bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Oxygen Evolution Reaction Performance of Metal‐Organic Frameworks through Cathode Activation
Authors: Dong Jie , Boukhvalov Danil W. , Lv Cuncai , Humphrey Mark G. , Zhang Chi , Huang Zhipeng
Published: July 2024

Due to their abundant active sites and porous structures, metal‐organic frameworks (MOFs) have garnered significant interest as oxygen evolution reaction (OER) electrocatalysts. Nevertheless, the development of MOF s‐based electrocatalysts with efficient OER activity and excellent stability simultaneously still face challenges. Herein, a cathodic activation strategy was used to enhance the OER electrocatalytic performance of M‐HHTP for the first time, where M refers to Ni, Cu, Co, Fe, while HHTP denotes 2, 3, 6, 7, 10, 11‐hexahydroxytriphenylene. As a prototype, the activated Ni‐HHTP (HA‐Ni‐HHTP) demonstrates outstanding OER performance, with an overpotential as low as 140 mV at 20 mA cm−2 and a small Tafel slope of 78.7 mV−1, surpassing commercial RuO2 and rivaling state‐of‐the‐art MOFs‐based electrocatalysts. Characterizations and density functional theory calculations reveal that the superior performance of HA‐Ni‐HHTP is primarily ascribed to changes in semiconductor type, contact angle, and oxygen vacancy content induced by cathodic activation. Electrochemical impedance spectroscopy analysis using the transmission line model confirms that cathodic activation accelerates charge transport, enhancing the OER process. Furthermore, the cathodic activation strategy holds promise for improving the water oxidation performance of other MOFs such as Fe‐HHTP, Co‐HHTP, and Cu‐HHTP.
PROteolysis Targeting Chimeras: A new cutting‐edge nanomedicine for colorectal cancer
Authors: Maitra Swastika , Mukerjee Nobendu , Mukherjee Dattatreya , Ghosh Arabinda , Alexiou Athanasios T.
Published: July 2024

Colorectal cancer (CRC) is a prevalent malignancy with a high mortality rate, necessitating innovative treatment strategies. PROTACs (PROteolysis Targeting Chimeras) represent a promising therapeutic approach by targeting and degrading oncogenic proteins via the ubiquitin‐proteasome pathway. This study explores the potential of using exosomes as delivery vehicles for PROTACs to enhance treatment efficacy. Exosomes, due to their biocompatibility and inherent targeting capabilities, offer a precise method for delivering PROTACs to CRC cells, potentially overcoming challenges associated with traditional therapies such as drug resistance and off‐target effects. By harnessing the advantages of both exosome‐based delivery and PROTAC technology, this approach aims to improve targeted protein degradation and therapeutic outcomes in CRC treatment. Further research is required to optimize exosome engineering, ensure efficient PROTAC loading, and validate the safety and efficacy of this novel therapeutic strategy through preclinical and clinical trials.
Ionic‐Liquid‐Supported Magnetic Nanoparticles: Synthesis, Characterization, and Their Use for the Separation of Co and Ni from Li in Aqueous Solutions
Authors: Almeida Joana C. , Cardoso Celso E. D. , Neves Márcia , Trindade Tito , Freire Mara G. , Pereira Eduarda
Published: July 2024

The evolution of the electric vehicle market and the ongoing demand for lithium (Li), cobalt (Co) and nickel (Ni) for batteries production requires secondary sources for obtaining these elements. The recycling of Li‐ion batteries involves hydrometallurgical processes with potential environmental implications, hence there is an urgent need for sustainable and more efficient recycling methods. Functionalized colloidal magnetic nanomaterials have gained interest as sorbents as they can selectively bind and remove metal species from waters, allowing their easy recovery through magnetic separation. This work addresses the preparation and evaluation of silica‐coated magnetite nanoparticles (NPs), as alternative materials to recover Co and Ni from aqueous media, after their surface modification with 1‐methyl‐3‐propylimidazolium chloride. The magnetic nanosorbents were fully characterized and the influence of solution pH and amount of ILs on the NPs surface was evaluated. Our research allows us to conclude that IL functionalized magnetic nanoparticles can be explored as an alternative to hydrometallurgical processes for the separation of Co and Ni from alkaline lixiviates of spent lithium‐ion battery (LIB) powders.
The role of motivation in shaping social inclusion of people with intellectual disabilities in physical‐sports activity contexts
Authors: Ocete Calvo Carmen , Pérez‐Calzado Elena , Berástegui Ana , Franco Álvarez Evelia
Published: July 2024

