bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Elderly Residents in Nursing Homes Handle Loneliness—From the Nurses’ Perspective
Authors: Naik, MHSc Prathima , Ueland, PhD Venke Irene 
Published: December 2020

Introduction Elderly people who leave their home environment and move to a nursing home enter a phase in life with diminishing contact with family and friends. This situation often results in a feeling of loneliness with a concomitant deterioration in physical and mental health. By exploring the topic through the lens of the nurses, this study takes a novel approach to address an under-researched area in the nursing field. Objective The objective of the study was to identify, based on the nurses’ experience, how elderly residents handle loneliness in the nursing home. Methods This study used a qualitative explorative approach with data collected through two focus group interviews with nine nurses at two elderly care facilities in Norway. The resulting transcripts were examined using an approach based on inductive content analysis. Results Three main categories emerged as crucial to help lonely nursing home residents cope with day-to-day life: (i) maintaining ties to one’s earlier life; (ii) engaging in recreational pursuits; and (iii) building new networks. Conclusion Analysing the findings based on sense of coherence (SOC) and person-centred care (PCC) theories illustrates the importance of maintaining a connection with both family and friends. To that point, having access to familiar objects from their earlier life seemingly provides meaning to the residents by bridging the past and the present. Recreational activities, ideally adapted to each person’s needs and ability, have a positive impact by providing structure and meaning that help overtake feelings of loneliness. Building a new network with fellow residents and staff imparts a sense of meaningful community belonging and projects both dignity and self-worth.
Cities and Greenhouse Gas Emissions: Moving Forward
Authors: Hoornweg Daniel , Sugar Lorraine , Gomez Claudia Lorena Trejos 
Published: December 2020

Cities are blamed for the majority of greenhouse gas (GHG) emissions. So too are more affluent, highly urbanised countries. If all production- and consumption-based emissions that result from lifestyle and purchasing habits are included, urban residents and their associated affluence likely account for more than 80 per cent of the world’s GHG emissions. Attribution of GHG emissions should be refined. Apportioning responsibility can be misguided, as recent literature demonstrates that residents of denser city centres can emit half the GHG emissions of their suburban neighbours. It also fails to capture the enormous disparities within and across cities as emissions are lowest for poor cities and particularly low for the urban poor. This article presents a detailed analysis of per capita GHG emissions for several large cities and a review of per capita emissions for 100 cities for which peer-reviewed studies are available. This highlights how average per capita GHG emissions for cities vary from more than 15 tonnes of carbon dioxide equivalent (tCO2e) (Sydney, Calgary, Stuttgart and several major US cities) to less than half a tonne (various cities in Nepal, India and Bangladesh). The article discusses where GHG emissions arise and where mitigation efforts may be most effective. It illustrates the need to obtain comparable estimates at city level and the importance of defining the scope of the analysis. Emissions for Toronto are presented at a neighbourhood level, city core level and metropolitan area level, and these are compared with provincial and national per capita totals. This shows that GHG emissions can vary noticeably for the same resident of a city or country, depending on whether these are production- or consumption-based values. The methodologies and results presented form important inputs for policy development across urban sectors. The article highlights the benefits and drawbacks of apportioning GHG emissions (and solid waste generation) per person. A strong correlation between high rates of GHG emissions and solid waste generation is presented. Policies that address both in concert may be more effective as they are both largely by-products of lifestyles.
Recombinant porcine FVIII for bleed treatment in acquired hemophilia A: findings from a single-center, 18-patient cohort
Authors: Ellsworth Patrick , Chen Sheh-Li , Kasthuri Raj S. , Key Nigel S. , Mooberry Micah J. , Ma Alice D. 
Published: December 2020

Abstract
Acquired hemophilia A (AHA) is a rare bleeding disorder in which acquired autoantibodies to endogenous factor VIII (FVIII) decrease FVIII activity and lead to a bleeding phenotype. A substantial majority of individuals who develop AHA present with severe bleeding. Effective treatment requires both immunosuppressive therapy and prompt hemostatic treatment. Bleeding is commonly treated with bypassing agents (BPAs) such as recombinant activated FVII (rFVIIa) or activated prothrombin complex concentrates Disadvantages to BPAs include the inability to monitor response with standard laboratory assays, inconsistent hemostatic efficacy, and thrombosis. Recombinant porcine FVIII (rpFVIII: Obizur, Baxter, Deerfield, IL) was approved by the US Food and Drug Administration (FDA) for bleed treatment in AHA in 2014, and has the advantage of laboratory monitoring of FVIII activity levels and known hemostatic efficacy in the presence of anti-human FVIII inhibitors and after failure of BPAs. Using an algorithm-based approach, rpFVIII has been used to successfully treat 18 patients with AHA at our center with substantially lower doses than the current FDA-recommended dosing. Additionally, data from our cohort show that the preexposure anti-porcine Bethesda titer does not reliably predict the clinical response to rpFVIII treatment and is not correlated with the anti-human Bethesda titer. We also present data showing lower total rpFVIII use for initial bleed resolution when rpVIII is used upfront, as compared with use as rescue therapy. We validated our dosing algorithm, which uses much lower than FDA-recommended doses with 14 more patients than in our previously reported patient series.
Human milk triggers coagulation via tissue factor–exposing extracellular vesicles
Authors: Hu Yong , Hell Lena , Kendlbacher Ruth Anna , Hajji Najat , Hau Chi , van Dam Annemieke , Berckmans René J. , Wisgrill Lukas , Ay Cihan , Pabinger Ingrid , Brisson Alain , Repa Andreas , Nieuwland Rienk , Thaler Johannes 
Published: December 2020

