bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration
Authors: Curyto Kim , Wray Laura O , Sullivan Jennifer L , McConnell Eleanor S , Jedele Jenefer M , Minor Lisa , Karel Michele J 
Published: June 2023

Abstract

Background and Objectives
Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide.

Research Design and Methods
STAR was selected as an evidence-based practice for DBD, adapted for and piloted in VA (STAR-VA), and implemented through a train-the-trainer program from 2013 to 2018. Training and consultation were provided to 92 CLC teams. Evaluation before and after training and consultation included descriptive statistics of measures of clinical impact and survey feedback from site teams regarding self-confidence, engagement, resource quality, and content analysis of implementation facilitators and challenges.

Results
STAR-VA training and consultation increased staff confidence and resulted in significant decreases in DBD, depression, anxiety, and agitation for Veterans engaged in the intervention. Implementation outcomes demonstrated feasibility and identified facilitators and barriers. Key findings were interpreted using implementation frameworks and informed subsequent modifications to sustain implementation.

Discussion and Implications
STAR-VA successfully prepared teams to manage DBD and resulted in improved outcomes. Lessons learned include importance of behavioral health–nursing partnerships, continuous engagement, iterative feedback and adaptations, and sustainment planning. Evaluation of sustainment factors has informed selection of implementation strategies to address sustainment barriers. Lessons learned have implications for integrating team-based practices into system-level practice.
Building a Program Theory of Implementation Using Process Evaluation of a Complex Quality Improvement Trial in Nursing Homes
Authors: Ginsburg Liane R , Easterbrook Adam , Massie Ariane , Berta Whitney , Doupe Malcolm , Hoben Matthias , Norton Peter , Reid Colin , Song Yuting , Wagg Adrian , Estabrooks Carole 
Published: June 2023

Abstract

Background and Objectives
Significant quality problems exist in long-term care (LTC). Interventions to improve care are complex and often have limited success. Implementation remains a black box. We developed a program theory explaining how implementation of a complex intervention occurs in LTC settings—examining mechanisms of impact, effects of context on implementation, and implementation outcomes such as fidelity.

Research Design and Methods
Concurrent process evaluation of Safer Care for Older Persons in residential Environments (SCOPE)—a frontline worker (care aide) led improvement trial in 31 Canadian LTC homes. Using a mixed-methods exploratory sequential design, qualitative data were analyzed using grounded theory to develop a conceptual model illustrating how teams implemented the intervention and how it produced change. Quantitative analyses (mixed-effects regression) tested aspects of the program theory.

Results
Implementation fidelity was moderate. Implementation is facilitated by (a) care aide engagement with core intervention components; (b) supportive leadership (internal facilitation) to create positive team dynamics and help negotiate competing workplace priorities; (c) shifts in care aide role perceptions and power differentials. Mixed-effects model results suggest intervention acceptability, perceived intervention benefits, and leadership support predict implementation fidelity. When leadership support is high, fidelity is high regardless of intervention acceptability or perceived benefits.

Discussion and Implications
Our program theory addresses important knowledge gaps regarding implementation of complex interventions in nursing homes. Results can guide scaling of complex interventions and future research.
Law, film, and trans identity in Hong Kong
Authors: Wan Marco 
Published: June 2023

Abstract
This article examines the construction of trans identity in Hong Kong law and cinema. By juxtaposing the key Hong Kong court cases on trans rights and some recent feature films on trans experience, it argues that film can reproduce and reinforce the understanding of identity in the court cases, and that they can unwittingly perpetuate the dynamic of exclusion enacted in those cases. Law and popular film may seem to be distinct discursive domains, but their constructions of trans identity are in fact intertwined. The article contends that to break out of these limiting identity formulations, we need to move beyond the dominant imaginaries of law and popular culture. It offers one way of doing so by turning to independent queer filmmaking as a forum for articulating and recognizing alternative trans subjectivities.
Combinatorial Influence of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) Treatment on Cutaneous Wound Healing in BALB/c Mice
Authors: Mohammed Rebar N , Aziz Sadat Sadat Abdulla , Hassan Snur M A , Mohammed Hawraz Farhad , Ramzi Derin Omer 
Published: June 2023