The present study aims to test a model in which basic psychological needs (BPN) satisfaction in physical‐sport activity contexts is associated with self‐determined motivation, which, in turn, would predict the social inclusion of people with intellectual disabilities. A total of 286 people with intellectual disabilities (53.5% men) who reported engaging in physical‐sport activities responded to a validated questionnaire about the satisfaction of their BPN, motivation (using the Self‐determination index [SDI]), and social inclusion. A Pearson's bivariate correlation and structural equation modeling were conducted. The resulting model was reanalyzed in a multigroup analysis to test its invariance across self and proxy reports. Positive associations were found between the satisfaction of the BPN and the SDI. However, the SDI and social inclusion were positively associated only in proxy reports (βself = 0.07 vs. βproxy = 0.30). The tested model established positive relationships between the BPN and SDI in autonomy (βself = 0.21 vs. βproxy = 0.18), competence (βself = 0.47 vs. βproxy = 0.53), and relatedness (βself = 0.21 vs. βproxy = 0.23). Further research is needed to understand the factors leading to discrepancies between participants and proxies when relating the SDI to social inclusion in the context of physical‐sport activity. However, the results obtained suggest that it would be optimal to develop contexts of practice for people with intellectual disabilities in which the satisfaction of their BPN is favored and that this has a positive impact on their motivation and social inclusion.
Impact of dance classes on motor and cognitive functions and gut microbiota composition in multiple sclerosis patients: Randomized controlled trial
Authors: Adamová Louise Mária , Slezáková Darina , Hric Ivan , Nechalová Libuša , Berisha Genc , Olej Peter , Chren Matej , Chlapcová Adela , Penesová Adela , Minár Michal , Bielik Viktor
Published: July 2024

Evidence suggests that multiple sclerosis (MS) induces a decline in motor and cognitive function and provokes a shift in gut microbiome composition in patients. Therefore, the aim of the study was to explore the effect of dance classes on the motor and cognitive functions and gut microbiota composition of MS patients. In this randomized controlled trial, 36 patients were randomly divided into two groups: the experimental group (n = 18) and the passive control group (n = 18). Supervised rock and roll and sports dance classes were performed for 12 weeks at a frequency of two times a week. Before and after the intervention, fecal samples were taken and the motor and cognitive function assessments were completed. Fecal microbiota were categorized using primers targeting the V3–V4 region of 16S rDNA. Our results revealed significant differences in mobility performance (T25‐FWT), attention and working memory (TMT B), and finger dexterity (9‐HPT) within the experimental group. Furthermore, we reported favorable shifts in gut microbial communities (an increase in Blautia stercoris and a decrease in Ruminococcus torques) within the experimental group. In conclusion, our randomized control trial on the effects of 12‐week dance classes in MS patients found significant improvements in motor and cognitive functions, with further moderate influence on gut microbiota composition.
Low-Level Dietary Clothianidin Exposure Preferentially Causes Prepupal Mortality of Monarch Butterflies (Danaus plexippus)
Authors: Bargar Timothy A.
Published: July 2024

Data from prior research indicate the prepupal stage of the monarch butterfly life cycle is more sensitive to clothianidin exposure than the larval stage. A set of experiments was conducted to determine if the dietary clothianidin exposures that cause prepupal mortality are environmentally relevant. Monarch larvae were raised from egg to pupae on clothianidin-contaminated swamp milkweed plants (Asclepias incarnata). Larval growth as well as larval and prepupal survival were monitored throughout the experiments, in which the exposures ranged from 1.4 to 2793.1 ng/g leaf. Exposures of 5.4 to 46.9 ng/g leaf resulted primarily in prepupal mortality, whereas higher exposures of 1042.4 to 2793.1 ng/g leaf resulted exclusively in larval mortality, indicating the prepupal stage is more sensitive to clothianidin exposure than the larval stage. A median lethal concentration and a 10% lethal concentration of 37 and 6 ng/g leaf, respectively, were estimated for prepupal mortality. Both effect concentrations are within the range of clothianidin concentrations reported in leaves collected from wild milkweed plants, indicating prepupal mortality is an environmentally relevant effect. Environ Toxicol Chem 2024;43:2039–2044. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
Late Palaeozoic potassic igneous rocks of the Molo‐Sarychat pluton in the eastern Kyrgyz Tien Shan: Geochemistry, U–Pb zircon geochronology and implications for related skarn‐porphyry Mo‐W‐Cu‐Au mineralization
Authors: Soloviev Serguei G. , Kryazhev Sergey G. , Semenova Dina V. , Kalinin Yury A. , Bortnikov Nikolay S.
Published: July 2024

The Molo‐Sarychat multiphase pluton is situated along the fault systems of the ‘Main Structural Line of Tien Shan’ (known also as the ‘Nikolaev Line’). It comprises mafic to intermediate (monzodiorite, monzonite) and silicic (quartz monzonite, monzogranite and leucogranite‐alaskite) rocks, followed by the late mafic (monzodiorite‐porphyry to lamprophyre) dikes. Isotopic U‐Pb zircon dating of quartz monzonite and monzogranite indicates their Early Permian age (ca. 293 to 286 Ma). The rocks appear to have been produced by remelting of a partially crystallized (mush) magma batch at deeper levels, which is evident by the presence of zircon antecrysts dated at some 306 to 320 Ma. These geochronological data are consistent with a post‐collisional setting of the pluton that occurred after the cessation of subduction, which affected the Middle Tien Shan in the Late Palaeozoic. Geochemical signatures of the igneous rocks from the Molo‐Sarychat pluton correspond to high‐K calc‐alkaline to shoshonitic series intrusions emplaced in a post‐collisional setting. An initial shoshonitic magma was produced by a low‐degree partial melting of the metasomatically enriched upper mantle, with amphibole fractionation in a deep (lower crustal) magma chamber. In this evolution, a generation, under the influence of mantle‐supplied fluids and heat, granitic magmas in the crustal protolith can be suggested, with further mixing/mingling of the mantle‐derived mafic (shoshonitic) magma and mantle‐induced crustal granitic magma, followed by the magma fractionation and emplacement at shallower crustal levels. The skarn‐porphyry Mo‐Cu‐W(‐Au) mineralization associated with the Molo‐Sarychat pluton complements the group of similar deposits associated with high‐K calc‐alkaline to shoshonitic series intrusions in the Middle Tien Shan and globally. The characteristic Mo‐W‐Cu‐Au metal assemblage and the high endowment in W and particularly Mo can be related to the fertilization of subduction‐modified subcontinental mantle in these metals, and its subsequent involvement in the magma generation in post‐collisional setting. A certain role of crustal magma sources in the strong Mo endowment can be considered that would be consistent with some A‐type granitoid affinity of the igneous rocks. The Early Permian age of these high‐potassic intrusions supporting their post‐collisional emplacement is remarkably similar to the age of hydrothermal alteration assemblages, previously reported for the super‐large Kumtor Au deposit situated in a similar post‐collisional setting nearby.
Analysis of posture and balance impairments in individuals with chronic nonspecific neck pain—An observational study
Authors: Prakash Nithin , Cleland Joshua , Kalyan Hemant K. , Roy Ajit Kumar , Jose Naveen Mathew , Harikesavan Karvannan
Published: July 2024

