Digital Commons Network^™

The Influence Of Ultra-Wide Field Fluorescein Angiography On The Diagnosis And Management Of Diabetic Retinopathy, Nicole K Scripsema, Tala Al-Khaled, Amy Song, Joelle A Hallak, Rawan Allozi, Aziz A Khanifar, Thanos D Papakostas, Christina Y Weng, Ronald C Gentile, J Peter Campbell, Jessica G Lee, Gennady Landa, Felix Y Chau, William F Mieler, Meenakashi Gupta, Amani A Fawzi, Judy E Kim, Jennifer I Lim, Robison Vernon Paul Chan

Faculty, Staff and Students Publications

Purpose: To study the influence of ultra-widefield fluorescein angiography (FA) on the diagnosis and management of diabetic retinopathy (DR).

Methods: Ten experts in DR completed an online survey in which they were asked to diagnose and manage DR cases using different imaging modalities. Experts independently reviewed 20 cases of DR and provided a diagnosis and management plan for each case, first based on ultra-widefield color-free and red-free images alone and again with the corresponding ultra-widefield FA images. Experts were polled on their diagnostic confidence, use of FA in clinical practice, and opinions on the value of ultra-widefield FA. Based on …

Global Cardiac Anesthesia Workforce Assessment: A Cross-Sectional Observational Survey Study, Alexander J C Mittnacht, Carolina S Romero Garcia, Joshua B Cadwell, Jiapeng Huang, Iwan Sofjan, Mohamed R Eltahan, Hong Liu, Chirojit Mukherjee, Fabio Guarracino, Andrew Shaw, Pablo Motta, International Academy Of Cardiac Anaesthesiologists (Iaca) Global Survey Team

Faculty, Staff and Students Publications

Objective: The primary aim of this survey was to assess the demographics, training background, practice setting, and work environment of cardiac anesthesiologists globally.

Design: Cross-sectional study of the global cardiac anesthesia workforce. A multilingual web-based survey was conducted between June 1 and December 31, 2023.

Setting: The survey was distributed via cardiac anesthesia societies, special interest groups, and social media using a non-probabilistic sample and with snowballing techniques.

Participants: Anesthesiologists actively practicing cardiac anesthesia.

Interventions: None.

Measurements and main results: In total, 3,430 participants from 99 countries responded. Results were summarized as descriptive data comparing geographical regions, and noticeable differences …

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred Kim, Maureen Mcmahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, T Mark Beasley

Faculty, Staff and Students Publications

Objective: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

Methods: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …

A New Approach To Probabilistic County Population Forecasting With An Example Application To West Texas, David Swanson, Jeff Tayman, Mike Cline

Publications, Reports and Presentations

This paper shows how measures of uncertainty can be applied to existing subnational population forecasts using the 107 counties that make up West Texas as a case study. The measures of forecast uncertainty are relatively easy to calculate and meet several important criteria routinely applied by state and local demographers. We also report the results of two independent comparisons supporting the argument that our approach is valid. The paper concludes it is well-suited for developing probabilistic population forecasts in the United States and elsewhere.

Addressing Anxiety And Depression In The Allergy Clinic Through Motivational Interviewing, Brief Cognitive Behavioral Therapy, And Curious Questions, Marylee Verdi, Dominic Candido, Juliette Madan, Jonathan A Bernstein, Don Bukstein, Aikaterini Anagnostou, Matthew Greenhawt, S Shahzad Mustafa, Julie Wang, Anna Nowak-Wegrzyn, Elissa M Abrams, John Oppenheimer, Alexandra E Conway, Andrew A White, Taylor A Doherty, Richard P Morse, Marcus Shaker