Abstract
Bone marrow, a soft spongy tissue, is containing mesenchymal stem cells, that are well-recognized according to their self-renewability and stemness. Therefore, we hypothesized that bone marrow aspirate concentrate (BMAC) could have a pivotal influence on the process of wound healing in particular when it is combined with platelet-rich plasma (PRP). Thirty-six albino mice (BALB/c) were used in the study and they were grouped as negative-control, PRP treated, BMAC treated and BMAC plus PRP treated. An incisional wound (1 cm2) was made at the back of mouse and their wounds were treated according to their treatment plan and group allocations. Later, the skin at the treated wound sites was collected on days 7, 14, and 21 for histopathological investigation. The results showed that there was a statistically significant difference in BMAC+PRP-treated wounds over the rest of the treated groups in the acceleration of wound healing throughout the experiment by increasing the rate of wound contraction, re-epithelization process, and granulation tissue intensity with fluctuated infiltration in the number of the neutrophils, macrophages, and lymphocytes, also restoration of the epidermal and dermal thickness with less scarring and hair follicle regeneration vs to the negative-control, PRP and BMAC only treated groups. Our findings indicated that BMAC containing mesenchymal stem cells is an efficient approach, which can be used to enhance a smooth and physiopathological healing process, especially when it is used in combination with PRP.
Safe insertion of Veress needle for the induction of pneumoperitoneum: a technical note
Authors: Alam Fahreyar , Badminton Rebecca , Tsvetkov Filip , Hanif Zulfiqar , Payne Richard 
Published: June 2023

Abstract
Techniques for the induction of pneumoperitoneum for laparoscopic surgery remain varied as complication risk remains with all techniques. Veress needle is used for the induction of pneumoperitoneum as a technique of preference or when an open technique is considered challenging as in obese patients. We present a novel safe technique for insertion of Veress needle by measuring the depth of the anterior abdominal wall prior to insertion. Accurate measurements help in the safe insertion of the Veress needle for inducing pneumoperitoneum and hence reduce the incidence of intra-abdominal injuries.
Connection Between Sleep and Psychological Well-Being in U.S. Army Soldiers
Authors: Holmes Kristen E , Fox Nadia , King Jemma , Presby David M , Kim Jeongeun 
Published: June 2023

ABSTRACT

Introduction
The goal of this exploratory study was to examine the relationships between sleep consistency and workplace resilience among soldiers stationed in a challenging Arctic environment.

Materials and Methods
A total of 862 soldiers (67 females) on an Army base in Anchorage, AK, were provided WHOOP 3.0, a validated sleep biometric capture device and were surveyed at onboarding and at the conclusion of the study. Soldiers joined the study from early January to early March 2021 and completed the study in July 2021 (650 soldiers completed the onboarding survey and 210 completed the exit survey, with 151 soldiers completing both). Three comparative analyses were conducted. First, soldiers’ sleep and cardiac metrics were compared against the general WHOOP population and a WHOOP sample living in AK. Second, seasonal trends (summer versus winter) in soldiers’ sleep metrics (time in bed, hours of sleep, wake duration during sleep, time of sleep onset/offset, and disturbances) were analyzed, and these seasonal trends were compared with the general WHOOP population and the WHOOP sample living in AK. Third, soldiers’ exertion, sleep duration, and sleep consistency were correlated with their self-reported psychological functioning. All analyses were conducted with parametric and non-parametric statistics. This study was approved by The University of Queensland Human Research Ethics Committee (Brisbane, Australia) Institutional Review Board.

Results
Because of the exploratory nature of the study, the critical significance value was set at P &lt; .001. Results revealed that: (1) Arctic soldiers had poorer sleep consistency and sleep duration than the general WHOOP sample and the Alaskan WHOOP sample, (2) Arctic soldiers showed a decrease in sleep consistency and sleep duration in the summer compared to that in the winter, (3) Arctic soldiers were less able to control their bedroom environment in the summer than in the winter, and (4) sleep consistency but not sleep duration correlated positively with self-report measures of workplace resilience and healthy social networks and negatively with homesickness.

Conclusions
The study highlights the relationship between seasonality, sleep consistency, and psychological well-being. The results indicate the potential importance of sleep consistency in psychological functioning, suggesting that future work should manipulate factors known to increase sleep consistency to assess whether improved sleep consistency can enhance the well-being of soldiers. Such efforts would be of particular value in an Arctic environment, where seasonality effects are large and sleep consistency is difficult to maintain.
Progress in the Typhoid Conjugate Vaccine Program Rollout Supported by Gavi During the COVID-19 Pandemic and the Path Forward
Authors: Russell Allyson L , Hampton Lee M , Sinha Antara , Luquero Francisco J , Abdelwahab Jalaa’ 
Published: June 2023

Abstract
Gavi supports countries to introduce typhoid conjugate vaccine (TCV) with catch-up campaigns. Available TCVs are highly efficacious, equity-focused, and critical to curbing the expansion of antimicrobial resistance. Four Gavi-supported countries have introduced TCVs since 2018. In the wake of the COVID-19 emergency, momentum is building to scale up TCV introduction worldwide, supported by global partners and Gavi’s funding for improved typhoid diagnostics.
Diagnostics for Typhoid Fever: Current Perspectives and Future Outlooks for Product Development and Access
Authors: Sapkota Jyotshna , Roberts Tamalee , Basnyat Buddha , Baker Stephen , Hampton Lee M , Dittrich Sabine 
Published: June 2023