Background

Neck pain is one of the most burdensome chronic musculoskeletal problems globally. Impaired proprioception is associated with chronic nonspecific neck pain as the structures of the cervical spine are crucial for proprioception and balance. There is a paucity of literature examining objective measures of balance and postural sway in patients with nonspecific neck pain.

Methods

This study was observational consisting 126 individuals (63 cases and 63 controls) who were recruited using convenience sampling. The demographics of the samples were collected and the postural and balance impairment was assessed using Biodex Balance SD. Mean, Median, and SD were obtained and the inferential analysis was done using the Whitney U Test and the level of significance was accepted at p < 0.05.

Results

The subjects with neck pain showed had a lower static stability index, static sway index, static stability index—forward backward and static sway index lateral scores than the normal counterparts. There are significant differences in the overall static stability index (p < 0.001). There was a significant difference in static sway index (p = 0.003) and static stability index lateral (p = 0.004). There was no significant difference for static sway index forward and backward (p = 0.550) and lateral sway index (p = 0.711).

Conclusion

Subjects with neck pain had a lower static stability index, static sway index, static stability index—forward backward, and static sway index lateral scores than the normal counterparts and there was a significant difference between the static sway and static stability index in forward and backward directions as well as in lateral direction. These findings may help to assess the specific balance parameters and address the underlying causes of balance issues in patients with neck pain and also provide a comprehensive care to the patients.

Clinical Trial Registration

The trial was registered with CTRI India with registration number: CTRI/2022/07/044222.
Non‐isothermal flow dynamics during reverse roll coating phenomena of non‐Newtonian polymer
Authors: Hanif Alia , Abbas Zaheer
Published: July 2024

Roll coating plays a major role in industrial coating, including wallpapers, plastic and photographic films, sticky tapes, magnetic recordings, wrapping magazines and books, and so on. The current study proposes a mathematical model for a non‐isothermal, incompressible Sutterby fluid flowing through a narrow gap between two heated, counterrotating rollers. Lubrication approximation theory is used to simplify nondimensional expressions. The perturbation technique provides exact results for velocity profile, temperature, flow rate, and pressure gradient, whereas the numerical technique (Simpson rule) is used to compute the pressure profile and flow rate, respectively. The effects of the involved parameters on various physical characteristics like pressure, flow rate, temperature, pressure gradient, force, and power input are depicted in graphs and tabular form. A mechanism for controlling the coating thickness, power input, flow rate, separation force, and pressure distribution is provided by the material properties involved. With variations to a Sutterby fluid parameter and the velocity ratio K, both the pressure gradient and pressure decrease. It is significant to note that the temperature distribution is controlled by the velocities ratio and Brinkman number. Moreover, the separation point is shifted towards the nip area and the coating thickness on the web reduces with increasing velocities ratio K.
Atypical hemolytic‐uremic syndrome after COVID‐19 vaccine: A case report
Authors: Campos Marcos Adriano Garcia , Ataídes Rômullo José Costa , Ferreira Maxwell Cabral , Alves Adriano Soares , Silva Gyl Eanes Barros
Published: July 2024

Background

The emergence of new SARS‐CoV‐2 variants and the global COVID‐19 pandemic spurred urgent vaccine development. While common vaccine side effects are well‐documented, rare adverse events necessitate post‐marketing surveillance. Recent research linked messenger RNA vaccines to thrombotic microangiopathy (TMA), a group of syndromes characterized by microvascular hemolytic anemia and thrombocytopenia. This report describes a new‐onset atypical hemolytic‐uremic syndrome (aHUS) occurring after COVID‐19 vaccination and complements recent literature.

Case Presentation

A previously healthy 25‐year‐old woman developed malaise, nausea, edema, and renal dysfunction 60 days postvaccination. Laboratory findings confirmed TMA diagnosis. Genetic testing for complement system mutations was negative. Kidney biopsy supported the diagnosis, and the patient required hemodialysis.