Faculty, Staff and Students Publications

Allergic diseases, particularly food allergy, can be associated with significant psychosocial impairment. Allergist-immunologists can provide evidence-based information to correct misperceptions and misunderstandings regarding food allergy that may perpetuate cycles of fear and anxiety. Whereas motivational interviewing can be an empathetic approach to empower patients to actualize health goals, cognitive behavioral therapy (CBT) aims to provide disease-state insight to facilitate an understanding of risk that can transform health beliefs and behaviors. Brief CBT is a clinical approach that can help address ineffective management paradigms through conversations that begin with curious questions. In this review, we discuss evidence supporting implementation of an …

Privacy In Perspective: Research Participants’ Priorities And Concerns Related To Sharing Data Generated In Human Neuroscience Studies, Christi J Guerrini, Jill O Robinson, Norah L Crossnohere, Mary A Majumder, Kathryn Maxson Jones, Whitney Bash Brooks, Sameer A Sheth, Amy L Mcguire

Faculty, Staff and Students Publications

The societal benefits from sharing and reusing data collected in human neuroscience studies are widely appreciated. However, there are persistent barriers to data sharing as well as privacy concerns related to unauthorized access, misuse, and reidentification of deidentified data. Thus far, few studies have been conducted with neuroscience research participants to understand their data sharing priorities and concerns. We conducted a survey utilizing an experimental design with N=52 participants in neuroscience studies funded by the U.S. National Institutes of Health representing diverse neurotechnologies and health conditions. Respondents prioritized sharing practices that maximize reuse of data to benefit patients and reduce …

The Psychiatric Genomics Consortium: Discoveries And Directions, Arpana Agrawal, Cynthia M Bulik, Dawit Shawel Abebe, Ole A Andreassen, Elizabeth G Atkinson, Karmel W Choi, Aiden Corvin, Helena L Davies, Lea K Davis, Anna R Docherty, Howard J Edenberg, Barbara Franke, Joel Gelernter, Paola Giusti-Rodríguez, John M Hettema, Jens Hjerling-Leffler, Hailiang Huang, Emma C Johnson, Cathryn M Lewis, Yi Lu, Mary-Ellen Lynall, Joanna Martin, Andrew M Mcintosh, Janitza L Montalvo-Ortiz, Niamh Mullins, Caroline M Nievergelt, Kevin S O'Connell, Michael C O'Donovan, Adeniran Okewole, Roseann E Peterson, Danielle Posthuma, Jonathan Sebat, Jordan W Smoller, Reeteka Sud, Biju Viswanath, James T R Walters, Hyejung Won, Naomi R Wray, Patrick F Sullivan, Coordinating Committee Of The Psychiatric Genomics Consortium

Faculty, Staff and Students Publications

The Psychiatric Genomics Consortium (PGC) has fueled discoveries of common and rare genetic variation contributing to liability to many psychiatric and neurodevelopmental conditions. This narrative review reflects on major findings from the past half decade of research by this international group of investigators in five priority areas: discovery of common variants using GWAS; rare variation and its interplay with polygenic risk; leveraging genetics to go beyond diagnostic boundaries; ascribing functional attributes to genomic discoveries; and developing and implementing processes for data sharing, outreach to various communities, and training. The insights gained in these domains frame the agenda for the next …

Acquired Resistance In Cancer: Towards Targeted Therapeutic Strategies, Alice Soragni, Erik S Knudsen, Thomas N O'Connor, Cristina E Tognon, Jeffrey W Tyner, Beatrice Gini, Donghwa Kim, Trever G Bivona, Xingxing Zang, Agnieszka K Witkiewicz, David W Goodrich, Dadi Jiang, Seth T Gammon, Christopher D Willey, Paul C Boutros, Vlad C Sandulache, Abdullah A Osman, Jeffrey N Myers, Kamiya Mehla, Pankaj K Singh, Keith S Chan, Hongbo Gao, Himangi Marathe

Faculty, Staff and Student Publications

Development of acquired therapeutic resistance limits the efficacy of cancer treatments and accounts for therapeutic failure in most patients. How resistance arises, varies across cancer types and differs depending on therapeutic modalities is incompletely understood. Novel strategies that address and overcome the various and complex resistance mechanisms necessitate a deep understanding of the underlying dynamics. We are at a crucial time when innovative technologies applied to patient-relevant tumour models have the potential to bridge the gap between fundamental research into mechanisms and timing of acquired resistance and clinical applications that translate these findings into actionable strategies to extend therapy efficacy. …

