bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired oxygenation and hemodynamic instability are independent predictors of long-term mortality in a regional cohort needing urgent fixed-wing intensive care transport to tertiary care
Authors: Sundbom Marcus Fredriksson , Sangfelt Amalia , Lindgren Emma , Nyström Helena , Johansson Göran , Brändström Helge , Haney Michael 
Published: November 2020

Abstract
Background We aimed to test if impaired oxygenation or major hemodynamic instability at the time of emergency intensive care transport between hospitals are predictors of long-term mortality.Methods From a regional hospital intensive care transport research database, the study cohort was identified as those emergency intensive care cases transported in fixed-wing air ambulance from outlying hospitals to a regional tertiary care center during 2000–2016 for adults (16 years old or older). Impaired oxygenation was defined as oxyhemoglobin % - inspired oxygen fraction ratio (S/F ratio) < 100. Major hemodynamic instability was defined as need for treatment with noradrenaline infusion to sustain mean arterial pressure (MAP) at or above 60 mmHg or having a mean MAP < 60. All-cause mortality at 3 months after transport was the primary outcome, and secondary outcomes were all-cause mortality at 6 and 12 months. Multivariate cumulative survival and hazard analysis was performed for intervals 3, 6 and 12 months.Results There were 2142 patients included in the analysis. The S/F ratio < 100 was associated with increased mortality risk compared to S/F > 300 at all time-points, with hazard ratio (HR) 2.9 (1.9–4.4 95% CI, p < 0.001) at 12 months. Major hemodynamic instability during ICU transport was associated with increased HR of all-cause mortality up to one year with hazard ratio 1.9 (1.5–2.5, p < 0.001).Conclusion Major impairment of oxygenation and/or major hemodynamic instability at the time of ICU transport to get to urgent tertiary intervention is strongly associated with reduced survival at least up to one year after the transport, in this cohort. These findings support the conclusion that these conditions are markers for many fold increase in risk for death notable already at 3 months after transport for patients with these conditions. How much this risk is modifiable is not assessable in this analysis.
SARS-CoV-2-specific T cell immunity in mild hypertensive patients with COVID-19 in China
Authors: Zeng Qiang , Huang Gang , Li Yong-Zhe , Li Yirong , Dong Shenyong , Xu Guoqiang , Xu Yang 
Published: November 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) pandemic leads to severe illness, life-threatening complications, and death, especially in high-risk groups such as elderly people and individuals with hypertension or diabetes. It has been shown that SARS-CoV-2-specific T cell immunity is important for the patient recovery from COVID-19. However, there are no reports about SARS-CoV-2-specific T cell immunity in hypertensive patients with COVID-19.Results: In this work, through the study of a cohort of 76 mild cases of hypertensive patients with COVID-19 and 572 hypertensive patients without COVID-19, we discovered that SARS-CoV-2 infection in hypertensive patients is characterized by T lymphopenia during the acute phase and the high frequency of CD4+CD25+, CD4+CD45RO+, and CD8+CD28+ T cells in the recovery phase. We also showed that strong SARS-CoV-2-specific CD4+IFNg+ T cell responses are associated with high SARS-CoV-2-specific antibody titers in hypertensive patients with COVID-19.Conclusions: The subsets of T cells including CD4+CD25+, CD4+CD45RO+, and CD8+CD28+ could be valuable biomarkers for the estimation of the progression of hypertensive patients with COVID-19. The hypertensive patients with COVID-19 exhibits T lymphopenia during the acute phase and have proper immune function during the recovery phase. This study may provide valuable insights for the monitoring and treatment of hypertensive patients with COVID-19.
“Having more women humanitarian leaders will help transform the humanitarian system”: Challenges and Opportunities for Women Leaders in Conflict and Humanitarian Health
Authors: Patel Preeti , Meagher Kristen , Achi Nassim El , Ekzayez Abdulkarim , Sullivan Richard , Bowsher Gemma 
Published: November 2020

