bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

AbstractThis 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

ABSTRACT
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.
Effects of 3% binahong (Anredera cordifolia) leaf extract gel on alveolar bone healing in post-extraction tooth socket wound in Wistar rats (Rattus norvegicus)
Authors: Hanafiah Olivia Avriyanti , Hanafiah Diana Sofia , Dohude Gostry Aldica , Satria Denny , Livita Livita , Moudy Nindha Siti , Rahma Rahma 
Published: September 2021

Background: Binahong (Anredera cordifolia (Ten.) STEENIS) is a widely available herbal plant in Indonesia and has been intensely researched for its healing abilities due to its biological activities, but few have studied its capability in accelerating hard tissue healing in post-extraction tooth sockets. The purpose of this study was to analyse the effects of 3% binahong leaf extract gel on alveolar bone healing in post-extraction sockets in Wistar rats. Methods: In this study, 48 male Wistar rats were randomly allocated to twelve groups. After the extraction of the left mandibular incisor, sockets in Group I to IV were given 3% binahong leaf extract gel, group V to VIII were given a control gel, and group IX to XII were given Gengigel® for 14 days. The residual socket volume (RSV) and fibroblast proliferation were observed on the 3rd, 7th, and 14th day post-extraction, while the osteoblast and osteocyte proliferation were observed on the 7th, 14th, and 28th day post-extraction. The RSV data were analysed using repeated measure ANOVA and one-way ANOVA, while the histopathological data were analysed using one-way ANOVA. Results: The results showed that the binahong group had the lowest RSV and the highest fibroblast proliferation compared to the other groups on the 7th day (p<0.05) and the highest osteoblast and osteocyte proliferation compared to the other groups on the 14th day (p<0.05). Conclusion: The experiment showed that 3% binahong leaf extract gel could accelerate wound closure, which was characterized by a greater decrease in the RSV value in comparison to the other treatment groups and could enhance alveolar bone healing by increasing the proliferation of fibroblasts, osteoblasts, and osteocytes.
Driving-induced lower back pain: Investigation of causes and recommendations with TRIZ
Authors: Ng Poh Kiat , Mohamed Muhammad Syafiq Syed , Yeow Jian Ai 
Published: September 2021

Background: Driving-induced lower back pain (DLBP) is associated with long driving times and awkward postures. Nonetheless, its actual causes and solutions remain unclear due to intervening causes from activities of daily living and traumatic injuries. This study investigated the causes and recommendations for DLBP using the theory of inventive problem solving (TRIZ). Methods: A cause-and-effect chain analysis (CECA) was conducted based on discussions with 19 ergonomics experts from Malaysia. Engineering contradictions were formulated according to the causes and associated with the parameters of the TRIZ system. These parameters were then intersected in the contradiction matrix to extract the inventive principles. Finally, recommendations were made based on these principles. Results: CECA uncovered the design- and posture-related causes of DLBP. It was implied that missing seat adjustment controls might cause drivers to sit with their knees positioned higher than their hips. This issue causes an excessive posterior pelvic tilt, resulting in DLBP. To address this issue, an inert atmosphere involving the addition of inflatable bubble wraps to elevate the posterior position was recommended. Conclusion: While there have been studies on DLBP, the present study demonstrated originality by using TRIZ to preliminarily but systematically investigate and resolve DLBP. Further triangulations, prototyping, experimentations, and verifications were not possible due to time and budgetary constraints. Nevertheless, this research uncovered the TRIZ-integrated perspectives on ergonomic solutions to DLBP that are more cost-effective than medical treatments or design overhauls.
Strychnine poisoning due to traditional Chinese medicine: a case series
Authors: Tong Hok-Fung , Chan Candace Yim , Ng Sau-Wah , Mak Tony Wing-Lai 
Published: September 2021

Background: Strychnine poisoning is rare but possibly fatal. The most reported sources of strychnine poisoning include rodenticides and adulterated street heroin. Here we report a case series of an unusual cause of strychnine poisoning – Strychni semen, a herb known as “maqianzi” in traditional Chinese medicine (TCM). Methods: All cases of strychnine poisoning confirmed by the Hospital Authority Toxicology Reference Laboratory (HATRL, the highest-level clinical toxicology laboratory in Hong Kong) between May 2005 and May 2018 were reviewed. Results: Twelve cases of strychnine poisoning were recorded, and Strychni semen was the exclusive source. Ten (83.3%) patients presented with muscle spasms, and four (33.3%) developed typical conscious convulsions. The poisoning was severe in two (16.7%) patients, moderate in three (25%) and mild in eight (58.3%). No case fatality was recorded. Three (25%) patients were TCM practitioners and two (16.7%) were laymen who bought the herb themselves without a proper prescription. Conclusion: The practice of TCM is becoming popular in different parts of the world amid the COVID-19 pandemic. The spectrum of clinical features of strychnine poisoning secondary to Strychni semen are similar to those arising from different origins. Eliciting a history of TCM use, apart from exposure to rodenticides and drugs of abuse, may allow timely diagnosis in patients with compatible clinical features. Enhancement of TCM safety could minimize the hazard.
Contact tracing during the COVID-19 outbreak: a protocol for enabling rapid learning from experiences and exploring the psychological impact on contact tracers
Authors: O'Donovan Róisín , Buckley Claire , Crowley Philip , Fulham-McQuillan Hugh , Gilmore Brynne , Martin Jennifer , McAuliffe Eilish , Moore Gemma , Nicholson Emma , Ní Shé Éidín , O'Hara Mary Clare , Segurado Ricardo , Sweeney Mary Rose , Wall Patrick , De Brún Aoife 
Published: September 2021

Background: Given the unprecedented nature of the COVID-19 pandemic, the Irish health system required the redeployment of public sector staff and the recruitment of dedicated contact tracing staff in the effort to contain the spread of the virus. Contact tracing is crucial for effective disease control and is normally carried out by public health teams. Contact tracing staff are provided with rapid intensive training but are operating in a dynamic environment where processes and advice are adapting continuously. Real-time data is essential to inform strategy, coordinate interconnected processes, and respond to needs. Given that many contact tracers have been newly recruited or redeployed, they may not have significant experience in healthcare and may experience difficulties in managing the anxieties and emotional distress of the public. Aim: (i) identify emerging needs and issues and feed this information back to the Health Service Executive for updates to the COVID-19 Contact Management Programme (CMP); (ii) understand the psychological impact on contact tracers and inform the development of appropriate supports. Methods: We will use a mixed-methods approach. A brief online survey will be administered at up to three time points during 2021 to measure emotional exhaustion, anxiety, general health, and stress of contact tracing staff, identify tracing systems or processes issues, as well as issues of concern and confusion among the public. Interviews will also be conducted with a subset of participants to achieve a more in-depth understanding of these experiences. Observations may be conducted in contact tracing centres to document processes, practices, and explore any local contextual issues. Impact: Regular briefs arising from this research with data, analysis, and recommendations will aim to support the work of the CMP to identify problems and implement solutions. We will deliver regular feedback on systems issues; challenges; and the psychological well-being of contact tracing staff.