bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of genetically modified platelet-derived growth factor-BB over-expressing mesenchymal stromal cells during core decompression for steroid-associated osteonecrosis of the femoral head in rabbits
Authors: Guzman Roberto Alfonso , Maruyama Masahiro , Moeinzadeh Seyedsina , Lui Elaine , Zhang Ning , Storaci Hunter W. , Tam Kaysie , Huang Elijah Ejun , Utsunomiya Takeshi , Rhee Claire , Gao Qi , Yao Zhenyu , Yang Yunzhi Peter , Goodman Stuart B.
Published: September 2021

Background

Approximately one third of patients undergoing core decompression (CD) for early-stage osteonecrosis of the femoral head (ONFH) experience progression of the disease, and subsequently require total hip arthroplasty (THA). Thus, identifying adjunctive treatments to optimize bone regeneration during CD is an unmet clinical need. Platelet-derived growth factor (PDGF)-BB plays a central role in cell growth and differentiation. The aim of this study was to characterize mesenchymal stromal cells (MSCs) that were genetically modified to overexpress PDGF-BB (PDGF-BB-MSCs) in vitro and evaluate their therapeutic effect when injected into the bone tunnel at the time of CD in an in vivo rabbit model of steroid-associated ONFH.

Methods

In vitro studies:Rabbit MSCs were transduced with a lentivirus vector carrying the human PDGF-BB gene under the control of either the cytomegalovirus (CMV) or phosphoglycerate (PGK) promoter. The proliferative rate, PDGF-BB expression level, and osteogenic differentiation capacity of unmodified MSCs, CMV-PDGF-BB-MSCs, and PGK-PDGF-BB-MSCs were assessed. In vivo studies: Twenty-four male New Zealand white rabbits received an intramuscular (IM) injection of methylprednisolone 20 mg/kg. Four weeks later, the rabbits were divided into four groups: the CD group, the hydrogel [HG, (a collagen-alginate mixture)] group, the MSC group, and the PGK-PDGF-BB-MSC group. Eight weeks later, the rabbits were sacrificed, their femurs were harvested, and microCT, mechanical testing, and histological analyses were performed.

Results

In vitro studies:PGK-PDGF-BB-MSCs proliferated more rapidly than unmodified MSCs (P < 0.001) and CMV-PDGF-BB-MSCs (P < 0.05) at days 3 and 7. CMV-PDGF-BB-MSCs demonstrated greater PDGF-BB expression than PGK-PDGF-BB-MSCs (P < 0.01). However, PGK-PDGF-BB-MSCs exhibited greater alkaline phosphatase staining at 14 days (P < 0.01), and osteogenic differentiation at 28 days (P = 0.07) than CMV-PDGF-BB-MSCs. In vivo:The PGK-PDGF-BB-MSC group had a trend towards greater bone mineral density (BMD) than the CD group (P = 0.074). The PGK-PDGF-BB-MSC group demonstrated significantly lower numbers of empty lacunae (P < 0.001), greater osteoclast density (P < 0.01), and greater angiogenesis (P < 0.01) than the other treatment groups.

Conclusion

The use of PGK-PDGF-BB-MSCs as an adjunctive treatment with CD may reduce progression of osteonecrosis and enhance bone regeneration and angiogenesis in the treatment of early-stage ONFH.
Role of GDF-15, YKL-40 and MMP 9 in patients with end-stage kidney disease: focus on sex-specific associations with vascular outcomes and all-cause mortality
Authors: Laucyte-Cibulskiene Agne , Ward Liam J. , Ebert Thomas , Tosti Giulia , Tucci Claudia , Hernandez Leah , Kautzky-Willer Alexandra , Herrero Maria-Trinidad , Norris Colleen M. , Pilote Louise , Söderberg Magnus , Brismar Torkel B. , Ripsweden Jonaz , Stenvinkel Peter , Raparelli Valeria , Kublickiene Karolina ,   The GOING-FWD Consortium
Published: September 2021

Background

Sex differences are underappreciated in the current understanding of cardiovascular disease (CVD) in association with chronic kidney disease (CKD). A hallmark of CKD is vascular aging that is characterised, amongst others, by; systemic inflammation, microbiota disbalance, oxidative stress, and vascular calcification—features linked to atherosclerosis/arteriosclerosis development. Thus, it is the necessary to introduce novel biomarkers related to athero-/arteriosclerotic damage for better assessment of vascular ageing in patients CKD. However, little is known about the relationship between uraemia and novel CVD biomarkers, such as growth differentiation factor-15 (GDF-15), cartilage glycoprotein-39 (YKL-40) and matrix metalloproteinase-9 (MMP-9). Therefore, we hypothesise that there are sex-specific relationships between GDF-15, YKL-40, MMP-9 levels in end-stage kidney disease (ESKD) patients in relation to gut microbiota, vascular calcification, inflammation, comorbidities, and all-cause mortality.

