One of the public fundamental disciplines that is typically put up among the professional teaching units in universities is dance. In order for this sports project with fitness, mental health, and aesthetic functions to be widely developed in universities, the use of reasonable, scientific, and targeted teaching methods can effectively improve the instructional effect. At the same time, it has further promoted the quality of education in universities and implemented the guiding ideology of “health first.” In order to avoid the classifier's performance-degrading effects brought on by the high dimension, this research suggests combining the classifier's psychological stress identification algorithm with a particle swarm optimization (PSO) approach. The experimental findings reveal that the PSO-SVM algorithm, PSO-BP algorithm, improved PSO-SVM algorithm, and improved PSO-BP algorithm, respectively, have recognition rates for psychological stress of 82.50%, 84.50%, 90.17%, and 94.83%. Additionally, the recognition rates of the improved PSO classifier are significantly higher than those of the basic PSO algorithm, demonstrating the improved PSO algorithm's strong generalization ability in optimization. With the introduction of western advanced ideas and industrial technology into China in the 19th century, it also brought different national cultures, among which ballroom dancing, the predecessor of sports dance, was one. This new dance was gradually accepted by the upper class and developed in China's coastal areas such as Shanghai, Guangzhou, and Tianjin .In the 21st century, sports dance has been known by more people, competitions of different sizes have emerged in an endless stream, and dance exchanges between China and foreign countries have become closer and closer. Chinese players have emerged in the international arena, demonstrating China's strength. People who study sports dance have developed from the middle-aged to the younger age, and more children and teenagers have become important people and reserve talents in sports dance learning . Since tWith the development of network technology, network resources grow rapidly, and rich network information resources become an important source for people to obtain information . HoweverAccording to psychological research, the assessment methods of psychological stress mainly include stress response questionnaire, life event resolution questionnaire, and perceived stress scale. Although these methods can roughly evaluate the educational psychological state of the tester, they are not accurate enough and have certain subjectivity. Nowadays, the collection and processing technology of physiological signals is more and more mature, and the physiological signals can effectively and accurately reflect the psychological stress state of the human body, and will not have too much impact on the tester. Therefore, it is an internationally recognized effective way to use physiological signals to evaluate stress. Therefore, in the teaching process, in addition to the conventional sports teaching methods, according to the characteristics of sports dance, scientific and targeted teaching methods should be adopted to improve the instructional effect, make up for the deficiencies in the above aspects, and further improve the sports dance theory, which has both practical and theoretical significance in sports dance teaching. In addition to constructing the support vector machine classification model and the SVM network model, this paper also introduces the particle swarm optimization algorithm. It trains and evaluates the classifiers using a particle swarm optimization approach combined with the two classifiers. This study enhances the particle swarm optimization (PSO) algorithm, adopts the particle swarm optimization model with contraction factor, ensures convergence of the PSO algorithm by choosing suitable parameters, and eliminates the speed boundary limit in order to increase the recognition rate of psychological stress. The SVM neural network and the support vector machine method are then optimized using the basic and advanced particle swarm optimization techniques in combination with the two classifiers, and the simulation results of the four algorithms are compared and examined.Most of the research of Chinese scholars on the instructional mode of dance sports in universities is based on experimental research and current situation analysis. They have not comprehensively analyzed and summarized the instructional mode of dance sports in universities and have not built a complete and stable instructional mode and framework according to the characteristics of the discipline. Therefore, this study hopes to play a role of guidance and reference. Constructing the instructional mode and framework of sports dance in universities plays an active role in improving the teaching theory of sports dance.Bortnyk, based on the psychological and physiological characteristics of different groups and the macroteaching concept, qualitatively put forward the significance of heuristic and exploratory teaching methods in sports dance class and matched reasonable assessment methods to achieve the teaching objectives . Jooste Since the new century, with the rapid and orderly development of China's contemporary social science and technology research, economic construction, and cultural construction, the talent factor has gradually become a representative factor to support and assist countries around the world to achieve rapid, stable, and orderly development, which indirectly poses a great challenge to the talent training mode of universities being applied in China. Since the goal of the dance teaching curriculum is to train students to learn dance knowledge and master dance skills, it is also a key course for dance students to exercise their temperament and shape good bodies. How to effectively use the rich teaching resources on the Internet is a key problem that needs to be solved at present. Judging from the basic memory decline curve of human brain, students may not remember exactly the same dance movements as the previous teacher's body language demonstration, so this will weaken the core significance of dance teaching. Every demonstration or lecture by a teacher will partially limit students' learning and knowledge infusion, but it is entirely possible to realize this appeal if computer technology is used. For example, teachers record each demonstration action into the website and show the dance through some three-dimensional action software or auxiliary instructional mode. First of all, this instructional mode can greatly facilitate students, and they can watch the teaching videos online anytime and anywhere; Dance explanation is the basic link of dance classroom teaching.In the dance training class, the teacher's explanation work is divided into two parts. First, explain the essentials of movements comprehensively and accurately, which is the part of theoretical teaching. Second is to correct the shortcomings of dance movements in dance training, which is the part of practice teaching. In this learning stage, teachers' language foundation is particularly important. They can summarize the specific contents and essentials of movements in concise and accurate language, enhance students' interest in dance learning, and improve their own dance level. As a teacher majoring in dance, he or she has been engaged in dance education for many years, or he or she has been an actor with rich stage performance experience. He or she should be familiar with the background knowledge of the dance he or she teaches, and can also supplement it in many ways. During the teaching work, rich historical and cultural knowledge and vivid language can fully arouse students' interests and help them understand the real connotation of the dance content. That is to say, just like all teaching work, the main purpose is to cultivate talents, among which professional level and moral quality are equally important. Teachers practice and preach with rigorous language, so that students can experience a rigorous attitude towards learning. Explain and practice classroom discipline requirements in person. Students can listen to teachers' language, observe the emotions expressed by teachers' language, and understand teachers' requirements in the classroom. Over time, students will establish a correct attitude towards life, which will be of great benefit to students' dance learning and even their whole life. Of course, in this process, dance teachers are strict with their own behavior, which plays a good role in demonstrating and setting an example. The roles of each component of the system have been organized in accordance with the demand relationship among administrators, instructors, and students that was examined above. Eight primary design tenets are covered by the online dance instruction system's design principles and goals: affordability, security, expansibility, progression, dependability, practicality, simplicity, and hierarchical modularity. Below, they are fully studied and expanded upon. The two common software architectures are C/S architecture and B/S architecture. Currently, the client/server architecture, often known as C/S (Client/Server), is one that is frequently used in software. The existing Internet's requirements, the trend of multiparty interconnection, global network opening, and information globalisation cannot be met by the classic C/S architecture, which is why the B/S architecture is progressively gaining popularity. When this architecture first appears, it challenges people's preconceived notions of conventional software architecture and offers software engineers a fresh perspective on their work. The architecture of the remote dance instruction system proposed in this paper is depicted in http://asp.net, JavaScript, and ADO Net, which is connected with the back-end database server while transmitting and receiving data through the HTTP protocol. It basically performs the following tasks: uploading the video resources for teachers' courseware, retrieving the list of teachers' uploaded resources, querying students' information, querying students' courses, and online learning and course selection.Three blocks, the client, the network server, and the database server, make up the usual three-layer B/S physical structure in the architecture diagram of the remote dance instruction system illustrated in Dance psychological factors belong to a branch of psychological factors. It makes relevant exploration and research on psychological factors in dance performance and teaching, and provides theoretical basis and scientific basis for dance teaching. Information security with information hiding technology as its core technology is disguised information security. The difference between camouflage information security technology and traditional password technology is that password only hides the content of information, while information camouflage hides not only the content but also the existence of information. Camouflage information security technology provides a security mode different from encryption, and its security comes from the paralysis of the perception of the third party. In this process, the role of carrier information actually includes two aspects: (1) providing a channel for transmitting information; (2) Provide