Abstract
Almost a century ago, it was discovered that human milk activates the coagulation system, but the milk component that triggers coagulation had until now been unidentified. In the present study, we identify this component and demonstrate that extracellular vesicles (EVs) present in normal human milk expose coagulant tissue factor (TF). This coagulant activity withstands digestive conditions, mimicking those of breastfed infants, but is sensitive to pasteurization of pooled donor milk, which is routinely used in neonatal intensive care units. In contrast to human milk, bovine milk, the basis of most infant formulas, lacks coagulant activity. Currently, the physiological function of TF-exposing vesicles in human milk is unknown, but we speculate that these vesicles may be protective for infants. Another explanation could be nipple skin damage, which occurs in most breastfeeding women. Milk-derived TF-exposing EVs may seal the wound and thereby reduce bleeding and breast inflammation.
Safety and efficacy of rivaroxaban in pediatric cerebral venous thrombosis (EINSTEIN-Jr CVT)
Authors: Connor Philip , Sánchez van Kammen Mayte , Lensing Anthonie W. A. , Chalmers Elizabeth , Kállay Krisztián , Hege Kerry , Simioni Paolo , Biss Tina , Bajolle Fanny , Bonnet Damien , Grunt Sebastian , Kumar Riten , Lvova Olga , Bhat Rukhmi , Van Damme An , Palumbo Joseph , Santamaria Amparo , Saracco Paola , Payne Jeanette , Baird Susan , Godder Kamar , Labarque Veerle , Male Christoph , Martinelli Ida , Morales Soto Michelle , Motwani Jayashree , Shah Sanjay , Hooimeijer Helene L. , Prins Martin H. , Kubitza Dagmar , Smith William T. , Berkowitz Scott D. , Pap Akos F. , Majumder Madhurima , Monagle Paul , Coutinho Jonathan M. 
Published: December 2020

AbstractAnticoagulant treatment of pediatric cerebral venous thrombosis has not been evaluated in randomized trials. We evaluated the safety and efficacy of rivaroxaban and standard anticoagulants in the predefined subgroup of children with cerebral venous thrombosis (CVT) who participated in the EINSTEIN-Jr trial. Children with CVT were randomized (2:1), after initial heparinization, to treatment with rivaroxaban or standard anticoagulants (continued on heparin or switched to vitamin K antagonist). The main treatment period was 3 months. The primary efficacy outcome, symptomatic recurrent venous thromboembolism (VTE), and principal safety outcome, major or clinically relevant nonmajor bleeding,were centrally evaluated by blinded investigators. Sinus recanalization on repeat brain imaging was a secondary outcome. Statistical analyses were exploratory. In total, 114 children with confirmed CVT were randomized. All children completed the follow-up. None of the 73 rivaroxaban recipients and 1 (2.4%; CVT) of the 41 standard anticoagulant recipients had symptomatic, recurrent VTE after 3 months (absolute difference, 2.4%; 95% confidence interval [CI], −2.6% to 13.5%). Clinically relevant bleeding occurred in 5 (6.8%; all nonmajor and noncerebral) rivaroxaban recipients and in 1 (2.5%; major [subdural] bleeding) standard anticoagulant recipient (absolute difference, 4.4%; 95% CI, −6.7% to 13.4%). Complete or partial sinus recanalization occurred in 18 (25%) and 39 (53%) rivaroxaban recipients and in 6 (15%) and 24 (59%) standard anticoagulant recipients, respectively. In summary, in this substudy of a randomized trial with a limited sample size, children with CVT treated with rivaroxaban or standard anticoagulation had a low risk of recurrent VTE and clinically relevant bleeding. This trial was registered at clinicaltrials.gov as #NCT02234843.
How much has allogeneic stem cell transplant–related mortality improved since the 1980s? A retrospective analysis from the EBMT
Authors: Penack Olaf , Peczynski Christophe , Mohty Mohamad , Yakoub-Agha Ibrahim , Styczynski Jan , Montoto Silvia , Duarte Rafael F. , Kröger Nicolaus , Schoemans Hélène , Koenecke Christian , Peric Zinaida , Basak Grzegorz W. 
Published: December 2020