Conclusion

This case illustrates the rare occurrence of aHUS following COVID‐19 vaccination, with unique characteristics compared to previous reports. Despite the critical role of vaccination in pandemic control, emerging adverse events, such as vaccine‐related TMA, must be recognized and investigated. Additional clinical trials are imperative to comprehend the clinical features and pathophysiological mechanisms underlying TMA associated with COVID‐19 vaccination.
Res‐MulFra: Multilevel and Multiscale Framework for Brain Tumor Segmentation
Authors: Huang Dan , Qiu Luyi , Liu Zifeng , Ding Yi , Cao Mingsheng
Published: July 2024

In clinical diagnosis and surgical planning, extracting brain tumors from magnetic resonance images (MRI) is very important. Nevertheless, considering the high variability and imbalance of the brain tumor datasets, the way of designing a deep neural network for accurately segmenting the brain tumor still challenges the researchers. Moreover, as the number of convolutional layers increases, the deep feature maps cannot provide fine‐grained spatial information, and this feature information is useful for segmenting brain tumors from the MRI. Aiming to solve this problem, a brain tumor segmenting method of residual multilevel and multiscale framework (Res‐MulFra) is proposed in this article. In the proposed framework, the multilevel is realized by stacking the proposed RMFM‐based segmentation network (RMFMSegNet), which is mainly used to leverage the prior knowledge to gain a better brain tumor segmentation performance. The multiscale is implemented by the proposed RMFMSegNet, which includes both the parallel multibranch structure and the serial multibranch structure, and is mainly designed for obtaining the multiscale feature information. Moreover, from various receptive fields, a residual multiscale feature fusion module (RMFM) is also proposed to effectively combine the contextual feature information. Furthermore, in order to gain a better brain tumor segmentation performance, the channel attention module is also adopted. Through assessing the devised framework on the BraTS dataset and comparing it with other advanced methods, the effectiveness of the Res‐MulFra is verified by the extensive experimental results. For the BraTS2015 testing dataset, the Dice value of the proposed method is 0.85 for the complete area, 0.72 for the core area, and 0.62 for the enhanced area.
The consequences of intimacy, oppression, and activism on gendered power relations in a high schoolLGBTQ+‐themed literature class
Authors: Mallory Allen B. , Blackburn Mollie V. , Schey Ryan
Published: July 2024

School‐based supports, such as LGBTQ+‐themed curriculum, invite opportunities for challenging oppression with respect to gender and its intersections with other identities such as sexuality and race. However, more understanding is needed regarding how literacy educators might leverage these opportunities. This article describes how intimacy, oppressive actions, and activism functioned in relation to one another in an LGBTQ+‐themed literature course at a grassroots public charter high school for the arts in a mid‐sized Midwestern city. The larger study, from which this article is derived, is a hybrid of ethnography and practitioner inquiry. Therefore, this study draws on field notes, transcribed video recordings of class, transcribed audio recordings of interviews, and student assignments related to a young adult novel. Our analysis of gendered power relations suggests that oppression can hinder intimacy, intimacy can hinder activism, but intimacy can also foster activism. With the goal of leveraging opportunities to challenge gendered oppression, we argue that students and teachers must navigate intimacy and intersecting structures of oppression to enact activism.
Chronic exposure to TiO2 micro‐ and nano particles: A biochemical and histopathological experimental study
Authors: Domingo Mariela Gisele , Kurtz Melisa , Maglione Guillermo , Martin Maximiliano , Brites Fernando , Tasat Deborah Ruth , Olmedo Daniel Gustavo
Published: July 2024

The aim of this work was to analyze the effects of long‐term exposure to titanium dioxide (TiO2) micro‐ (MPs) and nanoparticles (NPs) (six and 12 months) on the biochemical and histopathological response of target organs using a murine model. Male Wistar rats were intraperitoneally injected with a suspension of TiO2 NPs (5 nm; TiO2‐NP5 group) or MPs (45 μm; TiO2‐NP5 group); the control group was injected with saline solution. Six and 12 months post‐injection, titanium (Ti) concentration in plasma and target organs was determined spectrometrically (ICP‐MS). Blood smears and organ tissue samples were evaluated by light microscopy. Liver and kidney function was evaluated using serum biochemical parameters. Oxidative metabolism was assessed 6 months post‐injection (determination of superoxide anion by nitroblue tetrazolium (NBT) test, superoxide dismutase (SOD) and catalase (CAT), lipid peroxidation, and paraoxonase 1). Titanium (Ti) concentration in target organs and plasma was significantly higher in the TiO2‐exposed groups than in the control group. Histological evaluation showed the presence of titanium‐based particles in the target organs, which displayed no structural alterations, and in blood monocytes. Oxidative metabolism analysis showed that TiO2 NPs were more reactive over time than MPs (p < .05) and mobilization of antioxidant enzymes and membrane damage varied among the studied organs. Clearance of TiO2 micro and nanoparticles differed among the target organs, and lung clearance was more rapid than clearance from the lungs and kidneys (p < .05). Conversely, Ti concentration in plasma increased with time (p < .05). In conclusion, neither serum biochemical parameters nor oxidative metabolism markers appear to be useful as biomarkers of tissue damage in response to TiO2 micro‐ and nanoparticle deposits at chronic time points.
Benzimidazole‐based structure optimization to discover novel anti‐gastric cancer agents targeting ROS/MAPK pathway
Authors: Jia Gang , Wang Yuanying , Wang Jikuan , Yu Bingxin , Zhao Haiyang , Zhao Ze , Zhao Wenming , Gao Ya , Wang Bo , Song Zhiyu
Published: July 2024