camouflage for the transmission of hidden information.The interdisciplinary or marginal disciplines formed with various disciplines of psychology, such as cultural psychology, educational psychology, and sports psychology, are still new disciplines in China. Especially art psychology, dance psychology, performance psychology and so on, are all under construction. The so-called performance psychology refers to the sum of the behaviors and mental activities related to dance activities and their interactions. Singing psychology is a new discipline that studies the psychological phenomena and teaching practice of dance teachers, students, and all performers. It can help us deeply understand the internal relationship and objective laws between dance and brain thinking activities, so as to improve the teaching level of dance teachers, enhance students' learning ability and give full play to dancers' stage performance level.Eberhart and Kennedy in the US proposed the PSO algorithm in 1995. It is an algorithm for optimization that mimics fish and birds. PSO's origins can be traced to the discovery, following observation of some animals' social behaviors, that animal groups' contributions to knowledge have evolutionary benefits. This algorithm was then built around this discovery. Although individual creatures in nature lack intelligence, the entire biological community is capable of solving challenging issues. PSO technique was initially employed to address continuous optimization issues. Artificial intelligence has now been applied to combinatorial optimization issues as a result of ongoing research in the field. It has been highly respected and extensively researched by academics since it not only preserves the original global search method but also has easy operation compared to genetic algorithms and can dynamically adapt the search circumstances of currently tracked particles.i = T, and by comparing every particle, we can determine the optimal position for the entire population. When the optimal solution is found, the next generation of particles can be calculated by formulas  calculate the fitness value and evaluate the fitness of each particle; (3) update the individual optimum fitness value of each particle; (4) compare the current fitness value of each particle with the fitness value of the best position Gbest, and update Gbest if it is better than the fitness value of the best position; (5) calculate the particle's velocity Vi and position Xi by formulas (The steps and flow of particle swarm optimization are as follows: 1) initialize the particle swarm, and randomly set the initial position  initialiarticle;  calculatMost traditional pattern recognition methods need more training samples, and many practical applications have fewer training samples. Therefore, for a small sample set, the best model trained by machine learning does not mean that it has the best prediction ability. Therefore, how to obtain the best prediction model based on small samples has gradually become a hot and difficult point in the research field of pattern recognition. Support vector machine is a classification algorithm, which is based on statistical theory and adopts structural risk minimization criteria. It has strong generalization ability, especially for pattern recognition problems, such as small samples, nonlinear, and high-dimensional numbers. Support vector machine (SVM) was first derived from the linear separable optimal discriminant surface and then developed further. Then, when classifying the space with higher dimensions, the goal of SVM is to find the hyperplane so that each sample has the maximum distance from it. However, when we apply this algorithm to practical projects, we will find that most of the data in practical applications do not have linear separability. At this time, we will take some measures to solve this problem. At present, the most commonly used measures are to introduce relaxation variables and kernel functions, so that the data can be linearly separable by introducing these two models.∂(•) and then use this function to train the set. x is mapped into a high-dimensional space, and the formula is shown inWhen encountering nonlinear problems, we need to introduce the nonlinear function In the nonlinear case, the hyperplane is shown inThe decision function is shown inξi ≥ 0, and formula , and the formula is shown inThe kernel function introduced in this paper is The duality of the optimal hyperplane problem is described asThe corresponding decision function is shown inFrom the above formula derivation, it can be seen that the choice of kernel function is very important for SVM classification algorithm, and different kernel functions will have different classification results. At present, the most widely used kernel function in practical engineering is radial basis function, which is a nonlinear mapping method. This method maps the sample space to high-dimensional space, thus transforming it into a linear problem and solving the relationship between class attributes and classes. Therefore, this paper chooses radial basis function with certain advantages.C and kernel parameter g in SVM. The simulation process is shown in The system mainly uses the ECG acquisition circuit and NI myRIO as the data acquisition platform, and carries out software design based on the platform. Through software design with good architecture, the functions of hardware can be fully developed. At the same time, a good software development environment is very helpful to improve the performance and development efficiency of software. The PSO algorithm is used to optimize the error penalty factor C and G obtained by calculation are C = 5.6541 and G = 8.6218, where the number of iterations is 100. As can be seen from As can be seen from Without knowing the mathematical equation underlying input-output mapping relationships, SVM has the advantage of learning and storing a large number of input-output mapping relationships. The weights and thresholds will, however, have a significant impact on the training results for the BP neural network. As a result, the PSO algorithm is used in this research to optimize the SVM's weights and thresholds. PSO-SVM has 150 sets of training sample data and test sample data, similarly. 70 groups of data from low-pressure sample groups and 80 groups from high-pressure sample groups. In order to train the network, 55 sets of low-voltage sample data are extracted, and 15 sets of data are used for testing data in order to assess the network's capacity for classification. In contrast, 65 sets of high-voltage sample data are extracted in order to train the network, and 15 sets of data are used to assess the network's capacity for classification. PSO-SVM and improved PSO-SVM simulation results, as well as PSO-BP and improved PSO-BP simulation results, are compared. The modified PSO-SVM algorithm has a recognition rate for pressure that is 90.17% on average, which is higher than the recognition rate of the PSO-SVM algorithm. N-network experiment is 84.50%, as shown in The average recognition rate for the PSO-SVM through The classification accuracy of enhanced PSO-optimized BP is 93.33%, that of basic PSO-optimized BP is 86.67%, and that of improved BP is increased by 6.66%, according to the simulation experiment in This paper examines the background and significance of the topic selection of moral education penetration in dance teaching in universities, the review of the literature on this subject, the theoretical underpinnings of moral education penetration in dance teaching in universities, and the problems that currently exist in the process of moral education penetration in dance teaching. Since the inception of modern dance thinking, the idea and practice of teaching rhythm have been developed. It delivers not just a fresh approach to instruction but also a universal truth about the core of dance. It is both a rational step away from traditional dance schooling and a return to it. With the development of body rhythm, people have realized that in order to learn dance, one must first experience and learn body rhythm. This will not only help students to understand the true meaning of dance, but it will also help them to improve their sense of body rhythm and coordination, enhance their artistic sensibility and expressiveness, and help them to open their imagination and creativity. In order to identify and assess the psychological state of the human body, this paper proposes to use HRV signals. Then, using this information, it will analyze and reflect the heart rate variability characteristics of dancing activities and determine how the rules change under various stress conditions. As a result, it can more accurately analyze and identify education psychology and achieve the detection of dance education psychology.


While trust in the research process does not guarantee participation, trust is a precursor for those who decide to engage in health disparities research. Key findings will be integrated into the RCHDR research agenda to foster further development and implementation of innovative community-based participatory research toward the control and/or prevention of diseases that disproportionately affect minority and under-represented populations in Mississippi.Trust is critical to the development and maintenance of effective research collaborations and community engagement. The purpose of this study was to assess the current attitudes and level of trust pertaining to health research among residents of Central Mississippi, the priority health region for the Research Centers in Minority Institutions (RCMI) Center for Health Disparities Research (RCHDR) at Jackson State University. The cross-sectional study was conducted from November 2021 to April 2022. The data were analyzed using descriptive statistics carried out by SPSS statistical software. A total of 146 participants responded to the survey. The participants were predominately African American (99%) and female (75%). Historical research studies, the researchers’ qualities, and potential benefits from participation were factors affecting the level of trust in the research process. Ninety percent ( Trust, according to Webster’s dictionary, is defined as confidence, reliance, or resting of the mind on the integrity, veracity, justice, friendship, or other sound principles of another person. Trust is also defined as one’s belief that an entity  will act in one’s best interest. Trust is critical to the development and maintenance of effective collaborations and community engagement. It improves satisfaction with the research study, as well as results in better study outcomes ,2,3. ResConsequently, the mistrust for medical research and scientists was rooted in the African American community prior to the Tuskegee Syphilis Study. The lack of trust in health and medical research among African Americans can be traced to the incidents of medical experimentation and mistreatment during the pre- and post-civil war slavery period ,14. BefoIt is widely accepted that health research that includes members of the priority population as active contributors to the research process results in improved study outcomes and adherence to the findings ,17,18,19In a foundational study on community trust, Corbie-Smith  acknowleThe Jackson Heart Study (JHS), a twenty-year longitudinal study to