Abstract
Typhoid is an enteric disease caused by Salmonella Typhi. Like many febrile illnesses, typhoid presents with nonspecific symptoms. In routine healthcare settings in low- and middle-income countries, typhoid fever is suspected and treated empirically. Though many diagnostic tests are available for typhoid diagnosis, there are currently no diagnostic tests that meet ideal requirements for sensitivity, specificity, speed, and cost-effectiveness. With introduction of typhoid conjugate vaccine, it is essential to explore the current and future typhoid approach in the context of use case and access to ensure their utilization for disease control.
What Should We Be Recommending for the Treatment of Enteric Fever?
Authors: Parry Christopher M , Qamar Farah N , Rijal Samita , McCann Naina , Baker Stephen , Basnyat Buddha 
Published: June 2023

Abstract
Patients with suspected enteric (typhoid and paratyphoid) fever are predominantly managed as outpatients in endemic regions. Nonspecific clinical presentation, lack of accurate diagnostic tools, and widespread antimicrobial resistance makes management challenging. Resistance has been described for all antimicrobials including chloramphenicol, amoxycillin, trimethoprim-sulfamethoxazole, ciprofloxacin, ceftriaxone, and azithromycin. No significant differences have been demonstrated between these antimicrobials in their ability to treat enteric fever in systematic reviews of randomized controlled trials (RCTs). Antimicrobial choice should be guided by local resistance patterns and national guidance. Extensively drug-resistant typhoid isolates require treatment with azithromycin and/or meropenem. Combining antimicrobials that target intracellular and extracellular typhoid bacteria is a strategy being explored in the Azithromycin and Cefixime in Typhoid Fever (ACT-SA) RCT, in progress in South Asia. Alternative antimicrobials, such as the oral carbapenem, tebipenem, need clinical evaluation. There is a paucity of evidence to guide the antimicrobial management of chronic fecal carriers.
Achieving Impact: Charting the Course to Meet the Challenges Ahead at the 12th International Conference on Typhoid and Other Invasive Salmonelloses
Authors: Greear Jade A , Steele A Duncan , Garrett Denise O 
Published: June 2023

Abstract
Typhoid fever and other invasive salmonelloses remain a major public health concern, primarily in low- and middle-income countries in Asia and Africa, where transmission occurs through contaminated food or water. However, recent developments in research, policy, and implementation offer newfound optimism for prevention and control. Now, more than ever, a coordinated and multisectoral global response is needed. To chart the course to meet the challenges ahead, the Coalition against Typhoid, housed at the Sabin Vaccine Institute, virtually organized the 12th International Conference on Typhoid and Other Invasive Salmonelloses from December 7 to 9, 2021. This commentary provides an overview of the conference's significant findings, highlighting barriers and opportunities for prevention and control. Topics covered include diagnostics advancements, improved data methodologies for a better understanding of the disease burden, the incorporation of environmental surveillance and genomics, the threat of drug resistance, and the use of typhoid conjugate vaccines alongside other integrated solutions.
Currency Risk Premiums Redux
Authors: Nucera Federico , Sarno Lucio , Zinna Gabriele 
Published: June 2023

Abstract
We study a large currency cross-section using asset pricing methods that account for omitted-variable and measurement-error biases. First, we show that the pricing kernel includes at least three latent factors that resemble (but are not identical to) a strong U.S. “dollar” factor and two weak high Sharpe ratio “carry” and “momentum” slope factors. Evidence for an additional “value” factor is weaker. Second, using this pricing kernel, we find that only a small fraction of the over 100 nontradable candidate factors considered have a statistically significant risk premium, mostly relating to volatility, uncertainty, and liquidity conditions, rather than macro variables.
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Modern Midwifery and Maternal Mortality in Urban China, 1920s–1940s
Authors: Li Minghui 
Published: June 2023

Summary
This article investigates the history of midwifery from the 1920s to 1940s in China through looking at the linkage between modern midwifery and maternal mortality in urban areas. It first shows that people’s perceptions of maternal mortality and its causes changed from the nineteenth to the twentieth century, and that a modern form of midwifery service took shape in the Republican era (1912–49) in order for reducing maternal mortality rate and building a strong nation. Evidence from urban areas of Beijing and Sichuan between the 1920s and the 1940s demonstrates that the practice of modern midwifery varied with medical infrastructure and personnel in different places, and that modern midwives in small towns may practise against the rules, taking the initiative to use forceps and perform surgery to save mothers’ lives. The relationship between modern midwifery and maternal mortality in the researched period was more complex than medical experts’ anticipation.
Combinatorial islet protective therapeutic approaches in β‐cell transplantation: Rationally designed solutions using a target product profile
Authors: Lu Katie , Brauns Timothy , Sluder Ann E. , Poznansky Mark C. , Dogan Fatma 
Published: June 2023

