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The NIH 3D Print Exchange is a public and open source repository for primarily 3D printable medical device designs with contributions from expert-amateur makers, engineers from industry and academia, and clinicians. In response to the COVID-19 pandemic, a collection was formed to foster submissions of low-cost, local manufacture of personal protective equipment (Personal Protective Equipment (PPE)). We systematically evaluated the 623 submissions in this collection to understand: what makers contributed, how they were made, who made them, and key characteristics of their designs. Our analysis reveals an immediate design convergence to derivatives of a few initial designs affiliated with NIH partners (e.g., universities, the Veteran's Health Administration, America Makes) and major for-profit groups (e.g., Prusa). The NIH worked to review safe and effective designs but was quickly overloaded by derivative works. We found that the vast majority were never reviewed (81.3%) while 10.4% of those reviewed were deemed safe for clinical (5.6%) or community use (4.8%). Our work contributes insights into: the outcomes of distributed, community-based, medical making; features the community accepted as "safe" making; and how platforms can support regulated maker activities in high-risk domains (e.g., healthcare).

Many individuals with disabilities and/or chronic conditions (da/cc) experience symptoms that may require intermittent or on-going medical care. However, healthcare is an often-overlooked domain for accessibility work, where access needs associated with temporary and long-term disability must be addressed to increase the utility of physical and digital interactions with healthcare workers and spaces. Our work focuses on a specific domain of healthcare often used by individuals with da/cc: physical therapy (PT). Through a twelve-person interview study, we examined how people's access to PT for their da/cc is hampered by social (e.g., physically visiting a PT clinic) and physiological (e.g., chronic pain) barriers, and how technology could improve PT access. In-person PT is often inaccessible to our participants due to lack of transportation and insufficient insurance coverage. As such, many of our participants relied on at-home PT to manage their da/cc symptoms and work towards PT goals. Participants felt that PT barriers, such as having particularly bad symptoms or feeling short on time, could be addressed with well-designed technology that flexibly adapts to the person's dynamically changing needs while supporting their PT goals. We introduce core design principles (adaptability, movement tracking, community building) and tensions (insurance) to consider when developing technology to support PT access. Rethinking da/cc access to PT from a lens that includes social and physiological barriers presents opportunities to integrate accessibility and adaptability into PT technology., 22 pages, 2 tables

The COVID-19 pandemic upended college education and the experiences of students due to the rapid and uneven shift to online learning. This study examined the experiences of students with disabilities with online learning, with a consideration of surrounding stressors such as financial pressures. In a mixed method approach, we compared 28 undergraduate students with disabilities (including mental health concerns) to their peers during 2020, to assess differences and similarities in their educational concerns, stress levels, and COVID-19-related adversities. We found that students with disabilities entered the Spring quarter of 2020 with significantly higher concerns about classes going online, and reported more recent negative life events than other students. These differences between the two groups diminished 3 months later with the exception of recent negative life events. For a fuller understanding of students’ experiences, we conducted qualitative analysis of open-ended interviews. We examined both positive and negative experiences with online learning among students with disabilities and mental health concerns. We describe how online learning enabled greater access—e.g., reducing the need for travel to campus—alongside ways in which online learning impeded academic engagement—e.g., reducing interpersonal interaction. We highlight a need for learning systems to meet the diverse and dynamic needs of students with disabilities.

We present an ethnographic study of a maker community that conducted safety-driven medical making to deliver over 80,000 devices for use at medical facilities in response to the COVID-19 pandemic. To achieve this, the community had to balance their clinical value of safety with the maker value of broadened participation in design and production. We analyse their struggles and achievement through the artifacts they produced and the labors of key facilitators between diverse community members. Based on this analysis we provide insights into how medical maker communities, which are necessarily risk-averse and safety-oriented, can still support makers' grassroots efforts to care for their communities. Based on these findings, we recommend that design tools enable adaptation to a wider set of domains, rather than exclusively presenting information relevant to manufacturing. Further, we call for future work on the portability of designs across different types of printers which could enable broader participation in future maker efforts at this scale.

The shift in undergraduate student demographic composition, particularly for the science, technology, engineering, and mathematics (STEM) disciplines, has been coupled with an ever increasing need for faculty to be more culturally aware and responsive. Traditionally, higher education has relied on the professional development programs of disciplinary societies and associations to meet such needs. However, designing professional development for STEM faculty in ways that awaken awarenesses about racial differences and their impact on academic success requires more than the conventional faculty development offerings, which, more often than not, only give cursory nods to difference or limit programming to “cookbook” protocols of do's and don'ts. Indeed, today's STEM faculty professional development must be met with more sophisticated paradigms that foreground personal reflection and development. Safe brave spaces represent an ideal mechanism for supporting not only personal reflection but also the grappling with and letting go of the destructive values and beliefs that negatively impact undergraduate STEM student success. The chapter offers the reader a view into our perspective as conveners of safe brave professional development spaces. In it, we also share the words of a safe brave space occupier, demonstrating how the power of reflection can influence the value of safe brave spaces. As a result, the reader is left with a different lens through which STEM faculty professional development programs can and should be considered – whether it is who is in them, who is missing from them, or what is required to facilitate more productive interactions within them. Admittedly, there is more work yet to be done. Understanding that this work requires safety and bravery is a necessary next step.