examine cardiovascular disease among the largest cohort of African Americans in the United States, demonstrates how incorporating community engagement priorities can establish trust and maintain the interest of the community in research. The participants’ trust strengthened through community engagement has resulted in high participant recruitment, participant retention greater than 80%, and the improvement in specific health outcomes among African Americans in the study ,28. AmonThe research on the importance of participants’ attitudes and perceptions of research is increasing. The current study is novel because it relies on the principles of community-based participatory research to assess the influencing factors for trust and participation in research. Acquiring a greater understanding of the intricacies involved in research trust as a means of improving African Americans’ engagement in research is the overarching goal of this study. Its purpose was to assess the current attitudes and level of trust pertaining to health research among residents in the Central Mississippi tri-county areas of Hinds, Rankin, and Madison, the priority health region for the RCMI Center for Health Disparities Research (RCHDR) at Jackson State University. Applying the specific principles of the CBPR model, the current study sought to understand the attitudes towards and levels of trust for health disparities research among individuals residing in three Mississippi counties served by the Research Centers in Minority Institutions (RCMI) Center for Health Disparities Research (RCHDR). The RCHDR relies on the support and engagement of its community members and seeks to share research findings and relevant health education materials with the lay community. Therefore, to establish a community-supported research agenda, the RCHDR Community Engagement Core (CEC) interacted with community members to better understand how the residents’ felt about the health disparities research being conducted in their communities. The following principles of the CBPR model were utilized throughout the study. Principle one, the community was informed of the study and recognized as a unit that should have input. Their input helped to address principle 5, ensuring information garnered and shared was relevant and there was value added for the community. Finally, principles 7 and 9 were addressed by keeping the community involved in the evolution of the study through an iterative process allowing for feedback on instrument development and validation and dissemination of findings.Adult men and women 18 years of age and older who lived in Mississippi and resided in any one of the target counties of Hinds, Madison, and Rankin, which are served by the RCHDR, were eligible to participate. The RCHDR CEC conducted a cross-sectional study from November 2021 to April 2022. The study was approved by the University’s Institutional Review Board (#0014-22). The purposive sample of 150 individuals residing in the tri-county area was established a priori. A snowball strategy was utilized to finalize the study sample where each participant was asked to identify other potential survey takers or to share the link with those residing in the selected counties. Survey participants were recruited by the researchers, as well as members of the RCHDR Community Advisory Board via word-of-mouth and text messaging. Other recruitment activities included: (1) Posting the study information on the RCHDR website; (2) Emailing the information to members listed on the University and partnering community organizations’ listservs; (3) Placing printed surveys with consent forms on-site at partnering organizations and agencies. The survey and consent forms were administered via online and printed formats. The consent forms included the following statement, “This study is completely voluntary, and you have the right to choose to or not to participate. If you choose to participate, you can stop engagement at any time or refuse to answer any one of the survey questions without fear of penalty”. The consent form was displayed online or as a hard copy. The consent form was signed before starting the survey. The initial approach to the distribution of the trust survey required posting the survey link on the Center’s website. After two months, there were only 40 completed responses. The CEC research team consulted with its Community Advisory Board (CAB) to identify strategies to increase survey completion. While different efforts were employed, such as emailing individuals, introducing a text message that included the survey link, which was sent to phone contacts, helped the research team meet the participation goal. n = 15) to ensure validity and interpretability. The pilot provided feedback on the readability and ease of answering the questions and the length of time needed to complete the survey. The recommendations included updating the questionnaire to include instructions on answering a “ranking of answers” question when responding through the online form and ensuring printed copies of the survey would be available for requesting partner organizations. Once the survey was updated, another review was conducted, and the final survey was approved. The final version of the 30-item questionnaire included questions about the demographics of the participants and their attitudes and views toward health research. Questions 1–6 collected demographic data that included age, gender, race and ethnicity, and place of residence. Questions 7–9 asked the participants’ level of participation in community activities, including research activities, and the type of participation. These were multiple-choice and open-ended questions. Questions 10–29 relied on a 5-point Likert scale, with answers ranging from ‘extremely important to ‘not important at all’, ‘extremely likely to ‘not at all likely, or ‘extremely trusted’ to ‘no trust at all’. Questions 10–16 solicited the participants’ level of trust in the research personnel and how certain factors influenced their trust in the research team. Questions 17–25 included questions about the participants’ views of the community’s participation in the research process. Questions 26–29 asked about their trust in the COVID research and their willingness to participate in the COVID research. The last, question 30, asked the participants to rank the importance of health issues to be considered for future research endeavors. The choices were determined by the chronic illnesses listed on the Mississippi Department of Health’s website. Refer to The community trust instrument was adapted and customized from a previous instrument utilized by the JHS Community Engagement and Outreach Core. Three authors drafted the structured questionnaire, which was revised after feedback from another expert from the JHS at Jackson State University. The survey was created in Qualtrics XM. The survey was piloted with the Community Advisory Board (https://www.ibm.com/spss). Categorical variables were described using frequencies and percentages. Descriptive statistics are specific methods that enable the researcher to use, calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics enable the researcher to present data numerically in the document and/or in its tables, or graphically in figures and charts. Descriptive statistics were employed to present the characteristics of the population under investigation and allowed the researcher to communicate the results of the analyses to the local community and other interested parties and stakeholders. Descriptive statistics are appropriate for presenting the data to the lay community [This study used a descriptive research design. The data were analyzed using descriptive statistics carried out by SPSS statistical software , and two of the participants were white. Demographic details are presented in Forty percent had no previous experience in research or community engagement. The remaining 60% had one or more years of involvement in research or community activities. The largest group of participants (43%) had planned community activities and 35% were first-time participants. n = 108) of survey respondents expressed that the historical Tuskegee Study was important when considering participating in research. Nearly 94% (n = 136) of the survey participants agreed that a researcher’s prejudice can affect their trust in the research and 96% (n = 141) acknowledged that the researcher’s attitude was important for gaining their trust. Most of the participants, 98.50% (n = 144), agreed that the researcher’s knowledge was important in establishing trust in the research process. Nearly 80% (n = 116) of the respondents would like the researchers to look like them. More than 50% (n = 131) expressed that it was important to be involved in the research process, and 98.50% (n = 144) agreed that discussing the research findings with the participants was important for establishing trust in the research process. Additionally, having the support of the community leaders, including pastors and health advocates, would increase the level of trust among 92% (n = 131) of the respondents. Ninety-six percent (96%) believed that the research findings were likely to benefit their communities. Ninety percent  Center for Health Disparities Research at Jackson State University. The study sought to identify factors that could influence community trust in the research process and research engagement. While trust in the research process does not guarantee participation, trust is a precursor for those who decide to engage in the health sciences research process. Researcher’s attitude;Researcher’s race;Researcher’s knowledge;Participant engagement;Sharing study findings;Benefits to the community;Community leaders (stakeholder) engagement;Incentives/resources garnered from participation.The results of this study serve to emphasize the importance of trust for study participation, particularly among African American communities. The responses of the participants signified that establishing trust involved several factors. They are the following:Trust is instrumental in inspiring community members to participate in research activities. Many of the participants had no previous experience in research or community engagement, and more than half of the survey respondents expressed that the historical Tuskegee Study was important when considering whether they will participate in the research. Many of them are still mindful of the fact that community members participating as research subjects had their rights violated. In addition, a variety of other ethical issues, such as informed consent, racism, paternalism, unfair subject selection in research, maleficence, truth-telling, and justice, were synonymous with that study. While about two-thirds of them had one or more years of involvement in research or community activities, less than half of the participants had planned community activities experience, and one-third of them were first-time participants.Most of the survey participants agreed that a researcher’s prejudice can affect their trust in the research and most of them acknowledged that the researcher’s attitude was important in gaining their trust. So, there are sometimes caution warning signs aroused when the rigor, objectivity, and validity of the researchers’ work come into question. In such cases, researchers’ work is believed to be driven more by their own vested interest or personal agenda.The participants also indicated that they believed the researcher’s knowledge was important in establishing trust in the research process. In biomedical research, in particular, the absence of trust is a serious threat to the success of any research enterprise. The majority confirmed that they would like the researchers to look like them.Most of the participants understood that it was important to be involved in the research process, and they believed that discussing the research findings with the participants was important for establishing trust in the research process. Scholars believe that trust in communities can also translate to other types of successes and accomplishments, such as stronger volunteerism, healthier residents, as well as economic prosperity. The participants in this study believed that having the support of the community leaders, including pastors and health advocates, would increase the level of trust. Participants were convinced that the research findings were likely to benefit their communities.The research suggests that African American participation in health research and clinical trials has been limited ,6,12. DeResearchers, such as Thetford and colleagues  and PeekImproving the level of trust in the research process with the hopes of increasing participation requires transparency and a willingness to disclose truthful details regarding risks and benefits . This waNearly 70% of participants agreed that financial incentives were important, and 57% agreed that some form of compensation other than money would increase their participation in the research; noting that this gesture demonstrates that the researchers value and respect the participants’ time and commitment. As the number of projects implemented in the community increases, the public is becoming more aware of the financial investments and gains for the researchers ,27. In tOverall, the survey participants expressed trust in the research process and their attitudes suggested future engagement in trustworthy research projects led by credible researchers.The current study provides results for a very small sample of the predominately African American population in select counties, and therefore, may not be generalizable to other racial groups or those who do not reside in the study area. Recruitment bias may affect the generalizability of the findings. Utilizing the snowball strategy for recruitment can attract participants from friend groups with similar attitudes and views pertaining to a topic. As a cross-sectional study relying on an online survey, willing participants without internet access were unlikely to complete the questionnaire and we were unable to expound on various points of interest, including personal reasons for the trust in the research process. For this study, not all participants responded to every survey question, so there are missing data.The state of Mississippi has historically and continuously had the worst health indicators in the nation and its African American residents, who are disproportionately affected by many diseases ,31 couldThe study supports policies that will inform and train minority communities to work on the research studies and establish standards for community incentives and sustained resources. Policies and programs should focus on ensuring the next and future generations of minority researchers in addition to providing tailored learning opportunities that prompt and sustain their involvement. This would include ensuring versions of the protocol and findings are accessible and translated for their comprehension. Research sponsors may find it beneficial to ensure trusted community-based organizations and representatives are primaries on the projects and recipients of funding, guaranteeing that resources are assigned to facilitate the execution of their roles and tasks. The study findings support the importance of the relationship established between the researchers and the community members. The researchers are the face of the process and the first point of interaction to foster the trust required to engage the community members in research discovery. There is a growing consensus that researchers who represent the racial and ethnic distinctions of the study participants can improve trust and create a sense of comfort among those participants ,24. Rese


Powered exoskeletons are typically task-specific, but to facilitate their wider adoption they should support a variety of tasks, which requires generalizeable controller designs. In this paper, we present two potential controllers for ankle exoskeletons based on soleus fascicles and Achilles tendon models. The methods use an estimate of the adenosine triphosphate hydrolysis rate of the soleus based on fascicle velocity. Models were evaluated using muscle dynamics from the literature, which were measured with ultrasound. We compare the simulated behavior of these methods against each other and to human-in-the-loop optimized torque profiles. Both methods generated distinct profiles for walking and running with speed variations. One of the approaches was more appropriate for walking, while the other approach estimated profiles similar to the literature for both walking and running. Human-in-the-loop methods require long optimizations to set parameters per individual for each specific task, the proposed methods can produce similar profiles, work across walking and running, and be implemented with body-worn sensors without requiring torque profile parameterization and optimization for every task. Future evaluations should examine how human behavior changes due to external assistance when using these control models. Exoskeletons have the potential to enhance human function under a variety of conditions, with many individuals who would benefit from external assistance . Designing exoskeletons specialized for individual tasks results in mechanical designs, as well as controllers, which are highly tailored to their assigned task, thereby limiting their versatility. This paper will present two controllers that have the potential to provide personalized assistance across a variety of tasks, using active ankle exoskeleton control as a test case. The ankle is an area of particular interest for exoskeletal assistance, as it is a key contributor to propulsion in gait –3, and uResearchers have previously used a variety of approaches for controller creation, including heuristics –13; optiIt would ultimately be preferable to develop a universal controller that is applicable across tasks, eliminating the complexities of mode switching or parameter selection. Development of a universal controller requires understanding the influencing factors, which depend on the goal of the exoskeleton. A common objective is the reduction of metabolic cost , 12, 13 Walking and running are useful first areas to explore for general controllers, while covering a large portion of the common locomotion types. In a typical walking or running cycle, the leg accepts the load in early stance when the foot strikes the ground, tensioning the Achilles tendon. Then the body moves in front of the foot, which further tensions the tendon. When the stance phase terminates with the foot pushing off the ground, the energy stored in the tendon is released, and the leg then swings through to restart the cycle. Initial exoskeleton controls designed to support gait explored mimicking the human ankle joint torque profile to assist the user , 20. HowHITL optimization of assistive torque profiles accounts for hard-to-model aspects of the whole human-exoskeleton system, such as changes in muscle activation at other joints in response to the provided assistance. This method optimizes parameters of a general torque profile for an individual using an objective function, eliminating the assumptions that come from trying to apply a model to individuals with different physical characteristics , 10, 15.Recently, Slade et al.  attempteIn addition to the power and HITL-based approach, energy shaping has been used to create controllers that generalize across ground slopes . Energy An alternate strategy is to use direct measurements of the muscle length/velocity to define the torque profile. Nuckols et al. used ultrasound measurements of the soleus velocity recorded while walking, which were quickly analysed offline , uses the ATP model for both fast and slow twitch muscle, where Asnet is a scale factor on the estimated muscle-tendon unit (MTU) force (F) converted to a torque through a conversion factor (CF). This scaling modifies the torque such that assistance is applied in the most ATP expensive portions of the gait cycle, i.e. when the fascicle shortening velocity is high, primarily in the second half of the stance phase. The second proposed controller, deadbanded (DB), applies the magnitude of a modified ATP usage model as the input to the ankle exoskeleton. The ATP model is modified with a deadband around fascicle speeds less than the speed when the tendon reaches its peak stretching velocity, limiting the potential for the exoskeleton to interfere with energy storage in the Achilles tendon, functionally shifting the curve. The peak values for each model were scaled to match the nearest speed HITL reported in the literature , in peak values FS  Nm/kg to DB  Nm/kg. For the two higher speeds, DB generated a torque application in early stance due to the bi-modal fascicle velocity, As with walking, FS and DB. While onset of FS occurred within the range of onsets for the HITL optimized profiles, the peak and offset occurred earlier, which can also be seen in DB was within the HITL range for both onset and peak, but offset occurred prior to the HITL range, although it was the closest method for running. The response of CS and FD for running matches that of walking, where DB had greater similarity, although we can only compare for a single speed in running.In DB appears to be the strongest candidate, as it does not require any knowledge of muscle force, while producing torque profiles with similar timings to the HITL profile for both walking and running.FS is well suited for walking, but requires an estimate of fascicle force and does not generalize as well as the other methods, as seen by the early peak timing for running, This paper explored two approaches for estimating a task-invariant ankle exoskeleton torque controller based on ATP models.DB does not necessitate an estimate of the muscle force, but it does require understanding the interplay between muscle contraction and tendon loading. To benefit from the passive energy storage and return from the tendon, a low level of contraction is required so the tendon can tension. This approach used a deadband set to when the tendon was at its peak lengthening velocity, therefore limiting the amount of interference with tendon loading in early stance. However, the fascicle may lengthen . The gastrocnemius continues shortening and activating after the soleus at running speeds similar to 3.0 m/s . In thisDB, Late stance torque application may change the behavior of the fascicle, which may also impact the preferred speed of the person. The data set used for analysis had no external torque applied and at higher running speeds it is seen that there is a second mode in the fascicle velocity