Methods

ESKD patients, males (n = 151) and females (n = 79), not receiving renal replacement therapy were selected from two ongoing prospective ESKD cohorts. GDF-15, YKL-40 and MMP9 were analysed using enzyme-linked immunosorbent assay kits. Biomarker levels were analysed in the context of gut microbiota-derived trimethylamine N-oxide (TMAO), vascular calcification, inflammatory response, oxidative stress, comorbidities, and all-cause mortality.

Results

Increased GDF-15 correlated with higher TMAO in females only, and with higher coronary artery calcification and IL-6. In females, diabetes was associated with elevated GDF-15 and MMP-9, whilst males with diabetes only had elevated GDF-15. No associations were found between biomarkers and CVD comorbidity. Deceased males and females had higher GDF-15 concentrations (p = 0.01 and p < 0.001, respectively), meanwhile only YKL-40 was increased in deceased males (p = 0.02).

Conclusions

In conclusion, in males GDF-15 and YKL-40 were related to vascular calcification, inflammation, and oxidative stress, whilst in females GDF-15 was related to TMAO. Increased levels of YKL-40 and GDF-15 in males, and only GDF-15 in females, were associated with all-cause mortality. Our findings suggest that sex-specific associations of novel CVD biomarkers have a potential to affect development of cardiovascular complications in patients with ESKD.
Learning nodes: machine learning-based energy and data management strategy
Authors: Kim Yunmin , Lee Tae-Jin
Published: September 2021

The efficient use of resources in wireless communications has always been a major issue. In the Internet of Things (IoT), the energy resource becomes more critical. The transmission policy with the aid of a coordinator is not a viable solution in an IoT network, since a node should report its state to the coordinator for scheduling and it causes serious signaling overhead. Machine learning algorithms can provide the optimal distributed transmission mechanism with little overhead. A node can learn by itself by utilizing the machine learning algorithm and make the optimal transmission decision on its own. In this paper, we propose a novel learning Medium Access Control (MAC) protocol with learning nodes. Nodes learn the optimal transmission policy, i.e., minimizing the data and energy queue levels, using the Q-learning algorithm. The performance evaluation shows that the proposed scheme enhances the queue states and throughput.
Visual impairment and medication safety: a protocol for a scoping review
Authors: Giles Sally J. , Panagioti Maria , Riste Lisa , Cheraghi-Sohi Sudeh , Lewis Penny , Adeyemi Isabel , Davies Karen , Morris Rebecca , Phipps Denham , Dickenson Christine , Ashcroft Darren , Sanders Caroline
Published: September 2021

Background

The number of individuals with a visual impairment in the UK was estimated a few years ago to be around 1.8 million. People can be visually impaired from birth, childhood, early adulthood or later in life. Those with visual impairment are subject to health inequities and increased risk for patient safety incidents in comparison to the general population. They are also known to be at an increased risk of experiencing medication errors compared to those without visual impairment. In view of this, this review aims to understand the issues of medication safety for VI people.

Methods/design

Four electronic bibliographic databases will be searched: MEDLINE, Embase, PsycInfo and CINAHL. Our search strategy will include search combinations of two key blocks of terms. Studies will not be excluded based on design. Included studies will be empirical studies. They will include studies that relate to both medication safety and visual impairment. Two reviewers (SG and LR) will screen all the titles and abstracts. SG, LR, RM, SCS and PL will perform study selection and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data to be collected will include study characteristics (year, objective, research method, setting, country), participant characteristics (number, age, gender, diagnoses), medication safety incident type and characteristics.

Discussion

The review will summarise the literature relating to medication safety and visual impairment.
Unconditionally energy stable second-order numerical scheme for the Allen–Cahn equation with a high-order polynomial free energy
Authors: Kim Junseok , Lee Hyun Geun
Published: September 2021

In this article, we consider a temporally second-order unconditionally energy stable computational method for the Allen–Cahn (AC) equation with a high-order polynomial free energy potential. By modifying the nonlinear parts in the governing equation, we have a linear convex splitting scheme of the energy for the high-order AC equation. In addition, by combining the linear convex splitting with a strong-stability-preserving implicit–explicit Runge–Kutta (RK) method, the proposed method is linear, temporally second-order accurate, and unconditionally energy stable. Computational tests are performed to demonstrate that the proposed method is accurate, efficient, and energy stable.
Mechanical ventilation-associated pneumonia caused by Acinetobacter baumannii in Northeast China region: analysis of genotype and drug resistance of bacteria and patients’ clinical features over 7 years
Authors: Zhang Tao , Xu Xiao , Xu Cai-Fang , Bilya Salisu Rabiu , Xu Wei
Published: September 2021

Objective

To investigate the clinical features and outcomes of patients with mechanical ventilation-associated pneumonia (VAP) caused by Acinetobacter baumannii (Ab), and to characterize the drug resistance of pathogenic strains and carbapenem resistance-associated genes.

Methods

Clinical data were collected from the PICU of Shengjing Hospital. Patients who met the diagnostic criteria of VAP and for whom Ab was a pathogen were selected as study participants. The patients were divided into carbapenem-resistant A. baumannii (CRAB) and carbapenem-sensitive A. baumannii (CSAB) groups. The genes closely associated with Ab resistance to carbapenems and the efflux pump-related genes were detected by real-time polymerase chain reaction, and results compared between the two groups.