Given the malignancy of gastric cancer, developing highly effective and low‐toxic targeted drugs is essential to prolong patient survival and improve patient outcomes. In this study, we conducted structural optimizations based on the benzimidazole scaffold. Notably, compound 8 f presented the most potent antiproliferative activity in MGC803 cells and induced cell cycle arrest at the G0/G1 phase. Further mechanistic studies demonstrated that compound 8 f caused the apoptosis of MGC803 cells by elevating intracellular reactive oxygen species (ROS) levels and activating the mitogen‐activated protein kinase (MAPK) signaling pathway, accompanied by corresponding markers change. In vivo investigations additionally validated the inhibitory effect of compound 8 f on tumor growth in xenograft models bearing MGC803 cells without obvious toxicity. Our studies suggest that compound 8 f holds promise as a potential and safe lead compound for developing anti‐gastric cancer agents.
Injuries of the posteromedial bundle of the posterior cruciate ligament after knee hyperextension trauma: A new clinical entity based on an original case series
Authors: Mouton Caroline , Ibañez Maximiliano , Hoffmann Felix , Monllau Joan Carles , Seil Romain
Published: July 2024

Purpose

This original case series aims to describe an uncommon triad of clinical signs in patients presenting with persistent pain and inability to resume physical activities after knee hyperextension trauma.

Methods

Patient history, clinical examination, arthroscopic findings and investigations of 12 patients who consulted with the senior author are presented.

Results

Twelve patients (seven males/five females) presented with persistent pain after knee hyperextension trauma either in sport or a traffic accident. They had a median age of 18.5 and a median body mass index of 23 kg/m2. All had medical visits and at least one magnetic resonance imaging (MRI) before visiting the senior author's institution but the cause of their problems could not be explained. The clinical examination of the injured knee appeared normal except for an uncommon triad of clinical signs with the knee close to extension: (1) a grade 1+ anterior–posterior laxity around 10–20° of knee flexion with a firm end‐point (pseudo‐Lachman sign), (2) a grade 1+ tibiofemoral step‐off sign with a posterior drawer at 10–20° of knee flexion and (3) an increased knee hyperextension compared to the contralateral side. Arthroscopy of eight patients confirmed the pseudo‐Lachman sign with a grade I posterior drawer close to knee extension, normal posterior laxity at 90° of knee flexion and an intact anterior cruciate ligament.

Conclusion

Patients displayed an increased hyperextension and posterior laxity close to knee extension which normalised at 90° of knee flexion. In patients with a history of knee hyperextension trauma associated with persistent pain, inability to resume physical activities, inconclusive MRIs and a standard clinical examination, clinicians should consider extending their investigations with the knee close to extension to identify this clinical triad consistent with a lesion to the posteromedial bundle of the posterior cruciate ligament.

Level of evidence

Level IV.
Anterior variable angle locking neutralisation plate superiority over traditional tension band wiring for treating transverse patella fractures
Authors: Tarabichi Majd , Mungalpara Nirav , Lichtig Asher , Kim Sunjung , Karam Joseph , Koh Jason , Amirouche Farid
Published: July 2024

Purpose

This paper investigates the biomechanical benefits of using hybrid constructs that combine cannulated screws with tension band wiring (TBW) cerclage compared to cannulated screws with anterior Variable Angle locking neutralisation plates (VA LNP). These enhancements can bear heavier loads and maintain the repaired patella's integrity, in contrast to traditional methods.

Method

Eighteen fresh‐frozen human cadaver patellae were carefully fractured transversely at their midpoints using a saw. They were then divided into two groups of nine for subsequent utilisation. Fixation methods included Cannulated Screw Fixation added with either TBW or VA LNP Fixation Technique. Cyclic loading simulations (500 cycles) were conducted to mimic knee motion, tracking fracture displacement with Optotrak. After that, the constructs were secured over a servo‐hydraulic testing machine to determine the load‐to‐failure on axial mode.

Results

The average fracture displacement for the anterior neutralisation plate group was 0.09 ± 0.12 mm, compared to 0.77 ± 0.54 mm for the tension band wiring with cannulated screw group after 500 cyclic loading. This result is statistically significant (p = 0.004). The anterior neutralisation plate group exhibited a mean load‐to‐failure of 1359 21.53 N, whereas the tension band wiring group showed 780.1 ± 22.62 N, resulting in a significant difference between the groups (p = 0.007).

Conclusion

This research highlights the superior biomechanical advantage of VA LNP over TBW for treating simple transverse patella fractures with two cannulated screws. It also highlights how the TBW is still a valuable option considering the load‐to‐failure limit.