Abstract
Background: It is estimated that over 40 percent of the half a million humanitarian workers who provide frontline care during emergencies, wars and disasters, are women. Women are at the forefront of improving health for conflict-affected populations through service delivery, education and capacity strengthening, advocacy and research. Women are also disproportionately affected by conflict and humanitarian emergencies. The growing evidence base demonstrating excess female morbidity and mortality reflects the necessity of evaluating the role of women in leadership driving health research, policy and programmatic interventions in conflict-related humanitarian contexts. Despite global commitments to improving gender equality, the issue of women leaders in conflict and humanitarian health has been given little or no attention. The aim of this paper focuses on three domains: importance, barriers and opportunities for women leaders in conflict and humanitarian health. Following thematic analysis of the material collected, we discuss the following themes: barriers of women’s leadership domain at societal level, and organisational level, which is subcategorized into culture and strategy. Building on the available opportunities and initiatives and on inspirational experiences of the limited number of women leaders in this field, recommendations for empowering and supporting women’s leadership in conflict health are presented. Methods: A desk-based literature review of academic and grey sources was conducted followed by thematic analysis.Results: There is very limited evidence on women leaders in conflict and humanitarian health. Some data shows that women have leadership skills that help to support more inclusive solutions which are incredibly important in this sector. However, deeply imbedded discrimination against women at the organisational, cultural, social, financial and political levels is exacerbated in conflict which makes it more challenging for women to progress in such settings.Conclusion: Advocating for women leaders in conflict and health in the humanitarian sector, governmental bodies, academia and the global health community is crucial to increasing effective interventions that adequately address the complexity and diversity of humanitarian crises.
Topical application of adipose tissue derived mesenchymal stem cells (ADMSCs) reduced cerebral edema in experimental traumatic brain injury (TBI)- a preliminary study
Authors: MA Hui , Cui Lian Xu , Lam Ping Kuen , Tong Cindy SW , Lo Kin KY , Wong George KC , Poon Wai Sang 
Published: November 2020

Abstract
Background:Our previous studies showed that topical application of mesenchymal stem cells (MSCs) improved functional recovery in rat traumatic brain injury (TBI) model, and hypoxic precondition further enhanced the therapeutic effects of MSCs. There was no previous study on the attenuation of cerebral edema by MSCs.Objective:We investigated whether topical application of normoxic and hypoxic MSCs could reduce cerebral edema in an experimental TBI model.Methods:2 million normoxic (N=24) and hypoxic (N=24) MSCs were applied topically to exposed cerebral cortex in a controlled cortical impact (CCI) model. The MSCs were fixed in position with fibrin glue. No treatment was given to control animals (TBI only: n=24). After surgery, four animals in each group were sacrificed daily (day 1 to day 6) for edema evaluation. Normal animals without TBI were used as reference (n=4). The expressions of GFAP, AQP4 and MMP9 were also investigated by immunofluorescence staining and RT-PCR at day 3. Results:The edema peaked within 3 days after TBI. Compared with the control, hypoxic MSCs reduced brain water content significantly (p<0.05). Both hypoxic and normoxic MSCs downregulated the expression of MMP9 and normalized AQP4 distribution to astrocytes end feet.Conclusion:Our preliminary study showed that topical application of hypoxic MSCs suppressed both vasogenic and cytotoxic edema formation.
Analysis of the heterogeneity of the BCR H-CDR3 repertoire in the bone marrow and spleen of 3-, 12-, and 20-month old mice&nbsp;
Authors: Ma Lina , Yao Xinsheng , Xinxin Tao , Xiaoyan He , Peng Wang , Long Ma , Bin Shi 
Published: November 2020

Abstract
The number of central and peripheral B cells and their responsiveness are decreased in aged mice. The diversity of mouse central and peripheral B cell repertoires with increasing age has not been elucidated. In this study, we demonstrated that there were significant differences in the usage of some V, D, and J genes in the BCR H-CDR3 repertoire of bone marrow B cells, spleen B cells and spleen memory B cells in 3-, 12-, and 20-month-old mice. In the productive, pseudogene, and out-of-frame sequences, bone marrow B cells had significant differences in 5′J trimming with age; peripheral spleen B cells and memory B cells had significant differences in N1 insertion, N2 insertion, P5'D insertion, and 5'D trimming with age. The BCR H-CDR3 repertoire diversity of mouse bone marrow B cells, spleen B cells and spleen memory B cells decreased with increasing age. The proportion of overlap in bone marrow and spleen B cells, but not spleen memory B cells, of mice at different ages was lower at 3 months than at 12 and 20 months. This study is the first to report the homogeneity and heterogeneity of the CDR3 repertoire of central and peripheral B cells change as mice age, to further investigation of the decline and response of B cell immunity in young/middle/old-aged mice.
Everything Counts -- A Method to Determine Viral Suppression Among People Living With Hiv Using Longitudinal Data for the Hiv Care Continuum. - Results of two large, German, multi-center real-life cohort studies over 20 years (1999-2018)
Authors: Schmidt Daniel , Kollan Christian , Stoll Matthias , Hamouda Osamah , Bremer Viviane , Kurth Tobias , Bartmeyer Barbara 
Published: November 2020

