BACKGROUND: Approximately 14 million individuals in the United States are eligible for lung cancer screening (LCS), but only 5.8% completed screening in 2021. Given the low uptake despite the potential great health benefit of LCS, interventions aimed at increasing uptake are warranted. The use of a patient-facing electronic health record (EHR) patient portal direct messaging tool offers a new opportunity to both engage eligible patients in preventative screening and provide a unique referral pathway for tobacco treatment.
OBJECTIVE: This study sought to develop and pilot an EHR patient-facing self-referral tool for an established LCS program in an academic medical center.
METHODS: Guided by constructs of the Health Belief Model associated with LCS uptake (eg, knowledge and self-efficacy), formative development of an EHR-delivered engagement message, infographic, and self-referring survey was conducted. The survey submits eligible self-reported patient information to a scheduler for the LCS program. The materials were pretested using an interviewer-administered mixed methods survey captured through venue-day-time sampling in 5 network-affiliated pulmonology clinics. Materials were then integrated into the secure patient messaging feature in the EHR system. Next, a one-group posttest quality improvement pilot test was conducted.
RESULTS: A total of 17 individuals presenting for lung screening shared-decision visits completed the pretest survey. More than half were newly referred for LCS (n=10, 60%), and the remaining were returning patients. When asked if they would use a self-referring tool through their EHR messaging portal, 94% (n=16) reported yes. In it, 15 participants provided oral feedback that led to refinement in the tool and infographic prior to pilot-testing. When the initial application of the tool was sent to a convenience sample of 150 random patients, 13% (n=20) opened the self-referring survey. Of the 20 who completed the pilot survey, 45% (n=9) were eligible for LCS based on self-reported smoking data. A total of 3 self-referring individuals scheduled an LCS.
CONCLUSIONS: Pretest and initial application data suggest this tool is a positive stimulus to trigger the decision-making process to engage in a self-referral process to LCS among eligible patients. This self-referral tool may increase the number of patients engaging in LCS and could also be used to aid in self-referral to other preventative health screenings. This tool has implications for clinical practice. Tobacco treatment clinical services or health care systems should consider using EHR messaging for LCS self-referral. This approach may be cost-effective to improve LCS engagement and uptake. Additional referral pathways could be built into this EHR tool to not only refer patients who currently smoke to LCS but also simultaneously trigger a referral to clinical tobacco treatment.

The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach.
A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura\'s Exercise Self-Efficacy Scale (Bandura\'s ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant.
A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01).
The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings.
https://clinicaltrials.gov/, (IRCT201706236261N17).

UNASSIGNED: Postpartum contraception is vital for maternal and child health, and reduces the risk of infant mortality. The Health Belief Model (HBM) is a widely accepted framework for exploring health behaviors, such as contraceptive use. Therefore, this study aimed to investigate the factors influencing postpartum contraceptive use in Nigeria and to contextualize the findings within the framework of the HBM.
UNASSIGNED: This study was a secondary analysis of cross-sectional data collected from the Demographic Health Survey conducted in Nigeria (NDHS). In total, 28,041 women were included in this study. Self-reported contraceptive use was the outcome, while the explanatory variables included maternal age, place of residence, region of residence, religion, marital status, educational level, household wealth quintiles, knowledge of the ovulatory cycle, decision-maker for health care, and distance to health care facilities. Descriptive statistics and multivariate logistic regression were used to summarize and identify factors influencing postpartum contraceptive use. The HBM was used to discuss the main findings.
UNASSIGNED: The prevalence of postpartum contraceptive use in Nigeria is 27%. Our findings showed that the odds of using contraceptives during the postpartum period were higher among women who knew their ovulation cycles, lived in urban areas in the southern region, had no distance barriers to health care, and were 25-49 years old. Education, wealth, and marital status also increase the odds of contraceptive use. However, women who lived in the northeast and northwest regions or shared decision-making with their partners had lower odds.
UNASSIGNED: This study highlights the need for region-specific and age-focused interventions to increase contraceptive use in Nigeria. Additionally, increasing accessibility and affordability of contraceptives for younger and economically disadvantaged women, along with promoting women\'s autonomy in decision-making, can further enhance contraceptive use across Nigeria.

Computational modelling was used to assess the capability of a deterministic and a probabilistic method to predict the incidence of AIS3+ injuries in passenger car occupants by comparing the predictions of the methods to the actual injuries observed in real-world crashes. The likelihood of sustaining an injury was first calculated using a computer model for a selected set of injury criteria in different impact conditions based on real-world crashes; AIS3+ injuries were then predicted using each method separately. Regardless of the method, the number of serious injuries was over-predicted. It was also noted that the used injury criteria suggested the occurrence of specific injuries that were not observed in the real world. Although both methods are susceptible to be adapted to improve their predictions, the question of the suitability of using some of the most commonly accepted injury criteria used with crash test dummies for injury assessment with human body models deserves further research.