Level of Evidence

Not Applicable.
HaloTag display enables quantitative single‐particle characterisation and functionalisation of engineered extracellular vesicles
Authors: Mitrut Roxana E. , Stranford Devin M. , DiBiase Beth N. , Chan Jonathan M. , Bailey Matthew D. , Luo Minrui , Harper Clare S. , Meade Thomas J. , Wang Muzhou , Leonard Joshua N.
Published: July 2024

Extracellular vesicles (EVs) play key roles in diverse biological processes, transport biomolecules between cells and have been engineered for therapeutic applications. A useful EV bioengineering strategy is to express engineered proteins on the EV surface to confer targeting, bioactivity and other properties. Measuring how incorporation varies across a population of EVs is important for characterising such materials and understanding their function, yet it remains challenging to quantitatively characterise the absolute number of engineered proteins incorporated at single‐EV resolution. To address these needs, we developed a HaloTag‐based characterisation platform in which dyes or other synthetic species can be covalently and stoichiometrically attached to engineered proteins on the EV surface. To evaluate this system, we employed several orthogonal quantification methods, including flow cytometry and fluorescence microscopy, and found that HaloTag‐mediated quantification is generally robust across EV analysis methods. We compared HaloTag‐labelling to antibody‐labelling of EVs using single vesicle flow cytometry, enabling us to measure the substantial degree to which antibody labelling can underestimate proteins present on an EV. Finally, we demonstrate the use of HaloTag to compare between protein designs for EV bioengineering. Overall, the HaloTag system is a useful EV characterisation tool which complements and expands existing methods.
Understanding adaptive responses in PrEP service delivery in Belgian HIV clinics: a multiple case study using an implementation science framework
Authors: Vanhamel Jef , Reyniers Thijs , Vuylsteke Bea , Callens Steven , Nöstlinger Christiana , Huis in ’t Veld Diana , Kenyon Chris , Van Praet Jens , Libois Agnes , Vincent Anne , Demeester Rémy , Henrard Sophie , Messiaen Peter , Allard Sabine D. , Rotsaert Anke , Kielmann Karina
Published: July 2024

Introduction

In Belgium, oral HIV pre‐exposure prophylaxis (PrEP) is primarily provided in specialized clinical settings. Optimal implementation of PrEP services can help to substantially reduce HIV transmission. However, insights into implementation processes, and their complex interactions with local context, are limited. This study examined factors that influence providers’ adaptive responses in the implementation of PrEP services in Belgian HIV clinics.

Methods

We conducted a qualitative multiple case study on PrEP care implementation in eight HIV clinics. Thirty‐six semi‐structured interviews were conducted between January 2021 and May 2022 with a purposive sample of PrEP care providers (e.g. physicians, nurses, psychologists), supplemented by 50 hours of observations of healthcare settings and clinical interactions. Field notes from observations and verbatim interview transcripts were thematically analysed guided by a refined iteration of extended Normalisation Process Theory.

Results

Implementing PrEP care in a centralized service delivery system required considerable adaptive capacity of providers to balance the increasing workload with an adequate response to PrEP users’ individual care needs. As a result, clinic structures were re‐organized to allow for more efficient PrEP care processes, compatible with other clinic‐level priorities. Providers adapted clinical and policy norms on PrEP care (e.g. related to PrEP prescribing practices and which providers can deliver PrEP services), to flexibly tailor care to individual clients’ situations. Interprofessional relationships were reconfigured in line with organizational and clinical adaptations; these included task‐shifting from physicians to nurses, leading them to become increasingly trained and specialized in PrEP care. As nurse involvement grew, they adopted a crucial role in responding to PrEP users’ non‐medical needs (e.g. providing psychosocial support). Moreover, clinicians’ growing collaboration with sexologists and psychologists, and interactions with PrEP users’ family physician, became crucial in addressing complex psychosocial needs of PrEP clients, while also alleviating the burden of care on busy HIV clinics.

Conclusions

Our study in Belgian HIV clinics reveals that the implementation of PrEP care presents a complex—multifaceted—undertaking that requires substantial adaptive work to ensure seamless integration within existing health services. To optimize integration in different settings, policies and guidelines governing PrEP care implementation should allow for sufficient flexibility and tailoring according to respective local health systems.
Using FRAME to characterize provider‐identified adaptations to a stepped care intervention for adolescents and youth living with HIV in Kenya: a mixed methods approach
Authors: Chhun Nok , Oketch Dorothy , Agot Kawango , Mangale Dorothy I. , Badia Jacinta , Kibugi James , Jiang Wenwen , Kirk Mary , Richardson Barbra A. , Kohler Pamela K. , John‐Stewart Grace , Beima‐Sofie Kristin
Published: July 2024

Introduction

The Data‐informed Stepped Care (DiSC) study is a cluster‐randomized trial implemented in 24 HIV care clinics in Kenya, aimed at improving retention in care for adolescents and youth living with HIV (AYLHIV). DiSC is a multi‐component intervention that assigns AYLHIV to different intensity (steps) of services according to risk. We used the Framework for Reporting Adaptations and Modifications‐Expanded (FRAME) to characterize provider‐identified adaptations to the implementation of DiSC to optimize uptake and delivery, and determine the influence on implementation outcomes.

Methods

Between May and December 2022, we conducted continuous quality improvement (CQI) meetings with providers to optimize DiSC implementation at 12 intervention sites. The meetings were guided by plan‐do‐study‐act processes to identify challenges during early phase implementation and propose targeted adaptations. Meetings were audio‐recorded and analysed using FRAME to categorize the level, context and content of planned adaptations and determine if adaptations were fidelity consistent. Providers completed surveys to quantify perceptions of DiSC acceptability, appropriateness and feasibility. Mixed effects linear regression models were used to evaluate these implementation outcomes over time.