in early stance, The ATP-based methods are focused mainly on the energy used by the muscle, which is important to reduce as the energy use of this muscle impacts metabolic cost. But a large portion of the ankle joint power is coming from the tendon, and balancing the contributions of these two components is an open area of exploration.FS appears to be the most narrowly applicable when considering gait, limited to situations where the tendon stores less energy, like walking. For more dynamic tasks like running, where passive energy storage in the tendon becomes more important [FS is expected to be less effective, also indicated by our findings. When FS is applied to running, the peak occurs earlier than in DB due to the MTU force occurring around mid-stance, Of the methods explored in this paper, mportant , 36, FS This initial analysis provides insight into how modeling chemical processes in muscles can be applied in exoskeleton control and is a promising first step to creating a generalizable controller that can be applied in real time, while being adaptable to changes in activity. These methods can provide personalized assistance as they directly measure muscle fiber velocity. The direct measure accounts for the underlying physiological variability which causes differences in muscle fiber velocities that arise between different people for the same task. This section provides guidance on how to implement these controllers.The methods proposed here will require the ability to estimate fascicle and tendon velocity, with one model also requiring force. Two possible ways to determine these values are through the use of ultrasound and through the use of machine learning. Having multiple methods for estimating MTU force and fascicle/tendon velocity allow for multiple pathways for implementing control strategies requiring force estimates. Fascicle and tendon normalized velocity can be measured using ultrasound, as was performed by Lai et al. . UltrasoMTU force can be estimated from ultrasound images as well , which hThese models will require future human studies validation to assess the response of the controllers and wearer to each other, their effectiveness in reducing metabolic cost, and how parameters may change with different activities. While the purpose of this paper was to provide a biological basis for understanding and producing exoskeleton torque, the level of complexity and fidelity required of the models is an open question. The models used in this paper only look at a single muscle with a simplified architecture. This local view from a single muscle does not account for the influence the external torque has on the whole system, which is taken into account in HITL optimization. If these changes in the whole body impact the metabolic cost, the local approach may not be as effective, although the soleus has been shown to correlate with overall metabolic cost when external torque is applied . FurtherMuscle pennation angle was not included by Lai et al.  and the Another limitation of using data from multiple sources is that the alignment of data can create errors. Lai et al.  reportedUltimately, these control strategies need to be implemented with people to understand their effectiveness and how they modify the behavior of the MTU during active exoskeleton assistance. This validation testing will also provide insight into the appropriateness of the way the profiles change with speed. The ultrasound data was collected without any external assistance, so it is unclear what changes occur in the MTU dynamics as a result of the addition of a specific external torque profile. The data comparisons between the HITL data and the data for unaided walking were collected on different individuals under different conditions. In the future, ultrasound data should be collected during HITL optimization and during application of other torque profiles, such as those proposed here, to allow analysis of individual responses to the external torque profiles. As part of this extended collection, HITL profiles should be created for a variety of speeds for both walking and running, allowing for a greater understanding of how speed influences the HITL profile. As the proposed methods generate different profiles with speed changes, having a collection of HITL profiles at different speeds would allow us to understand which of the different approaches most accurately reproduce the changes seen with changing speed. Additionally, because there are differences in timing for individuals in the HITL profiles, further study is needed to understand if these individual differences can be accounted for with the proposed methods. This validation could be completed using direct measures of the fascicle velocity or individual MTU properties to estimate the fascicle velocity. Also, the amount of error and variability in the timing of key points and magnitude of the profile should be further studied to understand the sensitivity of the metabolic cost to changes in timing and magnitude, as the sensitivity is currently unknown.DB control suggests that it may be advantageous to apply torque to reduce fascicle velocity. Directly controlling the external torque to allow for moderate fascicle shortening can reduce energy usage while still allowing for tendon loading. All of the methods mentioned are areas of open exploration, but incorporating biological models into the control system has the potential to create generalizable control strategies, reducing the specialization that is currently seen in exoskeletons.There are additional opportunities to create new controllers based on MTU dynamics . The DB N = 10) and individual data was not available. The fascicle lengths and velocities were calculated from B-mode ultrasound images using automated feature extraction with manual correction when automation failed or produced poor feature identification [N = 11) and Witte et al. [N = 12), respectively. The central HITL line is generated from the mean parameters of the study participants, the range was generated by finding curves of the max and min values across all the study participants. The EO profiles were generated using the values reported Slade et al. [N = 3) and interpolated to find the corresponding torque profile at the speeds reported by Lai et al. These references are used for model inputs and parameters and their use is described in the following sections.This paper relies entirely on data from the literature as inputs to the proposed models. The ultrasound data used for the muscle dynamics, the joint angle, and torque come from Lai et al. . These nfication . This aufication . Normalification . These dfication  (N = 11)e et al.  (N = 3) Muscles fibers are a collection of sarcomeres which are composed of actin and myosin fibers. When muscles contract, the heads of the myosin fiber bind to a site on the actin fiber, causing the shape of the myosin fiber head to change, pulling the actin fiber with it, at which point the actin fiber is released. To reset the shape of the myosin head, ATP is converted to adenosine diphosphate (ADP) at which point the cycle can start again . Muscle M (the asymptotic limit to the ATP hydrolysis rate at infinite velocity) and D  are parameters of a hyperbola that were fit by He et al. [VCE is the fascicle velocity (contracti le element), l0 is the resting length during static standing, and As is the ATP hydrolysis rate due to fascicle velocity.Since ATP is used to power the muscle contraction, the amount used can estimate the energy used by the muscle, although other metabolic processes tied to ATP usage, such as ATP re-synthesis, also play a role , 54. Thee et al.  to theirThis model of ATP usage was used to estimate the energy to plantarflex the ankle by the uni-articular soleus muscle. The soleus was selected as the only muscle contributing to ankle plantarflexion for generating a simplified energy profile, as it has been correlated with overall metabolic cost for walking , 55 and Rslow = 0.8 and Rfast = 0.2, where R is the fraction of the muscle that is composed of slow twitch or fast twitch muscles fibers. For eccentric contractions, a correction factor of 1/2.7 was applied to account for changes in energy usage due to joint speed. The actual correction factor for the muscles fibers of the soleus may differ, as this value was experimentally determined for knee joint velocity [The original model was developed for concentric contractions where the fascicles only shortened  and we evelocity . This siAsnet by the muscle force, Asnet. A constant moment arm (4.2 cm) for the Achilles tendon was used to convert joint torque to muscle-tendon-unit (MTU) force, F. The moment arm value was selected as the mean value between 20% and 60% of the walking gait cycle, the period when the soleus is most engaged. The specific value was calculated by Rasske et al. [F is multiplied by a scale factor, using a different constant value for the moment arm would not affect the findings of this paper with respect to the shape of the torque profile, but will alter the scale factor used. The linear muscle force scaling was used as the energy consumption versus force relationship of muscles has been shown to be approximately linear [The first model utilizing the ATP hydrolysis rate for exoskeleton control is to multiply e et al.  using uly linear . As withy linear . As the CF was defined. For both walking and running at the speed most similar to the HITL profiles from the literature [CF was selected so the HITL profile and FS profile would have the same peak magnitude. All walking data of FS used the CF value from the 1.4 m/s case, and all running data used the value from 3.0 m/s. This scaling was selected to allow for comparison of overall shape of the different methods at the speeds we have HITL data, but CF could be made into a continuous function to account for different speeds or activities.FS then becomes a torque profile based on the energy used by the muscle and the MTU force.To scale and convert the ATP hydrolysis rate to a normalized torque, the scale factor terature , 10, 1.4terature , CF was FS as in this region the joint torque is low. To this end, the fascicle velocity when the tendon reaches its maximal lengthening velocity  in place of As(VCE), multiplied by a scale factor, Cshifted, calculated in the same way as CF so that DB and the HITL profile have the same peak magnitude for similar walking and running speeds, As with The HITL profiles from the literature , 10 had Time points are important for confirming that actuation is being applied at the appropriate regions of the gait cycle, and for understanding details of the profile shape, but they don’t capture similarity of the overall shape. To evaluate overall similarity, the cosine similarity (CS) and Fréchet distance (FD) between the proposed methods and the HITL profile were calculated for the closest speed. For CS, the stance phase of the profiles were sub-sampled into 101 points , these were then treated as vectors in S1 DataThis compressed folder contains README.md, which contains instructions for running the code; UltrasoundModeling.m, a Matlab/Octave file which contains the code used to generate the plots and values found in this paper; a Digitize folder which contains comma separated variable (csv) files of the data from Lai et al.  digitize(ZIP)Click here for additional data file.