Unprecedented maker efforts arose in response to COVID-19 medical supply gaps worldwide. Makers in the U.S., participated in peer-production activities to manufacture personal protective equipment (PPE). Whereas, medical makers, who innovate exclusively for points of care, pivoted towards safer, reliable PPE. What were their efforts to pivot medical maker infrastructure towards reliable production of safe equipment at higher volumes? We interviewed 13 medical makers as links between institutions, maker communities, and wider regional industry networks. These medical makers organized stopgap manufacturing in institutional spaces to resolve acute shortages (March–May) and chronic shortages (May–July). They act as intermediaries in efforts to prototype and produce devices under regulatory, material, and human constraints of a pandemic. We re-frame their making efforts as repair work to offer an alternate critical view of optimism around making for crisis. We contribute an understanding of these efforts to inform infrastructure design for making with purpose and safety leading to opportunities for community production of safe devices at scale.

Medical making intersects opposing value systems of a medical “do no harm” ethos and makers’ drive to innovate. Since March 2020, online maker communities have formed to design, manufacture, and distribute personal protective equipment (PPE) and other medical devices needed to fight the COVID-19 pandemic. We present a participant observation study of 14 maker communities, which have developed differing driving principles for efforts with varied access to interdisciplinary expertise on online platforms that mutually shape collective action. Over time, these communities unintentionally align towards action-oriented or regulated practices because they often lack higher level insight and agency in choosing communication platforms. In response, we recommend: regulatory bodies to build coalitions with makers, online platforms to give communities more control over the presentation of information, and repositories to balance needs to distribute information while limiting the spread of misinformation.

Accessibility research has grown substantially in the past few decades, yet there has been no literature review of the field. To understand current and historical trends, we created and analyzed a dataset of accessibility papers appearing at CHI and ASSETS since ASSETS' founding in 1994. We qualitatively coded areas of focus and methodological decisions for the past 10 years (2010-2019, N=506 papers), and analyzed paper counts and keywords over the full 26 years (N=836 papers). Our findings highlight areas that have received disproportionate attention and those that are underserved--for example, over 43% of papers in the past 10 years are on accessibility for blind and low vision people. We also capture common study characteristics, such as the roles of disabled and nondisabled participants as well as sample sizes (e.g., a median of 13 for participant groups with disabilities and older adults). We close by critically reflecting on gaps in the literature and offering guidance for future work in the field.

Spreadsheet systems are used for storing and analyzing data across domains by programmers and non-programmers alike.While spreadsheet systems have continued to support increasingly large datasets, they are prone to hanging and freezing while performing computations even on much smaller ones. We present a benchmarking study that evaluates and compares the performance of three popular systems, Microsoft Excel, LibreOffice Calc, and Google Sheets, on a range of canonical spreadsheet computation operations. We find that spreadsheet systems lack interactivity for several operations, on datasets well below their advertised scalability limits. We further evaluate whether spreadsheet systems adopt database optimization techniques such as indexing, intelligent data layout, and incremental and shared computation,to efficiently execute computation operations. We outline several ways future spreadsheet systems can be redesigned to offer interactive response times on large datasets.

We introduce HomeSound, an in-home sound awareness system for Deaf and hard of hearing (DHH) users. Similar to the Echo Show or Nest Hub, HomeSound consists of a microphone and display, and uses multiple devices installed in each home. We iteratively developed two prototypes, both of which sense and visualize sound information in real-time. Prototype 1 provided a floorplan view of sound occurrences with waveform histories depicting loudness and pitch. A three-week deployment in four DHH homes showed an increase in participants' home- and self-awareness but also uncovered challenges due to lack of line of sight and sound classification. For Prototype 2, we added automatic sound classification and smartwatch support for wearable alerts. A second field deployment in four homes showed further increases in awareness but misclassifications and constant watch vibrations were not well received. We discuss findings related to awareness, privacy, and display placement and implications for future home sound awareness technology.

Social media platforms support the sharing of written text, video, and audio. All of these formats may be inaccessible to people who are deaf or hard of hearing (DHH), particularly those who primarily communicate via sign language, people who we call Deaf signers. We study how Deaf signers engage with social platforms, focusing on how they share content and the barriers they face. We employ a mixed-methods approach involving seven in-depth interviews and a survey of a larger population (n = 60). We find that Deaf signers share the most in written English, despite their desire to share in sign language. We further identify key areas of difficulty in consuming content (e.g., lack of captions for spoken content in videos) and producing content (e.g., captioning signed videos, signing into a phone camera) on social media platforms. Our results both provide novel insights into social media use by Deaf signers and reinforce prior findings on DHH communication more generally, while revealing potential ways to make social media platforms more accessible to Deaf signers.