Abstract
BackgroundThe aim of this study was to develop a standardized method to reconstruct persons' individual VL courses to determine viral suppression and duration of viremia for the HIV care continuum in Germany using longitudinal cohort data.MethodsWe analyzed data from two large, multi-center German cohort studies under the direction of the Robert Koch Institute. We included data from 1999-2018 of all diagnosed people and of people who initiated antiretroviral treatment (ART). We developed a model generating virtual VL values and an individual VL course corresponding to real VL measurements with a maximum distance of 180 days, considering ART status and VL dynamics. If the distance between VL measurements was >180 days, the time between was defined as gap time. Additionally, we considered blips, which we defined as a single detectable VL <1,000 copies/ml within 180 days.ResultsA total of 22,120 people (164,691 person-years, PY) after ART initiation were included in the analyses. The proportion of people with viral suppression (VL <50 copies/ml) increased from 34% in 1999 to 93% in 2018. The proportion of people with VL <200 copies/ml increased from 47% in 1999 to 96% in 2018. The proportion of people with viremia >1,000 copies/ml decreased from 37% in 1999 to 3% in 2018. The proportion of people with gap time fluctuated and ranged between 18% and 28%. An analysis of the first VL after gap time showed that 90% showed viral suppression, 5% VL between 50-<1,000 copies/ml and 5% VL >1,000 copies/ml.ConclusionWe provide a method for estimating viral suppression and duration of viremia using longitudinal VL data. We observed a continuous and remarkable increase of viral suppression. Furthermore, a notable proportion of those with viremia showed low-level viremia and were therefore unlikely to transmit HIV. Individual health risks and HIV drug resistance among those with low-level viremia are problematic, and viral suppression remains the goal. In 2018, 93% and 96% of people after ART initiation showed VL <50 copies/ml and VL <200 copies/ml, respectively. Therefore, using the threshold of VL <200 copies/ml, Germany reached the UNAIDS 95 target of viral suppression since 2017.
Financial burden impact quality of life among Lymphatic Filariasis Patients
Authors: Asiedu Samuel Opoku , Kwarteng Alexander , Amewu Emmanuel Kobla Atsu , Kini Priscilla , Aglomasa Bill Clinton , Forkuor John Boulard 
Published: November 2020

Abstract
Background: Human lymphatic filarial pathology is the main cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the morbidity associated with the disease with the purpose of improving the quality of life of the patients. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. Method: In the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the domains of LFSQQ instrument. Results: Of the 155 study participants recruited, 115 (74.19%) were females and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphedema while only 2 patients had stage seven (7) lymphedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = -0.504, p-value < 0.001) between the stage of lymphedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status was the lowest (45.94) among the study participants. Conclusion: Our findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their wellbeing.
Human fetal liver MSCs are more effective than adult bone marrow MSCs for their immunosuppressive, immunomodulatory and Foxp3+ T regs induction capacity
Authors: Yu Yi , Valderrama Alejandra Vargas , Han Zhongchao , Uzan Georges , Naserian Sina , Oberlin Estelle 
Published: November 2020