Researchers grapple with a challenging and consequential decision each time they choose a journal for manuscript submission. There are several online tools that attempt to identify appropriate journals for a manuscript, but each of these tools has shortcomings in terms of the journal data they provide and the exploration functionality they offer—and not one of these tools is open source. Jot is a free and open-source web application that matches manuscripts in the fields of biomedicine and life sciences with suitable journals, based on a manuscript's title, abstract, and  citations. Jot gathers a wealth of data on journal quality, impact, fit, and open access options that can be explored through a dashboard of linked, interactive visualizations. Journal articles are the currency of academic research. The reputation and career advancement of an individual researcher is influenced not only by the importance of their published results, but also by factors such as the number of articles they publish, the number of times their articles are cited, and the prestige of the journals that their articles are published in ,2. PubliJournal selection is not only consequential but also a challengingly complex decision. Journal selection has implications for readership, discoverability, accessibility, preservation, publication costs, time to publication, availability of download statistics, and rights accorded to reader and author . This wiTo support researchers, tools have been developed that match manuscripts with journals by manuscript title, abstract, and (in some cases) citations –8. TheseJot builds upon the API of Jane  . For a tJot uses the Bokeh library  to generWith the 'prospect' metric:we provide a rough, relative metric of the elusive 'probability of acceptance by a journal, capturing the ratio of 'things in favor of a manuscript' to 'all considerations for or against a manuscript'. In favor of a manuscript are the number of times the manuscript cites the journal (C) and the number of similar article matches for the journal from abstract and title queries . The impact (I) of the journal counts against the prospect with a scalar weighting factor (w). Laid out in a scatter plot of prospect vs impact, the Prospect view indicates journals that provide a good fit for submission . Users cSimilar articles are displayed on a similarity-score axis and colored according to the associated query (abstract or title). C, A, and T are tabulated in a central grid, accompanied by a histogram of impact values .An interactive table  providesScatter plots quantify impact versus three metrics of journal relevance, or 'fit': the sum of C, A, and T; the sum of article similarity scores; and the maximum similarity score .Journals that are not present in DOAJ but that do offer open-access pathways can be identified by following the Sherpa Romeo links in the Table view.Users can navigate to the journal listing in the NLM Catalog or article page in PubMed Central by clicking on the corresponding scatter plot marker.Results from the user's most recent search are stored within the browser session, allowing them to be explored again on subsequent visits to Jot. User preferences for impact metric and weight are also stored and used automatically with future searches.A download button on the Results page saves the full Jot dashboard to a single HTML file (with embedded JavaScript).Anyone can run—and tinker with—their own Jot server using our open-source Python package journal_targeter (GPLv3 license), available from the Python Package Index (PyPI) and GitHub . The CLIFor this very article, we used Jot to identify the Journal of the Medical Library Association (JMLA) as a desirable target journal, and one with which, prior to this work, we were not familiar. We selected a journal-citation metric, Source Normalized Impact per Paper (SNIP), that enables normalized comparisons between journals from different disciplines. JMLA stood out on our plot of prospect . Indeed,Selecting the five-journal subset identified by the quality indicators and switching back to the Prospect view, we see that they separate from the pack, lifted off the curve of lower-relevance journals , by the prospect of its acceptance, and according to the publishing attributes most important to them.Jot reports every journal for which Jane returns a result based on title and abstract queries. Accordingly, Jot inherits aspects of both the journal curation and the textual similarity algorithm that are implemented by Jane. With regard to journal curation, Jane provides a warning that predatory journals can appear among its results, and this warning applies for Jot as well. Following Jane's example, Jot provides indicators of journal quality such as MEDLINE indexing, PMC archival, DOAJ indexing, as well as impact metrics from curated sources such as Scopus and JCR. With regard to the textual similarity algorithm, Jane's implementation assigns importance to words based on frequencies of occurrence in the query text compared to specific journal articles and across the PubMed dataset as a whole. Such word- frequency matching can yield results that would not correspond with human judgment—especially when low-frequency words are inappropriately matched to homographs (words that share spelling but differ in meaning). In our analysis of this manuscript, for example, two out of the three top similarity scores (54.55 and 53.07) stemmed from homographic matches on the word “JOT”—used as an abbreviation for The Journal of Orthopaedic Trauma. Consequently, users should be attentive to the possibility of spurious matches and should examine the article matches that Jot provides to verify the relevance of any suggested journal.We hope that by sharing Jot with the wider research community—without cost and with the freedom to modify, tailor, and improve it—authors can benefit from a more comprehensive and informed view of their publishing options. Jot has proven useful for our laboratory and has been enthusiastically adopted by our colleagues. One group expressing special excitement about the application during development was health-sciences librarians (Bronars 2013). The librarians we consulted while developing Jot were a wealth of knowledge about the landscape of open access, the consequences of metrics literacy, indicators of discoverability, and database curation and selectivity, and they were highly attuned to the value of tying together multiple sources of journal information. Health-science librarians frequently work with students and early-career researchers seeking guidance on where to publish. Jot could assist this guidance and could also prove useful for librarians seeking to publish their own research. Jot has helped us by directing us to publication of this commentary in the Journal of the Medical Library Association, presenting a high potential to reach a target audience of health science librarians who regularly encounter decisions of journal choice. The potential for a more comprehensive and informed view arising from widespread use of Jot may in turn facilitate more active competition among journals, and therefore desirable evolution of the ever-developing enterprise of scientific publishing and research communication.


Hormonal dysfunctions in women during pregnancy can cause vestibular and/or cochlear disorders.to study hearing and vestibular complaints in pregnant women.this is a prospective study. 82 pregnant women participated on this study. For hearing and vestibular complaints, a questionnaire proposed by Castagno (1994) was employed.we could observe that tinnitus was the main auditory complaint (33%), although with no differences between the groups. Tinnitus was present among 52.44% of the pregnant women, mainly in the Group 2. According to symptoms related to dizziness, vertigo was the main auditory complaint in first trimester, whereas instability and gait unbalance were more frequent in the second trimester, and instability and tendency to fall in the third trimester. Nausea was the main symptom associated with dizziness in pregnant women, being more frequent in the first trimester of gestation.women during gestation have auditory and vestibular complaints, mainly dizziness and tinnitus. The inner ear is an organ which has two functions; the cochlea is responsible for hearing and the labyrinth for balance. Alterations in these organs can cause major difficulties for human beings, such as reductions on the capacity to react to environmental sounds, to keep an effective communication with the environment or even to alter body balance.The hormonal alterations which happen during the menstrual cycle, gestation and menopause can result in changes in the homeostasis of labyrinthine fluids, since they have a direct influence on the enzymatic process and the action of neurotransmitters. The compromise of labyrinth fluid characteristics, as well as the interference on the sensitivity of enzymatic receptors influences the basal metabolism of the inner ear, which can justify otologic symptoms in women. These alterations can be asymptomatic or clinically referred to as vertigo, instability, tinnitus, ear fullness, hypacusia and algiacusiaSymptoms such as dizziness, tinnitus and sudden hearing loss were often times associated with the action of estrogen and progesterone on the cochlea, posterior labyrinth and central auditory pathways with hearingIn females, any change in the metabolism of steroid hormones (estrogen and progesterone), responsible for the ovarian cycle can cause complications, among them we list vestibular alterations. These alterations may be peripheral or central; they may occur during the normal menstrual cycle, during gestation, during menopause and during the pre-menstrual timeManifestations of vestibular disorders include: unbalance, gait deviations, gait instability, a feeling of floating, rotation and falls. These disorders affect the life routine; family, social and professional relations; cause loss of self-confidence, concentration and performance, concentration and work, causing frustration and depressionThus, both the clinical manifestations caused by vestibular disorders as well as auditory symptoms cause a drop in quality of life, bringing about physical and psychological loss.Therefore, because of the close relation between hormonal disorders, which are present during gestation, and auditory and/or vestibular symptoms, this study aims at studying the occurrence of auditory and vestibular complaints in pregnant women.This is a prospective study carried out in two municipal health care facilities and one University Hospital. It was approved by the Ethics Committee of the institution under protocol # 23081.004593/2008-91.The pregnant women invited to take part in the study had their prenatal care at the Obstetrics Department of a University Hospital or in some health care facility.The study group was made up by the pregnant women who agreed to participate, after being told of its goal and signing a free and informed consent.We took off from the study those who had complaints of any sort regarding the ears, nose and/or throat prior to pregnancy, hypertension, and diabetes or, who used any type of drug or alcohol and those who had a risky pregnancy.For the study we used the Interview Protocol proposed by Castagno-G Group: all the pregnant women.-1T Group: women in the first gestational trimester, making up 22.-2T Group: women in the second gestational trimester, making up 33.