Spreadsheet systems enable users to store and analyze data in an intuitive and flexible interface. Yet the scale of data being analyzed often leads to spreadsheets hanging and freezing on small changes. We propose a new asynchronous formula computation framework: instead of freezing the interface we return control to users quickly to ensure interactivity, while computing the formulae in the background. To ensure consistency, we indicate formulae being computed in the background via visual cues on the spreadsheet. Our asynchronous computation framework introduces two novel challenges: (a) How do we identify dependencies for a given change in a bounded time? (b) How do we schedule computation to maximize the number of spreadsheet cells available to the user over time? We bound the dependency identification time by compressing the formula dependency graph lossily, a problem we show to be NP-Hard. A compressed dependency table enables us to quickly identify the spreadsheet cells that need recomputation and indicate them as such to users. Finding an optimal computation schedule to maximize cell availability is also NP-Hard, and even merely obtaining a schedule can be expensive-we propose an on-the-fly scheduling technique to address this. We have incorporated asynchronous computation in DataSpread, a scalable spreadsheet system targeted at operating on arbitrarily large datasets on a spreadsheet frontend.

Spreadsheet tools are ubiquitous for interactive adhoc data management and analysis. With increasing dataset sizes, spreadsheet tools fall short—they freeze during heavy computation within the sheet (interactivity); they are hard to navigate when datasets go beyond a certain size (navigability); they only support cell-at-a-time computation, severely limiting analysis capabilities (expressiveness). We have been developing DATASPREAD to holistically unify databases and spreadsheets to leverage the benefits of both, with a spreadsheet-like front-end and a database-like backend. We demonstrate three key features of DATASPREAD to address the aforementioned spreadsheet scalability challenges in interactivity, navigability, and expressiveness1. Our demonstration will let attendees perform typical analysis tasks on Microsoft Excel and DATASPREAD side-by-side, providing a clear understanding of the improvements offered by DATASPREAD over traditional spreadsheet tools.

In traditional usability studies, researchers talk to users of tools to understand their needs and challenges. Insights gained via such interviews offer context, detail, and background. Due to costs in time and money, we are beginning to see a new form of tool interrogation that prioritizes scale, cost, and breadth by utilizing existing data from online forums. In this case study, we set out to apply this method of using online forum data to a specific issue---challenges that users face with Excel spreadsheets. Spreadsheets are a versatile and powerful processing tool if used properly. However, with versatility and power come errors, from both users and the software, which make using spreadsheets less effective. By scraping posts from the website Reddit, we collected a dataset of questions and complaints about Excel. Specifically, we explored and characterized the issues users were facing with spreadsheet software in general, and in particular, as resulting from a large amount of data in their spreadsheets. We discuss the implications of our findings on the design of next-generation spreadsheet software.

Evaluation of joint toxic action of metal ion mixtures is one of the priority research areas due to the simultaneous occurrence of metals in the environment and the health risk they posed to humans and the environment as a mixture. Individual and composite mixture acute toxicities of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb), which are among the top eight toxic chemicals, were characterized at varying concentrations. MCF 7 cell lines were exposed to individual and composite mixtures containing the four metal ions in the proportion of their EPA's MCL for 24 hours, and the concentration-response data were generated spectrofluorometrically. Acute toxicities were estimated based on the uptake of fluorescence diacetate dye. Toxicological interactions among the four metals were profiled, based on computed interactive index. Results demonstrated that the toxicity of each of the metal ions was enhanced in the composite mixture, and the metals demonstrated differential interactions in a concentration dependent manner. Lead, the least toxic among the four metals, showed the highest enhancement (23-to 64-fold) in toxicity when in the mixture. Interaction among the four metals was largely additive although there was slight departures form additivity at the two extremes of the concentration range.

Three workshop sessions on personal professional development were held during the Third IUPAP Women in Physics Conference. These were designed to teach participants about planning for career success, “survival skills,” negotiation, and ways to transition into scientific leadership positions in their own countries.

BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease.

Although smallpox was globally eradicated in 1977, the current threat of smallpox as a bioterrorism agent is unknown. Based on intelligence reports, the U.S. government and public health sectors have recommended smallpox vaccination for very select individuals. Patients with cancer are at particular risk for complications from the smallpox vaccine because of potential immunosuppression. Vaccinated nurses caring for these patients also need to take special precautions because of the possibility of secondary transmission of this live vaccine to patients. This article reviews background information on bioterrorism, the presentation and clinical features of smallpox, contraindications to the smallpox vaccine, and implications for oncology nurses.