Results

The total mechanical ventilation time and the administration time of antibiotics after a diagnosis of Ab infection were significantly higher in the CRAB group. And the CRAB group strains were only sensitive to amikacin, cephazolin, compound sulfamethoxazole, and tigecycline. Genetic test results indicated that IPM expression was not significantly different between two groups. The OXA-51 and OXA-23 in the CRAB group was markedly higher than that in the CSAB group, while OXA-24 expression was markedly lower. The expression of AdeABC and AdeFGH was significantly greater in the CRAB compared to CSAB group.

Conclusion

In pediatric patients with VAP caused by Ab infection, the detection rate of CRAB strains is far higher than that of CSAB strains; The abnormal expression of β-lactamase-producing genes (OXA-23, OXA-24, and OXA-51) and efflux pump-related genes (AdeABC and AdeFGH) is closely related to the production of CRAB.
Thrombin-activated platelet-rich plasma enhances osteogenic differentiation of human periodontal ligament stem cells by activating SIRT1-mediated autophagy
Authors: Xu Yunhe , Wang Xiaoning , Liu Wenshu , Lu Weiwei
Published: September 2021

Background

Platelet-rich plasma (PRP) has the potential to be used for bone regeneration. However, its effect on osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and its effect on cell autophagy of hPDLSCs remain unknown. In this study, we investigated the effects of PRP on cell viability and osteogenic differentiation of hPDLSCs and the underlying molecular mechanisms.

Methods

hPDLSCs were isolated and identified by morphology and flow cytometry analysis. Next, thrombin-activated PRP was used to stimulate hPDLSCs. The MTT assay was used to analyze cell viability. Osteogenic differentiation was investigated using alkaline phosphatase (ALP) activity assay, alizarin red S (ARS) staining, and gene expression analysis of osteogenic markers. Expression of the autophagic proteins was determined using western blotting.

Results

Thrombin-activated PRP significantly enhanced cell viability, ALP activity, osteogenic-related mRNA levels and alizarin red-mineralization activity in hPDLSCs in a dose-dependent manner. Furthermore, activated PRP dose-dependently increased LC3-II/I ratio and the expression of SIRT1 and Beclin-1. PRP treatment also enhanced the autophagic flux. It was also demonstrated that the inhibition of SIRT1 using sirtinol or suppression of autophagy by 3-methyladenine (3-MA) abrogated PRP-induced viability and osteogenic differentiation of hPDLSCs.

Conclusion

Our study suggested that thrombin-activated PRP accelerated the viability and osteogenic differentiation of hPDLSCs via SIRT1-mediated autophagy induction.
Predictors of academic performance during the covid-19 outbreak: impact of distance education on mental health, social cognition and memory abilities in an Italian university student sample
Authors: Giusti Laura , Mammarella Silvia , Salza Anna , Del Vecchio Sasha , Ussorio Donatella , Casacchia Massimo , Roncone Rita
Published: September 2021

Background

This study aimed to investigate the impact of distance education (DE) on mental health, social cognition, and memory abilities in a sample of university students during the national COVID-19 lockdown in Italy and to identify the predictors of academic performance.

Methods

Two hundred and three students (76.4% women, mean age 24.3, SD ± 4.9) responded to an anonymous online cross-sectional survey between July 15 and September 30, 2020, on DE experience and cognitive and social-cognitive variables. A short version of the Beck Depression Inventory-II, ten images from the Eyes Task, and five memory vignette stimuli were included in the survey. Descriptive, one-way ANOVA, correlation, and logistic regression analyses were conducted.

Results

Half of the student sample reported significant impairment in concentration and learning abilities during DE. Regarding psychological health, 19.7%, 27.1%, and 23.6% of the sample reported mild, moderate, and severe depressive symptoms, respectively. Correlation analyses showed a statistically significant negative association between depression and the overall subjective evaluation of DE (r =  − 0.359; p < 0.000). Changes in one’s study context and habits, i.e., studying alone at one’s parents’ home instead of studying with colleagues or alone in a university “social place” (e.g., the university library), seemed to increase the likelihood of poor academic performance by almost 3 times (O.R. 3.918; p = 0.032). This predictor was no longer statistically significant in the subsequent step when the individual impairment predictors were entered. Learning concentration impairment during DE (O.R. 8.350; p = 0.014), anxiety about COVID-19 contagion for oneself or others (O.R. 3.363; p = 0.022), female gender (O.R. 3.141; p = 0.045), and depressive symptomatology (O.R. 1.093; p = 0.047) were ultimately determined to be the strongest predictors of poor academic performance, whereas the appreciation of DE represented a protective variable (O.R. 0.610; p < 0.000).