Abstract
Background: Mesenchymal stem cells (MSCs) display active capacities of suppressing or modulating harmful immune responses through diverse molecular mechanisms. These cells are under extensive translational efforts as cell therapies for immune-mediated diseases and transplantations. A wide range of preclinical studies and limited number of clinical trials using MSCs have not only shown promising safety and efficacy profiles but have also revealed changes in regulatory T cell (T reg) frequency and function. However, the mechanisms underlying this important observation are not well understood. Cell-to-cell contact, production of soluble factors, reprogramming of antigen presenting cells to tolerogenic phenotypes have emerged as possible mechanisms by which MSCs produce an immunomodulatory environment for T reg expansion. We and others demonstrated that adult bone-marrow (BM)-MSCs suppress adaptive immune responses directly by inhibiting the proliferation of CD4+ (“helper”) and CD8+ (“cytotoxic”) T cells but also indirectly through induction of Tregs. In parallel we demonstrated that fetal liver (FL)-MSCs displays much longer-lasting immunomodulatory properties compared to BM-MSCs, by inhibiting directly the proliferation and activation of CD4+ and CD8+ T cells. Therefore, we investigated if FL-MSCs exert their strong immunosuppressive effect also indirectly through induction of T regs.Methods: MSCs were obtained from FL and adult BM and characterized according to their surface antigen expression, their multilineage differentiation and their proliferation potential. Using different in-vitro combinations, we performed co-cultures of FL or BM-MSCs and murine CD3+CD25-T cells to investigate immunosuppressive effects of MSCs on T cells and to quantify their capacity to induce functional T regs. Results: We demonstrated that although both types of MSC exhibit similar phenotypic profile and differentiation capacity, FL-MSCs have significantly higher proliferative capacity and ability to suppress both CD4+ and CD8+ murine T cell proliferation and to modulate them towards less active phenotypes than adult BM-MSCs. Moreover, their substantial suppressive effect was associated with an outstanding increase of functional CD4+CD25+Foxp3+ T regs compared to BM-MSCs.Conclusions: These results highlight the immunosuppressive activity of FL-MSCs on T cells and show for the first time that one of the main immunoregulatory mechanisms of FL-MSCs passes through active and functional T reg induction.
Microbial fuel cell assisted utilization of glycerol for succinate production by mutant of Actinobacillus succinogenes
Authors: Zheng Tianwen , Xu Bin , Ji Yaliang , Zhang Wenming , Xin Fengxue , Dong Weiliang , Wei Ping , ma jiangfeng , Jiang Min 
Published: November 2020

Abstract
Background: The global production of glycerol is increasing year by year since the demands of biodiesel is rising. It is benefit for high-yield succinate synthesis due to its high reducing property. A. succinogenes, a succinate-producing candidate, cannot grow on glycerol anaerobically, as it needs a terminal electron acceptor to maintain the balance of intracellular NADH and NAD+. Microbial fuel cell (MFC) has been widely used to release extra intracellular electrons. However, A. succinogenes is a non-electroactive strain which need the support of electron shuttle in MFC, and pervious research showed that acid tolerant A. succinogenes has higher content of unsaturated fatty acids, which may be beneficial for the transmembrane transport of lipophilic electron shuttle.Results: MFC assisted succinate production was evaluated using neutral red as an electron shuttle to recover the glycerol utilization. Firstly, an acid tolerant mutant JF1315 was selected by atmospheric and room temperature plasma (ARTP) mutagenesis aiming to improve transmembrane transport of neutral red (NR). Additionally, MFC was established to increase the ratio of oxidized NR to reduced NR. By combining these two strategies, ability of JF1315 for glycerol utilization was significantly enhanced, and 23.92 g/L succinate was accumulated with a yield of 0.88 g/g from around 30 g/L initial glycerol, along with an output voltage above 300 mV.Conclusions: A novel MFC-assisted system was established to improve glycerol utilization by A. succinogenes for succinate and electricity production, making this system as a platform for chemicals production and electrical supply simultaneously.
Interpersonal Relationships and Drug Use Over Time Among Homeless People: A Qualitative Study
Authors: de Espíndola Marília Ignácio , Bedendo André , Silva Eroy Aparecida da , Noto Ana Regina 
Published: November 2020

Abstract
BACKGROUND: Homelessness is one of the most severe forms of social exclusion and is an important public health issue. It is characterized by processes of weakening of interpersonal bonds. The objective of this study was, therefore, to elucidate how interpersonal relationships change over the life cycle of homeless drug and alcohol users. METHOD: We used a qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs. The interviews were semi structured and used a timeline instrument. All interview were audio recorded, transcribed, and submitted to thematic analysis.RESULTS: Twenty individuals participated in the study. Reports on social exclusion over time stood out in respect of four main themes and their respective subthemes: Theme 1 – Childhood: instability upbringing, abuse, violence, and an absent or not very present father figure; Theme 2 – Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living with a partner or getting married: Theme 3 – Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution; Theme 4 – Cross-cutting factors: death of relatives and substance use. CONCLUSION: The results suggest that interpersonal relationships are permeated by successive breakups, conflicts and other events that start in childhood and can have a cumulative effect in later stages of life, and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all stages of life.
Sex Differences and Psychological Stress: Responses to the COVID-19 Pandemic in China
Authors: Yan Shiyan , Xu Rui , Stratton Terry D. , Kavcic Voyko , Luo Dan , Hou Fengsu , Bi Fengying , Jiao Rong , Song Kangxing , Jiang Yang 
Published: November 2020

Abstract
Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic.Results 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.