Congestion And Sinonasal Illness In Outer Space: A Study On The International Space Station, Faizaan Khan, Koyal Ansingkar, Roshan Dongre, Zain Mehdi, Aatin K Dhanda, Kayla Powell, Tariq Syed, Samuel E Razmi, Isuru Somawardana, Jeffrey T Vrabec, David Hilmers, Omar G Ahmed, Masayoshi Takashima

Faculty, Staff and Students Publications

Objectives: This study aims to characterize quantitative data pertaining to sinonasal symptoms and their related medication use aboard the International Space Station (ISS). A secondary focus involves correlating these findings with mission parameters such as extravehicular activity (EVA) participation and mission duration.

Methods: This retrospective cohort study was conducted utilizing data requested from the National Aeronautics and Space Administration (NASA) Lifetime Surveillance of Astronaut Health (LSAH) program.

Results: Of 71 de-identified ISS astronauts beginning with Expedition 1 in the year 2000 through 62 in 2019, there were 754 logged medical events; 60 astronauts reported any type of sinonasal medical event …

Psychometric Evaluation Of The Yale-Brown Obsessive-Compulsive Scale In Pregnant Women, Catherine E Rast, Rashelle Musci, Jonathan S Abramowitz, Gerald Nestadt, Paul Nestadt, Mary C Kimmel, Tracey Dibbs, Lauren M Osborne, Jack Samuels, Janice Krasnow, Eric A Storch

Faculty, Staff and Students Publications

Purpose: Although many women experience obsessive-compulsive symptoms during the perinatal period, the Yale-Brown Obsessive Compulsive Scale (YBOCS) has not yet been psychometrically evaluated in this population. This study examined the internal consistency, convergent and divergent validity, and factor structure of the YBOCS among pregnant women.

Methods: 256 Women who were 20 to 24 weeks pregnant completed the clinician-administered YBOCS and Mini International Neuropsychiatric Interview (MINI) along with a series of self-report questionnaires including the Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Obsessive-Compulsive Inventory-Revised (OCI-R).

Results: Internal consistency of the YBOCS was excellent, and there were strong …

Measuring The Impact Of A Delay In Care On Pediatric Otolaryngologic Surgery Completion, Geethanjeli N Mahendran, Ching Siong Tey, Mary Frances Musso, Grace Shebha Anand, Jeffrey Larson, Mitesh Mehta, Lara Reichert, Kara Prickett, Nikhila Pinnapureddy Raol

Faculty, Staff and Students Publications

Objective: To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression.

Methods: We identified patients ≤18 years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients' rate of and patterns of rescheduling surgery. Surveys were also sent to caregivers to better characterize his/her decision regarding moving forward with his/her child's surgery during COVID-19.

Results: A total of 1915 pediatric patients had elective surgeries canceled, of which 992 (51.8%) were rescheduled within 4 months. No …

The Microrna Mir-30a Blocks Adipose Tissue Fibrosis Accumulation In Obesity, Pradip K Saha, Robert Sharp, Aaron R Cox, Rabie Habib, Michael J Bolt, Jessica B Felix, Claudia E Ramirez Bustamante, Xin Li, Sung Yun Jung, Kang Ho Kim, Kai Sun, Huaizhu Wu, Samuel Klein, Sean M Hartig

Faculty, Staff and Student Publications

White adipose tissue (WAT) fibrosis occurring in obesity contributes to the inflammatory and metabolic comorbidities of insulin resistance and type 2 diabetes, yet the mechanisms involved remain poorly understood. Here, we report a role for the broadly conserved miRNA miR-30a as a regulator of WAT fibrosis and systemic glucose metabolism. Mice modified to express miR-30a at elevated levels in adipose tissues maintain insulin sensitivity coupled with reduced fatty liver disease when fed a high-fat diet. These effects were attributable to cell-autonomous functions of miR-30a that potently increase expression of adipocyte-specific genes. Proteomic screening revealed miR-30a limits profibrotic programs in subcutaneous …