Conclusions

The study showed a negative impact of DE on the mental health of students presenting depressive symptoms and impairment in concentration and learning, the latter identified as the strongest predictors of poor academic performances. The study confirms the emerging need to monitor the impact of DE, which occurred during the 2019/2020 academic year and will continue in the coming months, to refine educational offerings and meet students' psychological needs by implementing psychological interventions based on the modifiable variables that seem to compromise students’ psychological well-being and academic outcomes.
Agricultural suitability assessment and rehabilitation of subsided coal mines: a case study of the Dawu coal mine in Jiangsu, Eastern China
Authors: Yao Xiaomeng , Cui Xin
Published: September 2021

Land-use suitability assessment crucial is for coal mine rehabilitation planning, especially for the coal mines that have undergone varying degrees of mining subsidence. In this study, we present an assessment on the suitability of crop cultivation in the Dawu coal mining district in NW Jiangsu province, Eastern China. Distribution of local land subsidence is delineated with topographic analysis, and the weight-of-evidence (WoE) suitability assessment has encompassed various factors including the conditions of soil (e.g., acidity and porosity), groundwater level, irrigation and drainage, terrain slope, and land pollution. Consequently, the Dawu district is divided into four categories (high, moderate, low, very-low) of agricultural suitability. Collaborating with the local government agencies (e.g., Land and Resources Bureau and Agriculture Bureau), a land-use plan is proposed. In the plan, the highly suitable areas for agriculture (and the surrounding moderately suitable areas) are allocated as farmlands, whilst the other moderately to lowly suitable areas are allocated as ecological zones for restoring the ecosystem and ecological diversity. The barely suitable areas with severe subsidence are allocated as artificial lakes, which also serve as reservoirs for farmland irrigation and drainage. To protect these new farmlands from soil erosion, infrastructure such as embankment and windbreak are also included in our rehabilitation plan. Our study highlights the necessity of forward planning in coal mine rehabilitation.
Autumn migration of Ospreys from two distinct populations in Poland reveals partial migratory divide
Authors: Anderwald Dariusz , Czajka Łukasz , Rubacha Sławomir , Zygmunt Michał , Mirski Paweł
Published: September 2021

Background

Long-term ringing and telemetry studies show that the Osprey (Pandion haliaetus) is a broad-front migrant following different migratory flyways, depending on the geographical location of their breeding populations. We have investigated two distinct and declining populations of Osprey in Poland, separated by only a few hundred kilometres, and hypothesised they may exhibit two different migration routes. We followed mortality causes, comparing them between migration and stationary phases of annual cycle, as well as between two distinct populations.

Methods

Nineteen Ospreys, both juveniles and adults, were equipped with GPS loggers in 2017–2020 in two populations in western and eastern Poland and followed on their autumn migration. We calculated the distance they covered on the migration, number of stopover days, migration duration, daily distances covered and departure dates to compare them between age and sex classes and between the eastern and western populations.

Results

Ospreys from the western and eastern populations showed a partial migratory divide. While the first migrated through a western flyway, the second followed a central flyway, resulting in crossing the Mediterranean Sea in distant passes that affected the distance covered. Annual mortality reached at least 67% in juveniles and at least 57% in adults.

Conclusions

We showed that two distinct Osprey populations in Poland revealed a partial migratory divide, with one covering greater distances over sea and deserts over the central flyway. This might affect individual survival rates and contribute to a steeper decline in one of the populations. In order for this to be confirmed, more individuals still have to be followed.
Immediate implant placement following tooth extraction with simultaneous lateral sinus augmentation: a retrospective clinical study after at least 1 year of loading
Authors: Kim Bok-Joo , Kim Chul-Hoon , Kim Jung-Han
Published: September 2021

Background

Lateral sinus augmentation is necessary when the residual bone height is insufficient in the posterior maxilla. Immediate implant placement following tooth extraction with lateral sinus augmentation will shorten the number of operations and treatment time.

Purpose

To evaluate radiologic and clinical results for at least 1 year after loading in patients who underwent tooth extraction, implant placement, and lateral sinus augmentation at the same time.

Materials and methods

We retrospectively evaluated 35 implants placed in 25 patients. Preoperative and postoperative CBCT were compared and analyzed for residual bone height (RBH) and increased bone height (IBH), the initial torque value (ITV), and the implant stability quotient (ISQ). A comparative evaluation was performed between a 1-stage (non-submerged) group and a 2-stage (submerged) group. After loading for at least 1 year, clinical and radiological evaluations were performed to evaluate the survival rate.

Results

One of the 35 implants failed in osseointegration, and the remaining 34 showed successful results. The failure-free survival rate at 1 year was 97.06% (95% CI, 91.38-100.0%). The RBH ranged from 3.1 to 9.6 mm (mean, 5.62 ± 1.68 mm), and the IBH ranged from 3 to 15.3 mm (mean, 8.87 ± 2.74 mm). Among the RBH, ITV, ISQ, treatment period, final bone height, and failure evaluation by stage of implant placement, only ISQ showed statistical significance between the groups (p < .001). A comparison of RBH, ITV, and ISQ, regardless of group, showed that each value tended to increase, but there were no statistically significant differences.