-3T Group: women in the third gestational trimester, making up 27.82 pregnant women aged between 15 and 44 years participated in the study and were broken down into four groups:In order to analyze the results we used a descriptive analysis, and the results were organized in Tables and presented in absolute and relative numbers.In this paper we will show the data found in the interview with the women who were part of the sample.Through Analyzing the answers from the pregnant women as to their auditory complaints , we obseAuthors have investigated the presence of tinnitus in pregnant women through a questionnaire. In the control group there were women of matching ages but not pregnant. Among the pregnant women, 25% reported tinnitus- and we found a similar result (33%); and in the control group 11% of the women reported tinnitus. The results showed that there is an increase in the prevalence of tinnitus among pregnant women when compared to their non-pregnant counterparts. The authors reported that the feeling of fullness in the ear, tinnitus and autophonia were frequent complaints among pregnant womenResearchers found the presence of auditory complaints during pregnancy. The group was made up of 225 healthy pregnant women and the control group by 29 healthy women who were never pregnant. The results from the questionnaire showed that 24.9% of the pregnant women who reported auditory problems were: ear fullness, tinnitus and/or autophonia; however, after the delivery, all the symptoms subsided. Among control women, 3.4% had hearing complaints and there was a significant difference in the incidence of hearing problems between the groupsStill, on Nonetheless, women with otosclerosis, when pregnant, believe that their hearing worsens during the last months of one or more of their pregnancyIn our study, only one pregnant woman reported hearing improvement and she was in the second trimester of her pregnancy. Nonetheless, in the literature we found reports that in the beginning of the gestation we see a hearing sensitization, with hearing improvement, and throughout the gestational period the hearing continues stableDizziness was reported for more than half the pregnant women (52.44%) , presentThe release of neurotransmitters can alter the biochemical control of the inner ear, since these mediators can be released during pregnancy; it is possible that there is an increase in neurotological symptomsIt was seen that dizziness is more frequent in the first two trimesters of pregnancy; such result is in agreement with authors who reported that the vestibular disorders normalize throughout the gestational period, leading us to believe that there is labyrinthine habituationThe frequency of labyrinthine disorders - dizziness, tinnitus, hypacusia, separately or together, caused by hormonal disorders are referred by numerous authorsIn a study in which there was vestibular rehabilitation in 116 individuals with dizziness who had labyrinthine diseases of varied etiologies, 78 (67.2%) were women and 38 (32.7%) were men. Females have a greater organic predisposition to vestibular dysfunctions because of their intrinsic hormonal variation and the metabolic disorders frequently found in womenA study with the objective to check the incidence of non-labyrinthine factors in the occurrence of vertigo or dizziness, reported that that there are correlations between hormonal alterations associated to vertigoBy describing the evolution of a clinical case of Meniere's disease before, during and after pregnancy, the authors suggested that the coincidence of the drop in osmolarity and the increase in vertigo spells as being the possible effect factor of pregnancy during pregnancy on Meniere's disease. Therefore, changes in the osmotic fluid can affect the inner ear during pregnancyWe observed that in the first gestational trimester the most frequent symptom associated with dizziness was vertigo (22.72%), in the second gestational trimester it was instability (12.12%) and gait unbalance (12.12%). In the third gestational trimester it was instability (14.81%), followed by a tendency to fall (11.11%). Results suggest that a possible vestibular alteration stemming from the hormonal alteration would cause the vertigo complaint in the first gestational trimester, and this complaint in the following trimesters would happen by a labyrinthine habituation. According to the literature, the vestibular alterations normalize throughout the gestational period, leading us to assume there is labyrinthine habituationNow, the increase in the instability complaint in the following trimesters and the tendency to fall in the third trimester can be explained by the increase in body weight and postural change which occurs and increases as gestation progresses, these complaints were supported by the study which found a greater antero-posterior oscillation in the group of third trimester pregnant women in relation to the first trimester group, seeing a reduction in balance in this phasePregnancy is characterized by numerous alterations which happen to women - hormonal, anatomic, cardiovascular and pulmonary changes, edema, and weight gain which can affect the muscle-skeletal system and postureThe reduction in postural stability is associated with the risk of falls, and during pregnancy, the susceptibility for this event is comparable to the risk observed for elderly individualsThe study reported a reduction in balance in pregnant women on the second and third trimesters when compared to non-pregnant women and, besides these symptoms persisting in the post-partum period, there was no correlation between balance and weight gain, leading us to believe that the postural instability of this population is more associated with hormonal, ligament and joint changes than abdomen enlargement or weight gain. According to the same authors, during pregnancy the risk of falls is of 25%As to dizziness-related symptoms reported by the 82 pregnant women, (G group), the most frequent one was nausea (70.73%). As to the women in their first gestational trimester (group 1T), nausea was reported by 95.45% of the pregnant women. During the second gestational trimester (group 2T), nausea was reported by 72.72% of the women. Among the women in the last gestational trimester (group 3T), 48.14% reported nausea. The findings show that nausea is the main symptom associated with dizziness in pregnant women, and when the gestational trimesters are compared, we see that nausea is more frequent in the first gestational trimester, and it reduces as the pregnancy progresses. We did not find any studies in these regards in the literature.-The most frequent auditory complaint in pregnant women was tinnitus.-Dizziness was reported by more than half of the pregnant women, being more frequent in the first two gestational trimesters.-Nausea was the main symptom associated with dizziness in pregnant women, being more frequent in the first gestational trimester and reducing with pregnancy progression.-The findings from this study suggest that a possible vestibular alteration stemming from the hormonal alteration causes vertigo during the first gestational trimester, and this complaint reduces in the following trimesters because of labyrinthine habituation. The raise in instability complaints in the following trimesters and the tendency to fall on the third trimester can be explained by an increase in body weight and the postural change which happens and increases with the progression of pregnancy.Based on the results found in the present paper we can conclude that:Therefore, this study shows that pregnant women have auditory and vestibular complaints, especially dizziness and tinnitus.


The growing awareness of colonialism’s role in global health partnerships between HICs and LMICs and the associated calls for decolonization in global health has led to discussion for a paradigm shift that would lead to new ways of engagement and partnerships, as well as an acknowledgement that colonialism, racism, sexism, and capitalism contribute to inequity. While there is general agreement among those involved in global health partnerships that the current system needs to be made more equitable, suggestions for how to address the issue of decolonization vary greatly, and moving from rhetoric to reform is complicated. Based on a comprehensive (but not exhaustive) review of the literature, there are several recurring themes that should be addressed in order for the inequities in the current system to be changed. The degree to which decolonization of global health will be successful depends on how the global health community in both the HICs and LMICs move forward to discuss these issues. Specifically, as part of a paradigm shift, attention needs to be paid to creating a more equal and equitable representation of researchers in LMICs in decision-making, leadership roles, authorship, and funding allocations. There needs to be agreement in defining basic principles of best practices for global partnership, including a universal definition of ‘decolonization of global health’; the extent to which current policies allow the perpetuation of power imbalance between HICs and LMICs; a set of principles, best practices, and models for equitable sharing of funds and institutional costs among partners; a mechanism to monitor progress prospectively the equitable sharing of credits , including a set of principles, best practices, and models; and, a mechanism to monitor progress prospectively the extent to which decolonialization will contribute to strengthening institutional capacity in the LMIC institutions. Issues of equity and power asymmetry in global partnerships are driving the current discussion of decolonizing global health (DGH). Partnerships among institutions in high-income countries (HICs), sometimes also referred to as the Global North, and low- and middle-income countries (LMICs), also referred to as the Global South, have been the bedrock of global collaborations for decades. Within the past few years, however, there has been considerable discussion among global health practitioners in both HICs and LMICs of a perceived imbalance inherent in the current system, stemming from the legacy of former colonial relationships and power inequities. The consensus is that there is a need for a reexamination of the assumptions and practices underpinning global health partnerships, including the inequitable power dynamics and neocolonialist assumptions that have been long ignored 2345.234The call to recognize the colonial legacies of the past and to change the structures within which global health currently operates is fueling the global debate about diversity, equity, and inclusion. . The iss8While there is general agreement among those engaged in global health partnerships that the current system needs to be made more equitable, suggestions for effecting change vary greatly, and moving from rhetoric to reform is complicated. For example, decolonizing global health is a complex term that may mean different things to different people. There are divergent views about the best approaches to achieving the decolonization of global health and what that might eventually look like. Moreover, there is a lack of a coherent set of principles, approaches and tools, which individually and collectively hamper the ability to arrive at consensus definition.The growing awareness of colonialism’s role in global health partnerships between HICs and LMICs and the associated calls for decolonization in global health has led to calls for a paradigm shift that would lead to new ways of engagement and partnership, as well as an acknowledgement that colonialism, racism, sexism, and capitalism contribute to inequity. Presently, HIC institutions (academic and funders) consciously or unconsciously create a situation in which global health remains much too centered on individuals and agencies in HICs at the expense of the partners in LMICs. The HIC institution generally sets the research agenda, formulates the research questions, designs the study, obtains the funding, retains most of the overheads, conducts the analyses, presents the findings at conferences, and publishes the findings in English in journals that may be unavailable and/or unaffordable to their partner in the LMIC where the study is actually conducted.In 2021, the Consortium of Universities for Global Health (CUGH) established a working group of LMIC, HIC, and indigenous voices to address the issue of DGH. To gain a more complete understanding of perceptions of equity and power imbalances in global health partnerships, a survey was conducted. The target audience included members of CUGH engaged in global health research as well as members of the African Forum for Research and Education in Health , an interdisciplinary health professional grouping that seeks to improve the quality of health care in Africa through research, education, and capacity building. The survey instrument consisted of 10 closed- and open-ended questions and was drafted with input from the working group members from both HICs and LMICs. An online anonymous survey link