Results

Providers participated in eight CQI meetings per facility over a 6‐month period. A total of 65 adaptations were included in the analysis. The majority focused on optimizing the integration of DiSC within the clinic (83%, n = 54), and consisted of improving documentation, addressing scheduling challenges and improving clinic workflow. Primary reasons for adaptation were to align delivery with AYLHIV needs and preferences and to increase reach among AYLHIV: with reminder calls to AYLHIV, collaborating with schools to ensure AYLHIV attended clinic appointments and addressing transportation challenges. All adaptations to optimize DiSC implementation were fidelity‐consistent. Provider perceptions of implementation were consistently high throughout the process, and on average, slightly improved each month for intervention acceptability (β = 0.011, 95% CI: 0.002, 0.020, p = 0.016), appropriateness (β = 0.012, 95% CI: 0.007, 0.027, p<0.001) and feasibility (β = 0.013, 95% CI: 0.004, 0.022, p = 0.005).

Conclusions

Provider‐identified adaptations targeted improved integration into routine clinic practices and aimed to reduce barriers to service access unique to AYLHIV. Characterizing types of adaptations and adaptation rationale may enrich our understanding of the implementation context and improve abilities to tailor implementation strategies when scaling to new settings.
Implementation strategies to improve HIV care cascade outcomes in low‐ and middle‐income countries: a systematic review from 2014 to 2021
Authors: Lujintanon Sita , Eshun‐Wilson Ingrid , Tourneau Noelle Le , Beres Laura , Schwartz Sheree , Baral Stefan , Thompson Ryan , Underwood Ashley , Fox Branson , Geng Elvin H. , Kemp Christopher G.
Published: July 2024

Introduction

In low‐ and middle‐income countries (LMICs), which are disproportionately affected by the HIV epidemic and manage limited resources, optimized implementation strategies are needed to enhance the efficiency of the HIV response. Assessing strategy usage to date could identify research gaps and inform future implementation efforts. We conducted a systematic review to describe the features and distributions of published implementation strategies attempting to improve HIV treatment service delivery and outcomes.

Methods

We searched PubMed, Embase, and CINAHL and screened abstracts and full texts published between 1 January 2014 and 27 August 2021, for English‐language studies conducted in LMICs that described the implementation of HIV intervention and reported at least one HIV care cascade outcome, ranging from HIV testing to viral suppression. Implementation strategies were inductively specified, characterized by unique combinations of actor, action and action target, and summarized based on existing implementation strategy taxonomies. All strategies included in this study were independently reviewed to ensure accuracy and consistency.

Results

We identified 44,126 abstracts and reviewed 1504 full‐text manuscripts. Among 485 included studies, 83% were conducted in sub‐Saharan Africa; the rest were conducted in South‐East Asia and Western Pacific (12%), and the Americas (8%). A total of 7253 unique implementation strategies were identified, including changing health service delivery (48%) and providing capacity building and support strategies (34%). Healthcare providers and researchers led 59% and 28% of the strategies, respectively. People living with HIV and their communities (62%) and healthcare providers (38%) were common strategy targets. Strategies attempting to change governance, financial arrangements and implementation processes were rarely reported.

Discussion

We identified a range of published implementation strategies that addressed HIV cascade outcomes, though some key gaps exist. We may need to expand the application of implementation strategies to ensure that all stakeholders are meaningfully involved to support equitable implementation efforts across the geographic regions and target populations, and to optimize implementation outcomes.

Conclusions

Some health service delivery and capacity building and support strategies have been most commonly used to date. Future research and implementation may incorporate a more diverse range of strategies and detailed reporting on their usage to inform improved HIV responses globally.
Integrating a mental health intervention into PrEP services for South African young women: a human‐centred implementation research approach to intervention development
Authors: Velloza Jennifer , Ndimande‐Khoza Nomhle , Mills Lisa , Concepcion Tessa , Gumede Sanele , Chauke Hlukelo , Verhey Ruth , Chibanda Dixon , Hosek Sybil , Weiner Bryan J. , Celum Connie , Delany‐Moretlwe Sinead
Published: July 2024

Introduction

Adolescent girls and young women (AGYW) who may benefit from HIV pre‐exposure prophylaxis (PrEP) face high levels of common mental disorders (e.g. depression, anxiety). Common mental disorders can reduce PrEP adherence and increase HIV risk, yet mental health interventions have not been well‐integrated into PrEP delivery.

Methods

We conducted a four‐phase human‐centred design process, from December 2020 to April 2022, to understand mental health challenges among AGYW in Johannesburg, South Africa and barriers to integrated mental health and PrEP services. In the “Discover” phase, we conducted in‐depth interviews with AGYW and key informants (KIs) in Johannesburg. We conducted a rapid qualitative analysis, informed by the Consolidated Framework for Implementation Research (CFIR), to identify facilitators and barriers of integrated mental health and PrEP services and mapped barriers to potential implementation strategies. In the “Design” and “Build” phases, we conducted stakeholder workshops to iteratively adapt an evidence‐based mental health intervention, the Friendship Bench, and refine implementation strategies for South African PrEP delivery settings. In the “Test” phase, we piloted our adapted Friendship Bench package.