Conclusions

Immediate implant placement following tooth extraction with simultaneous lateral sinus augmentation is considered reliable even though the procedures had been performed at the same time.
International study of 24-h movement behaviors of early years (SUNRISE): a pilot study from Bangladesh
Authors: Hossain Mohammad Sorowar , Deeba Iztiba M. , Hasan Mahmudul , Kariippanon Katharina E. , Chong Kar Hau , Cross Penny L. , Ferdous Shameema , Okely Anthony D.
Published: September 2021

Background

The World Health Organization (WHO) released guidelines for physical activity, sedentary behavior, and sleep for children under 5 years of age in 2019. In response to these guidelines, this pilot study aimed to (i) determine the proportion of preschool children (ages 3-4 years) who met the WHO guidelines; (ii) examine the feasibility of the proposed protocol for the SUNRISE study; and (iii) assess the impact of the COVID-19 pandemic on movement behaviors of preschool children in Bangladesh.

Methods

Time spent in physical activity, sedentary behavior and sleep were objectively measured using two types of accelerometers (ActiGraph wGT3x-BT and ActivPAL4). Screen time and sleep quality were assessed via parent questionnaire. Fine and gross motor skills were measured using the Ages and Stages Questionnaire (3rd edition). Three executive functions were assessed using the Early Years Toolbox. Focus groups were conducted with parents and childcare staff to determine the feasibility of the protocol. Follow-up data during COVID-19 pandemic was collected from parents over phone.

Results

Data from 63 preschool-aged children and their parents was analyzed in this pilot study. Only three children (4.7%) met all components of the WHO guidelines. Separately, children meeting physical activity, sedentary screen time and sleep guidelines were 71.9%, 17.5%, and 59.7% respectively. The proportion of all children who were developmentally on-track for the gross and fine motor skills was 58.7% and 50.8%, respectively. Parents and educators reported that the protocol was feasible except for the activPAL-4 accelerometer. Approximately, 39% of children (14 out of 37) who wore this device developed itchy skin and rashes resulting in the suspension of using this device mid-way through data collection. During COVID-19, there was a significant decrease in children’s total physical activity (− 193 min/day), and time spent outside on weekdays (− 75 min/day) and weekend days (− 131 min/day) and a significant increase in sedentary screen time (+85 min/day).

Conclusion

Only a low proportion of children met the WHO guidelines. Methods and devices (except ActivPAL4) used in this pilot study proved to be feasible and this has paved the way to conduct the main SUNRISE study in Bangladesh. Future measures should be taken to address the issue of movement behaviors of children during the time of pandemics like COVID-19.
Depression is associated with increased disease activity and higher disability in a large Italian cohort of patients with rheumatoid arthritis
Authors: Pezzato Sara , Bonetto Chiara , Caimmi Cristian , Tomassi Simona , Montanari Ilaria , Gnatta Maria Giulia , Fracassi Elena , Cristofalo Doriana , Rossini Maurizio , Carletto Antonio , Tosato Sarah
Published: September 2021

Introduction

Depression is a quite common comorbidity in patients with rheumatoid arthritis (RA) and is thought to influence its severity. This study aims to estimate, in a large cohort of Italian patients with RA, the prevalence of depression and to investigate the clinical correlates of depression in terms of disease activity and disability.

Methods

This is a cross-sectional study enrolling 490 outpatients with RA (80% female, mean age 59.5). The Hospital Anxiety and Depression Scale (HADS) was used to assess the presence of depression with a cut-off of 11. We collected data about disease activity and disability with DAS28, TJC-68, PhGA, PGA, VAS, DAS28, SDAI, CDAI and HAQ.

Results

Prevalence of depression was 14.3% (95% CI: 11-17%). Depressed patients, when compared with not depressed ones, were found to have higher scores for TJC-68 (p = 0.011), PhGA (p = 0.001), PGA (p = 0.001), VAS (p = 0.001), DAS28 (p = 0.007), SDAI (p = 0.001), CDAI (p = 0.001) and HAQ (p = 0.001). Out of the 70 depressed patients, 30 subjects, already known to be depressed in the past, were still depressed at the time of the assessment, with only 11 (15.7%) under antidepressants. A multivariate analysis showed that male sex, higher PGA score, use of antidepressants and higher HAQ score were significantly associated with an increased risk of depression.

Conclusions

Our study shows that depression is common in RA and may affect its activity mainly via an alteration in the perception of the disease. Although its important implications, depression is still under-diagnosed and its management is inadequate.
Preparation of aerogel and its application progress in coatings: a mini overview
Authors: Mekonnen Berhanu Telay , Ding Wei , Liu Haiteng , Guo Song , Pang Xiaoyan , Ding Zhiwen , Seid Mohammed Hussein
Published: September 2021

Aerogels are predominantly mesoporous, extremely lightweight, low density (∼ 0.003 g/cm3) and thermally insulating materials. Over the years, aerogels have gained increasing attention due to their extraordinary properties (light, heat, sound, electricity and force) and application potentials in varieties of fields. Several studies have been carried out regarding aerogel preparation and its applications in coatings on different substrates. In this review, an overview of aerogels preparation and their application progress in coatings of most common substrates is presented. Attention is paid to aerogel coatings of textiles, leather, and substrates other than leather and textiles for special functionalities that could address the application progress in coatings. This review will help to inspire scientists and engineers towards novel aerogel materials and technologies to boost the industrial fabrication of flexible advanced materials.
Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services
Authors: Piat Myra , Wainwright Megan , Cherkas Danielle , Leblanc Sébastien , Sofouli Eleni , Rivest Marie-Pier , Albert Hélène , Casey Regina , O’Rourke Joseph J. , Labonté Lise
Published: September 2021

Background

Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic.