Sugar Functionalized Collagen Material For Local Modulation Of Innate Immunity, Francesca Taraballi, Claudia Corbo, Julia Enterria-Rosales, John Otto Martinez, Silvia Minardi, Laura Pandolfi, Xing Wang, Ennio Tasciotti, Kavindra V Singh, Cesar A Arias, Bruna Corradetti

Faculty, Staff and Students Publications

Small alterations during the early stages of the innate immune response to an implant can drive large changes in adaptive immunity. Biomaterials for regenerative purposes can be engineered to modulate this immune response in beneficial ways. This study presents an innovative patch designed and functionalized to target the innate immunity at the implant site. Mannose moieties are incorporated into collagen patches, resulting in a technology called Local Immunotuning Patch (LIP), designed to directly interact with antigen presenting cells through their mannose receptor. In vitro, LIP shows anti-inflammatory effects on bone marrow-derived macrophages and inhibitory properties even on methicillin-resistant bacterial strains. …

Small Molecule Inhibitor 3i-1000 Dosed During Bouts Of Anoxia Increases Survivability Of Austrofundulus Limnaeus Embryos, Connor Kime

University Honors Theses

The annual killifish Austrofundulus limnaeus possesses exceptional tolerance to prolonged anoxia, offering a unique vertebrate model for investigating cardiac resilience and survival under metabolic stress. This study tested whether inhibition of the GATA4–NKX2-5 transcriptional axis with the small molecule 3i-1000 enhances post-anoxic survival. WS40 embryos were exposed to 50 µM 3i-1000 during anoxia and early aerobic recovery. Outcomes were assessed across two independent experimental cohorts. Treated embryos exhibited higher survivability during reoxygenation: in the October cohort, survival increased from 76.0% in vehicle controls (n = 25) to 91.7% in treated embryos (n = 24); in the November cohort, survival improved …

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Seth Eisen, Alfred Kim, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

METHODS: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …

Barriers And Facilitators To Accessing Healthcare For People With Parkinson's Disease In Latin America: A Qualitative Study, Christine Jeyachandran, Catherine Spooner, Ana Margarita Rodriguez Salgado, Matthew Prina, Joel Rhee, Jorge Jesus Llibre-Guerra, Dani Kim, Juan J Llibre-Rodriguez, Mark F Harris

2020-Current year OA Pubs

AIMS: The aim of the study was to identify the barriers and facilitators to healthcare access for people with Parkinson's disease (PWP) in Spanish-speaking Latin American countries (LAC) in Central and South America, to understand their drivers and consider the implications for health systems in LAC.

METHODS: Four online semi-structured focus groups were conducted with 25 PWP who provide education and/or support to PWP. The study was designed and implemented by a person with lived experience of PD. Data were mapped to an existing model of access to healthcare that incorporates provider and consumer abilities.

FINDINGS: There were multiple provider …

Wearing The Keffiyeh: Solidarity, Resistance, Activism, Catherine Harper Ph.D, Tasnim Alahdal, Rawan Gamal Agha

Arts and Design

The Palestinian keffiyeh is a distinctly patterned black-and-white woven double-cloth, hand-stitched scarf, originally used by farmers of the region. It became a prominent symbol of Palestinian nationalism from mid-twentieth century. Adopted by Yasser Arafat in the 1960s, it became a masculinist icon of Palestine’s politics of resistance, extended by female Palestinian liberationist Leila Khaled’s hijabi-like use, and then mobilised by wider leftist, activist, even Israel-critical Jewish, protest groups in the West.

