONCLUSIONS: Our analyses identified well-characterized genes that were previously known to be involved in prostate cancer, validating our study, and also uncovered transcripts that had not previously been implicated in prostate cancer progression.

Steroid hormones, polypeptide growth factors, hormone refractory prostate cancer, and the neuroendocrine phenotype.

The growth, development, and differentiation of the prostate gland is largely dependent on the action of androgens and peptide growth factors that act differentially at the level of the mesenchymal and epithelial compartments. It is our premise that to understand the emergence of metastatic and hormone refractory prostate cancer we need to investigate: (1) how androgen action at the level of the mesenchyme induces the production of peptide growth factors that in turn can facilitate the growth and development of the epithelial compartment; (2) how androgen action at the level of the epithelium induces and maintains cellular differentiation, function, and replicative senescence; and (3) how transformation of the prostate gland can corrupt androgen and growth factor signaling homeostasis. To this end, we focus our discussion on how deregulation of the growth factor signaling axis can cooperate with deregulation of the androgen signaling axis to facilitate transformation, metastasis, and the emergence of the hormone refractory and neuroendocrine phenotypes associated with progressive androgen-independent prostate cancer. Finally, we suggest a working hypothesis to explain why hormone ablation therapy works to control early disease but fails to control, and may even facilitate, advanced prostate cancer.