was emailed to 170 individuals in December 2021, with a follow up reminder sent in January 2022. The following provides a summary of the quantitative and qualitative findings.Forty-four responses (response rate of 26%) were received, of which 24 (55%) were from individuals from HICs and 17 (39%) from individuals from LMICs. Three responses (7%) did not specify their country. When asked how many years they have been involved in global health partnerships, four (9.1%) reported less than five years, seven (15.9%) responded between five and nine years, 17 (38.6%) between 10 and 20 years, and 16 (36.4%) for more than 20 years.The overwhelming majority of respondents strongly agreed (59%) or agreed (32%) with the statement: “Colonialism adversely impacts global partnerships.” Among those from HICs, two-thirds (62.5%) strongly agreed and one-quarter (25%) agreed. Among those from LMICs, half (52.9%) strongly agreed with the statement while 41.2% agreed. The findings indicate that those in HICs, compared to LMICs, feel more strongly that colonialism adversely impacts global partnerships.When asked if they have experienced the negative effects of colonialism in their global partnership, 12 participants (27%) strongly agreed while 17 (38.6%) agreed. Among those were six from HICs (25%) and five (29.4%) from LMICs who strongly agreed with the statement. However, among those who agreed with the statement, there is a larger difference between those from HICs (41.7% who agreed) compared to those from LMICs (29.4% who agreed). One-fifth (20.8%) of those from HICs and almost one-quarter of those from LMICs (23.5%) disagreed or strongly disagreed with the statement.For the statement: “Even though the research is being conducted at my institution, I do not feel that I have equal control over the study  said that they strongly agreed or agreed with the statement as disagreed or strongly disagreed. Among those from HICs, one-quarter agreed with the statement while 50% disagreed or strongly disagreed. Differences were apparent among the responses from those from LMICs. Half (52.9%) said that they strongly agreed or agreed with the statement while 29.4% said that they disagreed or strongly disagreed.When asked about not being viewed as an equal partner in their global partnerships, 19 (43.2%) replied that they strongly agreed or agreed with the statement while 18 (40.1%) said that they disagreed or strongly disagreed. Among those in HICs, seven (29.2%) said that they agreed with the statement while over half (54.2%) disagreed or strongly disagreed. Ten individuals from LMICs (58.9%) strongly agreed or agreed that they felt that they were not viewed as an equal partner in global partnerships while 23.5% disagreed or strongly disagreed with the statement. Four individuals (16.7%) from HICs and three (17.6%) from LMICs said that they had no opinion.The survey provided an opportunity for respondents to provide responses to open-ended questions to provide more personal perspectives on the topic. Respondents were asked to briefly explain why they felt that the power relationships in the collaboration are not balanced. The main theme from the LMIC respondents was that financial interests control the power in the relationship and that funders have their own agendas and enter partnerships with preconceived viewpoints. In addition, respondents felt that greater value is often attached to skill sets of HIC partners, with little if any value attached to the skill sets of LMIC partners, unless they were educated in HICs. Several respondents noted that HIC researchers have more resources and better connections to research funders and often approach LMIC researchers as inferior partners, assuming that the HIC investigator should formulate the research questions while the LMIC researchers should implement the studies. A related issue is that LMIC institutions often don’t get the same indirect (overhead) funding as HIC institutions, which perpetuates the financial and power imbalances. When asked about what aspects of the partnerships could/should be changed to make things more equitable at the institutional and/or individual level, LMIC respondents made several recommendations, including the importance of building trust and respect, having explicit discussions so decisions are made transparently and jointly beginning with the project planning phase, establishing mechanisms for equitable control and distribution of financial resources, and building capacity at weaker institutions. Other suggestions from LMIC respondents focused specifically on authorship and the need to establish equal opportunities in co-authorship, especially first and last (senior) authorship.The survey also asked about how to make things more equitable at the funder level. The LMIC respondents, in particular, recommended including LMIC partners in agenda-setting decisions so that funders may gain insight into LMIC needs and challenges. In addition, equal opportunities for competition should be given and LMIC organizations should be empowered to compete favorably. One suggestion was that each partner, HIC and LMIC, could be funded directly instead of having a ‘lead’ institution (more often than not the HIC partner) receive the funds and then subcontract to the LMIC institution.One respondent, for whom the country income level was not stated, stated: “Treat us equally as you would treat your own scientists. Don’t say we are equal and then when a contract comes tell us to ‘Take it or leave it’!”The survey helped identify areas of concern as global health practitioners address power asymmetries and inequity in partnerships. There are several limitations to this survey, including the overall low response rate, low response rate among those in LMICs, contributing to selection bias. That being said, the qualitative responses help frame the dialogue about DGH going forward. There is a general consensus of the problems in the current system that should be addressed.Authorship is very important to researchers in all disciplines because it directly impacts decisions regarding hiring, tenure and promotion, and funding grants . Fair di12Since most global health journals of international reputation are written in English, this could systematically and unjustly exclude non-English speaking researchers even if they have substantially contributed to the research project. Also, compounding the issue is the lack of guidance on authorship from medical editors; of note is that the International Committee of Medical Journal Editors (ICMJE) authorship recommendations are viewed as the leading standard in health science research, although these recommendations are not often taken into account when deciding on authorship listing .Current leadership inequities include an over-representation of white men from HICs in global health leadership positions. Those with knowledge and experience in the project setting, individuals who have years of experience living and working in the country and speak the local language(s), often are not equally recognized for their contribution . This isThe extent to which collaborators from LMICs are listed as co-principal investigators (PIs) on grants and take the lead in overseeing the research or program project needs to be examined more fully. Given that sustainability is crucial in global health research, the LMIC co-investigator’s role is important, as this individual will be the point person to ensure that the project outlives the funding cycle. Sustainability should be the goal of global health partnerships, and not limited to the two- to three-year grant award.Research is heavily influenced by funding agencies, which are mainly based in HICs. While research agendas often address important areas for study, they may not reflect the interests at the host site. Further, individuals making funding decisions based on evaluation of grant submissions tend to be from HICs, and the grant is generally awarded to the HIC institution with funds then disbursed to the LMIC partner.Global health research often depends on strong clinical, laboratory and human resource infrastructure, which often are less developed in many LMICs. Most research studies do not have the budget or funder approval to make significant investments at the host institution, perpetuating dependency and inequity. There is a need for funding agencies to develop and provide frameworks for an ethical and equitable partnership, taking into account the roles of all of the partners. Further, funders should consider selecting grant reviewers based on gender, social, geographical, and ethnic backgrounds , security, waste disposal, utilities, libraries, and computer systems . The ratMany HICs provide core funding to their research institutions, but many LMICs do not, resulting in weak research infrastructure and exacerbating power imbalances between HIC and LMIC collaborators.There are numerous ongoing efforts at universities around the world that address the issue of decolonizing global health. Many are student-initiated and student-led. There also are calls to address the issue in the medical school curriculum , which are discussed in detail by Eichbaum et al.  and GarbAcademic institutions with ongoing decolonizing initiatives include (but are not limited to) the Karolinska Institute, the School of Global Health at the University of Copenhagen, the Harvard TH Chan School of Public Health, the Decolonize Global Health Working Group at the University of Edinburgh, and the Duke Decolonizing Global Health student working group at Duke University. Many other medical schools and universities are beginning to address the issue in various ways . The Consortium of Universities for Global Health (CUGH) Competencies Toolkit is helpful in defining appropriate roles and competencies for trainees and professionals working toward health equity and understanding of other cultures and contexts 24.The COVID-19 pandemic has necessitated a shift in global collaborative research. As travel from HICs was restricted and HIC partners focused more on their home-country needs, many LMIC collaborators seized the opportunity to demonstrate strong, independent leadership of their programs. These dynamics have increased momentum to decolonization and underscore the need to recalibrate power relationships to improve global health. COVID-19 travel restrictions also provided the impetus for the proliferation of virtual conferences, which enabled participants from around the world to attend without incurring the costs of visas, airfare and hotel, costs that can be prohibitive and may not be included in the project budget.The degree to which DGH will be successful depends on how the global health community decides to move forward to discuss, define, and agree to basic principles of best practices for global partnerships. Going forward, we need to agree on the reasons why and for whom we are decolonizing global health and build consensus . What isA universal definition of ‘decolonization of global health’ should be made with input from many different stakeholders and disciplines. Implicit is an agreement on the parameters of the definition.The extent to which organizations in HICs and LMICs knowingly or unknowingly perpetuate inequity is an issue that requires discussion. What are the parameters of the situation and how best can reform be enacted? To what extent do current policies allow the perpetuation of power imbalance? Answers to these questions will differ by country and site.There needs to be agreement on a set of principles, best practices, and models for equitable sharing of funds and institutional costs among partners.There needs to be agreement on the equitable sharing of credits , including a set of principles, best practices, and models.There needs to be agreement on ways to enhance institutional capacity in LMIC institutions.Funders should be brought into the dialogue on best practices for equity between LMIC and HIC grantees.The cost of inaction is too high to ignore and preserving the status quo should not be an option. If we do not heed the calls put forward to decolonize global health, we will squander the opportunity to make the system more equitable.The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the National Institutes of Health or other institutions.