In recent years, keffiyeh-patterned scarves, accessories, even dresses and skirts – in a range of colours – have appeared periodically in Western fashion stores, on couture catwalks, and …

Let’S Teach More Accurate And Inclusive History! The Case Of Islamic Contributions To Mathematics And Science, Nuh Aydin

Journal of Humanistic Mathematics

Schools commonly teach a history of mathematics and science that is Eurocentric. This selective version of the history of science, called Classical Narrative by some, is rooted in colonial times and mindset, and has reinforced certain negative opinions about other cultures. It ignores or downplays contributions to mathematics and sciences from non-western civilizations, and falsely attributes many scientific discoveries to European scholars. Medieval Islamic Civilization, which had strong connections to Renaissance Europe, serves as a clear example of how this narrative is distorted. Based on research on primary sources since the middle of the 20th century, we now know that …

Math Anxiety And Shame Exemplified On The Reality Show Survivor, James Drimalla, Dru Horne

Journal of Humanistic Mathematics

In an episode of season 45 of the reality show Survivor, three contestants competed in a challenge involving mathematics. In their reflections and responses to the challenge, the contestants discussed feelings of anxiety, fear, and shame. In this article, we describe (a) the challenge, (b) the three contestants’ attempts to complete the challenge and their responses to the challenge, (c) responses to the challenge in the media, and (d) relevant details of our personal experiences and related backgrounds. We then discuss themes of math anxiety, shame, and virtues, and encourage leaders in mathematical spaces to place a higher value on …

Memes As An Effective Approach To Increase Public Engagement With Mathematical Concepts, Juan M. Romero, Carlos Trenado

Journal of Humanistic Mathematics

A meme is a graphical concept or cultural item that is disseminated via the Internet, often through social media platforms. Memes serve as a mechanism for replicating cultural traits by incorporating aspects of cultural mutation and evolution. The potential of memes in learning and education has been emphasized in several recent studies. The present article examines the impact of memes in increasing public engagement with mathematics and mathematical concepts. By focusing on memes that exhibit specific attributes—such as emotional facial expressions of recognizable human characters and dialogues emphasizing the usefulness or beauty of a mathematical concept—we observe a significant increase …

Thumbtax, Robert F. Manning

Tax Adviser

No abstract provided.

Training To Teach: Creating Inclusive Learning Environments, Rebecca Anne Rose

Plymouth Interdisciplinary Education Open Journal

Inclusion is often discussed as a policy imperative, but its true impact is realised only through daily classroom practice. As student teachers, we argue that inclusion should move beyond compliance to become a mindset and a lived commitment. Our experiences reveal that policy and practice are not always as intertwined as we hope. As future educators, we aspire for inclusion to require ongoing self-reflection, courage, and compassion, ensuring every student is seen, valued, and empowered to succeed. We believe policy must genuinely support and reflect this commitment, making inclusion not just a requirement, but a fundamental part of educational culture …

Reflection On The ‘Power Of Us’ Conference: How Mainstream Schools In England Offer Provision To Children With Special Educational Needs (Sen), Grace H A Cooper

Plymouth Interdisciplinary Education Open Journal

The majority of children in England with Special Educational Needs or Disabilities (SEND) are educated within mainstream schools. Due to the broad range of needs of children, it is essential that mainstream schools are provided with adequate funding, preparation and training to ensure that the inclusion of every child is achievable and expected. Furthermore, sometimes schools feel that they cannot offer ample provision to give every child an equitable access to learning and therefore they are directed to SEND schooling – can a mainstream school be considered inclusive if they cannot support all children? This article will consider these arguments …

Collaborating Through Place-Based Partnerships For Inclusion, Suanne Gibson

Plymouth Interdisciplinary Education Open Journal

This reflective paper presents thoughts and insights from an interactive session delivered by Professor Suanne Gibson at this year’s ‘The Power of Us’ Spaghetti Bridge with University of Plymouth conference, on May 1^st.

