bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractSchool‐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

AbstractThe 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

AbstractGiven 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

AbstractPurposeThis 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.MethodsPatient history, clinical examination, arthroscopic findings and investigations of 12 patients who consulted with the senior author are presented.ResultsTwelve 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.ConclusionPatients 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 evidenceLevel 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

AbstractPurposeThis 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.MethodEighteen 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.ResultsThe 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).ConclusionThis 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 EvidenceNot 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

AbstractExtracellular 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

AbstractIntroductionIn 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.MethodsWe 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.ResultsImplementing 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.ConclusionsOur 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

AbstractIntroductionThe 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.MethodsBetween 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.ResultsProviders 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).ConclusionsProvider‐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

AbstractIntroductionIn 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.MethodsWe 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.ResultsWe 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.DiscussionWe 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.ConclusionsSome 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

AbstractIntroductionAdolescent 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.MethodsWe 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.ResultsInterviews 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.ConclusionsUsing 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.