AbstractWhile progress has been made in the development of islet cell transplantation (ICT) as a viable alternative to the use of exogenous insulin therapy in the treatment of type 1 diabetes, it has not yet achieved its full potential in clinical studies. Ideally, ICT would enable lifelong maintenance of euglycemia without the need for exogenous insulin, blood glucose monitoring or systemic immune suppression. To achieve such an optimal result, therapeutic approaches should simultaneously promote long‐term islet viability, functionality, and localized immune protection. In practice, however, these factors are typically tackled individually. Furthermore, while the requirements of optimal ICT are implicitly acknowledged across numerous publications, the literature contains few comprehensive articulations of the target product profile (TPP) for an optimal ICT product, including key characteristics of safety and efficacy. This review aims to provide a novel TPP for ICT and presents promising tried and untried combinatorial approaches that could be used to achieve the target product profile. We also highlight regulatory barriers to the development and adoption of ICT, particularly in the United States, where ICT is only approved for use in academic clinical trials and is not reimbursed by insurance carriers. Overall, this review argues that the clear definition of a TPP in addition to the use of combinatorial approaches could help to overcome the clinical barriers to the widespread adoption of ICT for the treatment of type 1 diabetes.
Increasing Diversity in the Physician Workforce: Pathway Programs and Predictive Analytics
Authors: Mayrath Michael , Fontanez Darah , Abdelbaset Ferrahs , Lenihan Bryan , Lenihan David V. 
Published: June 2023

Problem
Lack of diversity in the physician workforce has well-documented negative impacts on health outcomes. Evidence supports the use of pathway or pipeline programs to recruit underrepresented in medicine students. However, data on how a pathway program should deliver instruction are lacking. This report describes a multiyear project to build such a system with the goal of increasing diversity within medical school cohorts and ultimately the physician workforce.

Approach
In the 2015–2016 academic year, the Ponce Health Sciences University started a 3-phase project to create a data-driven medical school feeder system by coupling a pathway program with predictive analytics. Phase 1 launched the pathway program. Phase 2 developed and validated a predictive model that estimates United States Medical Licensing Examination (USMLE) Step 1 performance. Phase 3 is underway and focuses on adoption, implementation, and support.

Outcomes
Data analysis compared 2 groups of students (pathway vs direct) across specific factors, including Medical College Admission Test (MCAT) score, undergraduate grade point average (GPA), first-generation status, and Step 1 exam performance. Statistically significant differences were found between the 2 groups on the MCAT exam and undergraduate GPA; however, no significant differences were found between groups for first-generation status and performance on the Step 1 exam. This finding supports the authors’ hypothesis that although pathway students have significantly lower mean MCAT exam scores compared with direct students, pathway students perform just as well on the USMLE Step 1 exam.

Next Steps
Next steps include expanding the project to another campus, adding more socioeconomic status and first-generation data, and identifying best curricular predictors. The authors recommend that medical school programs use pathway programs and predictive analytics to create a more data-centered approach to accepting students with the goal of increasing physician workforce diversity.
The impact of the Dobbs decision on in-vitro fertilization and fertility care
Authors: Ulker Ashley , Evans M Blake , Craig LaTasha B. 
Published: June 2023

Purpose of review
The 2022 Supreme Court ruling in Dobbs vs Jackson marks a frightening new reality in America. Physicians and patients have been left confused and concerned regarding the broader implications of this ruling. Now that the constitutional right to an abortion has been overturned and the power has been relinquished to individual states, there is justifiable concern regarding the impact on in-vitro fertilization (IVF). This review explores the ways IVF and fertility care are at risk in the context of our new reality.

Recent findings
The decision to overturn the right to an abortion without specifying a viability standard opens the door to interpretation of when ‘life’ begins. Laws that do not specifically exempt IVF, or that include language suggesting that ‘life begins at fertilization’ pose a real threat to IVF. The potential for personhood laws poses a threat to embryo freezing and disposition, preimplantation genetic testing and culpability among other concerns.

Summary
Limitations to IVF may become an unintended consequence to the Dobbs decision, making IVF less efficient, more costly and unsafe, and inevitably limiting access to care. It is therefore crucial that public health legislation be rooted in science and not dictated by religion or politics. Physicians must act alongside legislators to protect reproductive freedom and access to care.