Suanne reflects on how her talk ‘Plymouth’s story: Place-based school improvement for inclusion 2021 onwards’ took shape, telling the tale of a city’s successful progression for inclusion via a series of cross city and cross sector partnerships and collaborations. Matters of educational leadership and effective management of inclusive ideals, innovative practices and policies for progress and evidenced impact across Plymouth are shared and critically considered. …

On Becoming A Hero: Insights From An Unexpected Experience, Christina Maslach

Heroism Science

In 1971, shortly after earning my Ph.D. at Stanford, I found myself unexpectedly drawn into the events of the Stanford Prison Experiment (SPE). Although I was not involved in the study’s design, my reaction to the disturbing behaviors I witnessed led me to confront my partner, Philip Zimbardo, about the ethics of continuing the research. That conversation ultimately led him to end the study. In this personal reflection, I revisit my experience as an unintentional “outsider ombudsperson,” exploring the psychological and ethical challenges that unfolded within the SPE. I reflect on what I learned about dissent, disobedience, and how stepping …

Icipe Spotlight Magazine 2025, International Centre Of Insect Physiology And Ecology (Icipe)

icipe Newsletters

Join us through a journey of a tapestry of voices, landscapes and possibilities. Get a copy of our inaugural edition of the icipe Spotlight magazine, a publication that is especially close to our hearts. The magazine illuminates our scientific breakthroughs and the lives they touch. While we celebrate our contribution to the global knowledge hub, our deepest fulfillment is in witnessing how the Centre’s knowledge and innovations transform lives and foster resilience.

Animal Science News (July 31, 2025), Department Of Animal Science

Animal Science Newsletters

No abstract provided.

Exploring Insights Into Women’S Education In Saudi Arabia Via Statistical Data, Abdullah M Basahel, Mohammad A Yamin

Journal of King Abdulaziz University: Economics and Administration

In many countries, education systems vary for males and females. Some schools are open to both genders, whereas others are exclusively for one gender only. This separation is not limited to certain regions; rather, it occurs worldwide. Saudi Arabia takes a unique approach in which male and female students attend joint classes but do so on separate campuses. Through technology, female students can participate via live video, whereas male students can participate in face-to-face classes with their teachers. This setup is used in various undergraduate and postgraduate programs in Saudi Arabia and other countries. We examine the advantages and disadvantages …

Determinants Of School Health Unit Program Implementation In Junior High Schools Of Boyolali District, Indonesia, Ayu Khoirotul Umaroh, Noor Alis Setiyadi, Kusuma Estu Werdani, Tanjung Anitasari Indah Kusumaningrum, Purwo Setiyo Nugroho

Kesmas

Adolescent health problems such as stunting, attempted suicide, and tobacco use in Indonesia require attention. To address these challenges, the School Health Unit Program, a school-based health initiative, aims to improve student health and academic achievement. This study examined the relationship between human resources, teachers’ knowledge, facilities and infrastructure, financial resources, and the planning process for implementing the School Health Unit Program in junior high schools in Boyolali District, Indonesia. A cross-sectional design was utilized, involving 50 junior high school teachers responsible for the School Health Unit as respondents, with data collected through structured questionnaires. Multivariate logistic regression analysis revealed …

Google Review Analysis Of “Duta We Care” Excellent Service As A Featured Service At A Central General Hospital In Padang, Alfitri Alfitri, Ricvan Dana Nindrea, Adek Setiawan, Elsa Yuniarti

Kesmas

Improving healthcare service quality required both technical and interpersonal enhancements through a personalized approach, as demonstrated by the “Duta We Care” program at a Central General Hospital in Padang. This study aimed to evaluate the program’s effectiveness by analyzing patient feedback from Google Reviews. A descriptive quantitative design examined 2,035 patient reviews from March 2013 to June 2024. Using NVivo 12 software, the data analysis generated word clouds. The results showed that 68.20% of reviews received a 5-star rating, 9.48% a 4-star rating, 4.35% a 3-star rating, 2.27% a 2-star rating, and 15.70% a 1-star rating. Words like “friendly,” “professional,” …