Results

Interviews with 70 Discover phase participants (48 AGYW, 22 KIs) revealed the importance of integrated mental health and PrEP services for South African AGYW. Interviewees described barriers and implementation strategies for mental health and PrEP services around the CFIR domains: intervention characteristics (e.g. challenges with AGYW “opening up”); outer Johannesburg setting (e.g. community stigma); inner clinic setting (e.g. judgemental healthcare providers); characteristics of counsellors (e.g. training gaps); and the implementation process (e.g. need for demand creation). The Design and Build workshops included 13 AGYW and 15 KIs. Implementation barriers related to the quality and accessibility of public‐sector clinic services, lay counsellor training, and community education and demand creation activities were prioritized. This led to 12 key Friendship Bench adaptations and the specification of 10 implementation strategies that were acceptable and feasible in initial pilot testing with three AGYW.

Conclusions

Using a human‐centred approach, we identified determinants and potential solutions for integrating mental health interventions within PrEP services for South African AGYW. This design process centred stakeholders’ perspectives, enabling rapid development of an adapted Friendship Bench intervention implementation package.
Providing HIV‐assisted partner services to partners of partners in western Kenya: an implementation science study
Authors: Sharma Monisha , Mambo Barbara Wanjiku , Kingston Hanley , Otieno George , Masyuko Sarah , Lagat Harison , Katz David A. , Wamuti Beatrice , Macharia Paul , Bosire Rose , Mugambi Mary , Kariithi Edward , Farquhar Carey
Published: July 2024

Introduction

Assisted partner services (APS), or exposure notification and HIV testing for sexual partners of persons diagnosed HIV positive (index clients), is recommended by the World Health Organization. Most APS literature focuses on outcomes among index clients and their partners. There is little data on the benefits of providing APS to partners of partners diagnosed with HIV.

Methods

We utilized data from a large‐scale APS implementation project across 31 facilities in western Kenya from 2018 to 2022. Females testing HIV positive at facilities were offered APS; those who consented provided contact information for all male sexual partners in the last 3 years. Male partners were notified of their potential HIV exposure and offered HIV testing services (HTS). Males newly testing positive were also offered APS and asked to provide contact information for their female partners in the last 3 years. Female partners of male partners (FPPs) were provided exposure notification and HTS. All participants with HIV were followed up at 12 months post‐enrolment to assess linkage‐to antiretroviral treatment (ART) and viral suppression. We compared HIV positivity, demographics and linkage outcomes among female index clients and FPPs.

Results

Overall, 5708 FPPs were elicited from male partners, of whom 4951 received HTS through APS (87% coverage); 291 FPPs newly tested HIV positive (6% yield), an additional 1743 (35.2%) reported a prior HIV diagnosis, of whom 99% were on ART at baseline. At 12 months follow‐up, most FPPs were taking ART (92%) with very few adverse events: <1% reported intimate partner violence or reported relationship dissolution. FPPs were more likely than female index clients to report HIV risk behaviours including no condom use at last sex (45% vs. 30%) and multiple partners (38% vs. 19%).

Conclusions

Providing HIV testing via APS to FPP is a safe and effective strategy to identify newly diagnosed females and achieve high linkage and retention to ART and can be an efficient means of identifying HIV cases in the era of declining HIV incidence. The high proportion of FPPs reporting HIV risk behaviours suggests APS may help interrupt community HIV transmission via increased knowledge of HIV status and linkage to treatment.
Recent and near‐term future changes in impacts‐relevant seasonal hydroclimate in the world's Mediterranean climate regions
Authors: Seager Richard , Wu Yutian , Cherchi Annalisa , Simpson Isla R. , Osborn Timothy J. , Kushnir Yochanan , Lukovic Jelena , Liu Haibo , Nakamura Jennifer
Published: July 2024

Change over recent decades in the world's five Mediterranean Climate Regions (MCRs) of quantities of relevance to water resources, ecosystems and fire are examined for all seasons and placed in the context of changes in large‐scale circulation. Near‐term future projections are also presented. It is concluded that, based upon agreement between observational data sets and modelling frameworks, there is strong evidence of radiatively‐driven drying of the Chilean MCR in all seasons and southwest Australia in winter. Observed drying trends in California in fall, southwest southern Africa in fall, the Pacific Northwest in summer and the Mediterranean in summer agree with radiatively‐forced models but are not reproduced in a model that also includes historical sea surface temperature (SST) forcing, raising doubt about the human‐origin of these trends. Observed drying in the Mediterranean in winter is stronger than can be accounted for by radiative forcing alone and is also outside the range of the SST‐forced ensemble. It is shown that near surface vapour pressure deficit (VPD) is increasing almost everywhere but that, surprisingly, this is contributed to in the Southern Hemisphere subtropics to mid‐latitudes by a decline in low‐level specific humidity. The Southern Hemisphere drying, in terms of precipitation and specific humidity, is related to a poleward shift and strengthening of the westerlies with eddy‐driven subsidence on the equatorward side. Model projections indicate continued drying of Southern Hemisphere MCRs in winter and spring, despite ozone recovery and year‐round drying in the Mediterranean. Projections for the North American MCR are uncertain, with a large contribution from internal variability, with the exception of drying in the Pacific Northwest in summer. Overall the results indicate continued aridification of MCRs other than in North America with important implications for water resources, agriculture and ecosystems.