Methods

Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct’s impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes.

Results

Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives—renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed “engaging implementation teams during the COVID-19 pandemic” for this study).

Conclusions

The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.
Daily weekday audit and feedback to clinicians for an inpatient intervention in obstetrics: is there sustained impact over the weekend? A secondary analysis of a prospective cohort study
Authors: Hamm Rebecca F. , Levine Lisa D. , Lane-Fall Meghan , Beidas Rinad
Published: September 2021

Background

Audit and feedback as an implementation strategy leads to small, but potentially important improvements in practice. Yet, audit and feedback is time and personnel intensive. Many interventions designed for inpatient care are meant to be utilized by care teams all days of the week, including weekends when research staff are at a minimum. We aimed to determine if audit and feedback regarding use of an evidence-based inpatient obstetric intervention performed only on weekdays could have a sustained impact over the weekend.

Methods

This study was performed as a secondary analysis of a prospective cohort study examining the impact of implementation of a validated calculator that predicts the likelihood of cesarean delivery during labor induction. During the 1 year postimplementation period, Monday through Friday, a member of the study team contacted clinicians daily to provide verbal feedback. While the same clinician pool worked weekend shifts, audit and feedback did not occur on Saturdays or Sundays. The primary outcome was intervention use, defined as documentation of counseling around the cesarean risk calculator result, in the electronic health record. Intervention use was compared between those with (weekdays) and without (weekends) audit and feedback.

Results

Of the 822 women meeting eligibility criteria during the postimplementation period (July 1, 2018–June 30, 2019), 651 (79.2%) were admitted on weekdays when audit and feedback was occurring and 171 (20.8%) on weekends without audit and feedback. The use of the cesarean risk calculator was recorded in 676 of 822 (82.2%) of eligible patient charts. There was no significant difference in cesarean risk calculator use overall by days when audit and feedback occurred versus days without audit and feedback (weekday admissions 82.0% vs. weekend admissions 83.0%, aOR 0.90 95% CI [0.57–1.40], p = 0.76). There was no significant trend in the relationship between calculator use and weekday versus weekend admission by month across the study period (p = 0.21).

Conclusions

Daily weekday audit and feedback for implementation of an evidence-based inpatient obstetric intervention had sustained impact over the weekends. This finding may have implications for both research staffing, as well as sustainability efforts. Further research should determine the lowest effective frequency of audit and feedback to produce implementation success.
Digital Pathology in Cameroon
Authors: Gruber-Mösenbacher Ulrike , Katzell Lauren , McNeely Mark , Neier Elisabeth , Jean Bobo , Kuran Avelino , Chamala Srikar
Published: September 2021

PURPOSE

Cancer is becoming increasingly prevalent among the group of treatable diseases in African countries. There is a shortage of clinicians and pathologists available for cancer diagnosis and treatment. These limited resources must be efficiently used to maximize the number of patients treated. One of the critical factors in treatment efficiency is the correct and timely diagnosis of specimens by pathologists. However, there is currently a significant shortage of cancer care clinicians in Africa and an even more considerable shortage of pathologists. This article presents an example in which telepathology was used to mitigate the lack of pathologists in Cameroon.

METHODS

The telepathology workaround was implemented in a district hospital based in Cameroon's Adamawa region, where a European surgeon provides cancer treatment. A small histology laboratory there is run by one histotechnologist who processes surgical biopsies into histology slides. As there are no pathologists on site, these slides are digitally scanned using a mobile phone and a whole slide imaging (WSI) scanner. The slides are then shared electronically with a volunteering pathologist in Europe who provides a diagnostic report.

RESULTS

From 2018 to July 2019, specimens for 101 patients were photographed through an iPhone connected to a microscope eyepiece producing several individual images per specimen. From July 2019 to December 2020, slides from 282 patients were scanned using WSI and digitally transmitted.

CONCLUSION

WSI on hematoxylin and eosin histology slides for remote diagnosis can increase cancer treatment efficacy and reduce overtreatment of tumors clinically suspicious for malignancy in under-resourced countries with a lack of pathologists.
Apelin-13 Reverses Bupivacaine-Induced Cardiotoxicity via the Adenosine Monophosphate–Activated Protein Kinase Pathway
Authors: Ye Yingchao , Cai Yaoyao , Xia Erjie , Shi Kejian , Jin Zhousheng , Chen Hongfei , Xia Fangfang , Xia Yun , Papadimos Thomas J. , Xu Xuzhong , Liu Le , Wang Quanguang
Published: September 2021

BACKGROUND:

Cardiotoxicity can be induced by the commonly used amide local anesthetic, bupivacaine. Bupivacaine can inhibit protein kinase B (AKT) phosphorylation and activated adenosine monophosphate–activated protein kinase alpha (AMPKα). It can decouple mitochondrial oxidative phosphorylation and enhance reactive oxygen species (ROS) production. Apelin enhances the phosphatidylinositol 3-kinase (PI3K)/AKT and AMPK/acetyl-CoA carboxylase (ACC) pathways, promotes the complete fatty acid oxidation in the heart, and reduces the release of ROS. In this study, we examined whether exogenous (Pyr1) apelin-13 could reverse bupivacaine-induced cardiotoxicity.