An integrated assessment framework that enables holistic safety evaluations addressing vulnerable road users (VRU) is introduced and applied in the current study. The developed method enables consideration of both active and passive safety measures and distributions of real-world crash scenario parameters.
The likelihood of a specific virtual testing scenario occurring in real life has been derived from accident databases scaled to European level. Based on pre-crash simulations, it is determined how likely it is that scenarios could be avoided by a specific Autonomous Emergency Braking (AEB) system. For the unavoidable cases, probabilities for specific collision scenarios are determined, and the injury risk for these is determined, subsequently, from in-crash simulations with the VIVA+ Human Body Models combined with the created metamodel for an average male and female model. The integrated assessment framework was applied for the holistic assessment of car-related pedestrian protection using a generic car model to assess the safety benefits of a generic AEB system combined with current passive safety structures.
In total, 61,914 virtual testing scenarios have been derived from the different car-pedestrian cases based on real-world crash scenario parameters. Considering the occurrence probability of the virtual testing scenarios, by implementing an AEB, a total crash risk reduction of 81.70% was achieved based on pre-crash simulations. It was shown that 50 in-crash simulations per load case are sufficient to create a metamodel for injury prediction. For the in-crash simulations with the generic vehicle, it was also shown that the injury risk can be reduced by implementing an AEB, as compared to the baseline scenarios. Moreover, as seen in the unavoidable cases, the injury risk for the average male and female is the same for brain injuries and femoral shaft fractures. The average male has a higher risk of skull fractures and fractures of more than three ribs compared to the average female. The average female has a higher risk of proximal femoral fractures than the average male.
A novel methodology was developed which allows for movement away from the exclusive use of standard-load case assessments, thus helping to bridge the gap between active and passive safety evaluations.

A power clamp circuit, which has good immunity to false trigger under fast power-on conditions with a 20 ns rising edge, is proposed in this paper. The proposed circuit has a separate detection component and an on-time control component which enable it to distinguish between electrostatic discharge (ESD) events and fast power-on events. As opposed to other on-time control techniques, instead of large resistors or capacitors, which can cause a large occupation of the layout area, we use a capacitive voltage-biased p-channel MOSFET in the on-time control part of the proposed circuit. The capacitive voltage-biased p-channel MOSFET is in the saturation region after the ESD event is detected, which can serve as a large equivalent resistance (~106 Ω) in the structure. The proposed power clamp circuit offers several advantages compared to the traditional circuit, such as having at least 70% area savings in the trigger circuit area (30% area savings in the whole circuit area), supporting a power supply ramp time as fast as 20 ns, dissipating the ESD energy more cleanly with little residual charge, and recovering faster from false triggers. The rail clamp circuit also offers robust performance in an industry-standard PVT (process, voltage, and temperature) space and has been verified by the simulation results. Showing good performance of human body model (HBM) endurance and high immunity to false trigger, the proposed power clamp circuit has great potential for application in ESD protection.

This study seeks to comparatively examine parents\' intention to vaccinate their children for three infectious diseases, including COVID-19, HPV, and monkeypox.
Utilizing a mixed-design survey and multilevel structural equation models, we investigated if perception of the diseases and vaccines explained the variance in parents\' vaccine-specific decision-making and population difference in vaccination intention.
Compared with the COVID-19 vaccine, parents were more willing to get an HPV vaccine for their children due to greater perceived benefit and lower perceived barrier. Concerns about vaccine safety and lower disease risk perception were associated with lower intention to get a monkeypox vaccine. Parents of color, less educated, and lower-income parents were less willing to get vaccines for their children due to low benefit perception and high perceived barriers.
Parents were motivated by different social and psychological factors when deciding whether to get a COVID-19, HPV, and monkeypox vaccine for their children.
Vaccine promotion should be tailored to the characteristics of the target population and the vaccines. Underprivileged communities may be better approached with information about vaccine benefit and barriers, and vaccines for unfamiliar diseases may be better communicated with disease risk information.

The purpose of the research was to pool the intention to receive the COVID-19 vaccine and its health belief model (HBM)-based predictors, which is helpful for decision-makers and program managers around the globe. The relevant database was searched and Joanna Briggs Institute (JBI) appraisal checklist was used to evaluate the studies. I2 test and funnel plot was utilized to check heterogeneity and publication bias, respectively. DerSimonian and Laird random-effects model was used. The overall pooled intention to receive COVID-19 vaccine globally was 67.69%. Higher levels of perceived susceptibility (AOR = 1.85), perceived severity (AOR = 1.45), perceived benefits (AOR = 3.10), and cues to action (AOR = 3.40) positively predicted the intention; whereas high level of perceived barrier negatively predicted it (AOR = 0.53). Health beliefs influenced COVID-19 vaccine intention globally. This implies that individuals need sound health education and publicity about vaccines before vaccination.

This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity\'s effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.

On-chip electrostatic discharge (ESD) protection is required for all integrated circuits (ICs). Conventional on-chip ESD protection relies on in-Si PN junction-based device structures for ESD. However, such in-Si PN-based ESD protection solutions pose significant challenges related to ESD protection design overhead, including parasitic capacitance, leakage current, and noises, as well as large chip area consumption and difficulty in IC layout floor planning. The design overhead effects of ESD protection devices are becoming unacceptable to modern ICs as IC technologies continuously advance, which is an emerging design-for-reliability challenge for advanced ICs. In this paper, we review the concept development of disruptive graphene-based on-chip ESD protection comprising a novel graphene nanoelectromechanical system (gNEMS) ESD switch and graphene ESD interconnects. This review discusses the simulation, design, and measurements of the gNEMS ESD protection structures and graphene ESD protection interconnects. The review aims to inspire non-traditional thinking for future on-chip ESD protection.