METHODS:

We used the bupivacaine-induced inhibition model in adult male Sprague Dawley (SD) rats (n = 48) and H9c2 cardiomyocyte cell cultures to explore the role of apelin-13 in the reversal of bupivacaine cardiotoxicity, and its possible mechanism of action. AMPKα, ACC, carnitine palmitoyl transferase (CPT), PI3K, AKT, superoxide dismutase 1 (SOD1), and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (p47-phox) were quantified. Changes in mitochondrial ultrastructure were examined, and mitochondrial DNA, cell viability, ROS release, oxygen consumption rate (OCR) were determined.

RESULTS:

Apelin-13 reduced bupivacaine-induced mitochondrial DNA lesions in SD rats (P < .001), while increasing the expression of AMPKα (P = .007) and PI3K (P = .002). Furthermore, apelin-13 blocked bupivacaine-induced depolarization of the mitochondrial membrane potential (P = .019) and the bupivacaine-induced increases in ROS (P = .001). Also, the AMPK pathway was activated by bupivacaine as well as apelin-13 (P = .002) in H9c2 cardiomyocytes. Additionally, the reduction in the PI3K expression by bupivacaine was mitigated by apelin-13 in H9c2 cardiomyocytes (P = .001). While the aforementioned changes induced by bupivacaine were not abated by apelin-13 after pretreatment with AMPK inhibitor compound C; the bupivacaine-induced changes were still mitigated by apelin-13, even when pretreated with PI3K inhibitor-LY294002.

CONCLUSIONS:

Apelin-13 treatment reduced bupivacaine-induced oxidative stress, attenuated mitochondrial morphological changes and mitochondrial DNA damage, enhanced mitochondrial energy metabolism, and ultimately reversed bupivacaine-induced cardiotoxicity. Our results suggest a role for the AMPK in apelin-13 reversal of bupivacaine-induced cardiotoxicity.
Race and the Integrity of the Line
Authors: Musser Amber Jamilla
Published: September 2021

It is rare to find visual representations of female sexual pleasure in sexological treatises. Robert Latou Dickinson's Atlas of Human Sex Anatomy (1932) uses illustrations of sexual response to avoid making his text sensuous or pornographic. Like the charts in William Masters and Virginia Johnson's Human Sexual Response (1966), these drawings are carefully nestled between statistics and physiological summaries to embed them within the realm of the scientific and pedagogical. However, both are presumed to be racially unmarked. This article shows how blackness disrupts visual representations of pleasure and femininity while theorizing how the line functions as a way to maintain a norm. Against this, the potential of brown jouissance emerges via the zigzag style of contemporary Filipino artist Jevijoe Vitug. In his portrait, a glimpse of racialized, sensual excess emerges.
No Equity without Data Equity: Data Reporting Gaps for Native Hawaiians and Pacific Islanders as Structural Racism
Authors: Morey Brittany N. , Chang Richard Calvin , Thomas Karla Blessing , Tulua ‘Alisi , Penaia Corina , Tran Vananh D. , Pierson Nicholas , Greer John C. , Bydalek Malani , Ponce Ninez
Published: September 2021

Data on the health and social determinants for Native Hawaiians and Pacific Islanders (NHPIs) in the United States are hidden, because data are often not collected or are reported in aggregate with other racial/ethnic groups despite decades of calls to disaggregate NHPI data. As a form of structural racism, data omissions contribute to systemic problems such as inability to advocate, lack of resources, and limitations on political power. The authors conducted a data audit to determine how US federal agencies are collecting and reporting disaggregated NHPI data. Using the COVID-19 pandemic as a case study, they reviewed how states are reporting NHPI cases and deaths. They then used California's neighborhood equity metric—the California Healthy Places Index (HPI)—to calculate the extent of NHPI underrepresentation in communities targeted for COVID-19 resources in that state. Their analysis shows that while collection and reporting of NHPI data nationally has improved, federal data gaps remain. States are vastly underreporting: more than half of states are not reporting NHPI COVID-19 case and death data. The HPI, used to inform political decisions about allocation of resources to combat COVID-19 in at-risk neighborhoods, underrepresents NHPIs. The authors make recommendations for improving NHPI data equity to achieve health equity and social justice.
Impossible Figures
Authors: Paul Drew
Published: September 2021

This essay examines three documentary depictions of gay Palestinians in Israel and the West Bank. These documentaries often problematically assume a fundamental incompatibility between gay identities and Arab and Palestinian cultures, thereby, first, placing their subjects in the position of choosing between living in Palestine/Israel and living as openly gay; and second, producing a narrative of impossibility, in which Palestinian and gay identities can only exist in irresolvable conflict. However, Paul also argues that critical reactions to these films, as well as some broader scholarly debates over sexual identities and practices in the Arab world, also reinforce this narrative of impossibility in a way that makes little room for the diverse lived experiences of gay Palestinians. In order to move beyond this narrative, Paul rereads these documentaries with an emphasis on the quotidian experiences of the films’ gay Palestinian subjects. Through attention to queerness as a spatial experience, he analyzes the ways in which these characters inhabit urban spaces in Israel and Palestine in ways that contest and disorient dominant narratives about these spaces. Paul concludes that a focus on such experiential moments reveals queer lives that are exuberant and subversive, and he shows the necessity of moving beyond narratives of impossibility in studies of sexuality in the Middle East.
Implications of exosomes derived from cholesterol-accumulated astrocytes in Alzheimer's disease pathology
Authors: Wu Qi , Cortez Leonardo , Kamali-Jamil Razieh , Sim Valerie , Wille Holger , Kar Satyabrata
Published: September 2021

Amyloid β (Aβ) peptides generated from the amyloid precursor protein (APP) play a critical role in the development of Alzheimer's disease (AD) pathology. Aβ-containing neuronal exosomes, which represent a novel form of intercellular communication, have been shown to influence the function/vulnerability of neurons in AD. Unlike neurons, the significance of exosomes derived from astrocytes remains unclear. In this study, we evaluated the significance of exosomes derived from U18666A-induced cholesterol-accumulated astrocytes in the development of AD pathology. Our results show that cholesterol accumulation decreases exosome secretion, whereas lowering cholesterol increases exosome secretion, from cultured astrocytes. Interestingly, exosomes secreted from U18666A-treated astrocytes contain higher levels of APP, APP-C-terminal fragments, soluble APP, APP secretases and Aβ1-40 than exosomes secreted from control astrocytes. Furthermore, we show that exosomes derived from U18666A-treated astrocytes can lead to neurodegeneration, which is attenuated by decreasing Aβ production or by neutralizing exosomal Aβ peptide with an anti-Aβ antibody. These results, taken together, suggest that exosomes derived from cholesterol-accumulated astrocytes can play an important role in trafficking APP/Aβ peptides and influencing neuronal viability in the affected regions of the AD brain.
Political Leaders’ Discourses and Securitization of Migration: A Comparison of Turkey and the United States
Authors: Kabacaoğlu Selin , Memişoğlu Fulya
Published: September 2021

With the growing importance of human mobility in the global agenda since the early 1990s, international migration has increasingly evolved into a securitized phenomenon. This has also made international migrantsa prominent target group of security speech acts. The main objective of this study is to explore migration-security nexus in the context of political discourses. The paper brings a comparative perspective to the role of political leader discourses in the securitization of migration by examining the cases of the United States (USA), hosting the largest number of international migrants, and Turkey, the world’s top refugee hosting country. Through the analytical lens of critical discourse analysis (CDA) and securitization theory, the study unpacks the rhetoric used by Turkish President Recep Tayyip Erdoğan and American President Donald John Trump towards migrants/ asylum seekers. As the key findings demonstrate, the way the two leaders reflect the migration-security relationship to their speech acts significantly varies. President Trump associates migrants with security issues in multiple ways including social, political and economic spheres, while President Erdoğan’s discourse links migrants with security issues inthe economic realm, but his general discourse reflects a desecuritization approach. In both countries, it is observed that the discourses of political leaders concerning migrants and asylum seekers exert influence on public opinion.
Analysis of Academic Integration Processes of Syrian Students at Harran University
Authors: Kaya Mahmut , Şahin Hatice
Published: September 2021

One of the main problems of Syrian refugees who took refuge in Turkey is education. Education is an important factor in the migration process as a tool of integration with the host society, preventing the risk of lost generation, reducing marginalization and radicalization, as a source of economic and social capital and upward social mobility. The subject of this study is the academic integration processes of Syrian students studying at Harran University. The research was carried out with a mixed method in which quantitative and qualitative methods were used together. The study is based on the results of a questionnaire with 326 people and a focus group meeting with 12 people. The study was conducted between March and December 2020. In the research, the results of the survey were analyzed through descriptive statistics, focus group interview thematic content analysis. According to the research findings; due to problems arising from war, immigration and other conditions, economic problems, language, exclusion and discrimination to a certain extent, accommodation, transportation, limited club membership and low participation in off-campus socialization processes, future anxiety in terms of employment, low book reading rate, factors such as insufficient household conditions, cultural ghettoization came forward. On the other hand friendship relations between the Syrian and Turkish students is a positive outlook. Satisfaction with academic and administrative staff is at a certain level. Şanlıurfa turns into a center of attraction to a certain extent in terms of education. Studying at Harran University is a joy for more than half of Syrian students. The results of the research show that a certain level of integration has been reached, but there are still aspects that are lagging and need to be strengthened.