Abstract
We performed a study to find out how advances in modern medicine have improved the mortality risk of allogeneic stem cell transplantation. We analyzed major transplantation outcome parameters in adult patients on the European Society for Blood and Marrow Transplantation (EBMT) registry who had hematologic malignancies and had received transplants from matched sibling donors. We performed multivariate analyses using the Cox proportional-hazards model including known risk factors for nonrelapse mortality and a matched-pairs analysis. We identified 38 800 patients who fulfilled the inclusion criteria. Considerable changes in patient characteristics have occurred in the past decades, such as older age, different underlying diseases, and a higher proportion of patients with advanced disease. Major reasons for transplantation-related death in the 1980s were infectious complications and graft-versus-host disease. Nonrelapse mortality, measured at 1 year after transplantation, has decreased over time: 29.7% from 1980 through 1989, 24.4% from 1990 through 1999, 14.8% from 2000 through 2009, and 12.2% from 2010 through 2016. On multivariate analysis, the year of transplantation was associated with reduced nonrelapse mortality (P &lt; .0001; hazard ratio [HR] [95% confidence interval (CI)], 0.8 [0.79-0.82], for 5-year intervals) and decreased overall mortality (P &lt; .0001; HR [95% CI], 0.87 [0.86-0.88]. In the matched-pairs analysis of 3718 patients in each group, nonrelapse mortality at 1 year was 24.4% in the 1990s and 9.5% from 2013 through 2016 (P &lt; .0001; HR [95% CI], 0.39 [0.34-0.43]). Transplantation-related mortality has decreased significantly in the past 40 years. These favorable data facilitate evidence-based treatment decisions on transplantation indications in the context of the availability of novel immunotherapies.
Anosmic flies: what Orco silencing does to olive fruit flies
Authors: Tsoumani Konstantina T. , Belavilas-Trovas Alexandros , Gregoriou Maria-Eleni , Mathiopoulos Kostas D. 
Published: December 2020

AbstractBackgroundThe olive fruit fly (Bactrocera oleae) is the most destructive pest of the olive cultivation worldwide causing significant production losses and olive fruit impoverishment, as its larvae feed exclusively on the olive fruit. Reproductive and sexual behavior, as well as host-plant recognition of the fly, are highly dependent on its chemosensory system. Therefore, exploring the role of genes that play a critical role in olfaction, could reveal potential molecular targets that determine species-specific features on chemical communication and could be used to impair sexual behavior.ResultsIn this study we identified the gene that encodes the conserved olfactory co-receptorOrco(Odorant receptor co-receptor), which interacts with all divergent insect odorant receptors, and investigated how disruption of its expression affects chemoreception. We initially searched the expression profile ofBo-Orcoin both sexes during sexual maturation, as well as pre- and post-mating communication by relative quantitative real time PCR (qRT-PCR) analysis suggesting thatBo-Orcowas abundantly expressed in sexually mature adults.We further investigated the functional role ofBo-Orcoin mating and oviposition behavior via transient gene silencing that was performed through in vivo dsRNA hemolymph injections in sexually mature flies 7 days after eclosion.Orco-knockdown phenotypes in both sexes showed reduced copulation rates in mating competitiveness tests, possibly through impaired olfactory-mediated detection of sex pheromone. In addition, oviposition was significantly inhibited in dsRNA-Orco injected females in a post-mating behavior test.ConclusionsOur results demonstrate thatOrcoplays a crucial role in the reproductive behavior of the olive fruit fly, since pre- and post-mating processes were affected. This is the first report in the olive fruit fly that links the chemosensory pathway with the mating behavior and the reproductive potential at a molecular basis, rendering this gene a potential target for the improvement of the olive fruit fly population control techniques.
Health research system resilience: lesson learned from the COVID-19 crisis
Authors: Yazdizadeh Bahareh , Majdzadeh Reza , Ahmadi Ayat , Mesgarpour Bita 
Published: December 2020

AbstractProducing evidence in epidemics is crucial to control the current epidemic and prevent its recurrence in the future. Data must be collected and analyzed rapidly to recognize the most efficient and feasible methods with proper timelines. However, there are many challenges a research system may encounter during a crisis. This article has presented lessons learned from the COVID-19 pandemic for health research system (HRS) to deal with current and future crises. Therefore, a HRS needs to produce and use evidence in such a situation. The components Knowledge Translation Self-Assessment Tool for Research Institutes (SATORI) framework was used to review the actions required and respond to the COVID-19 pandemic in a national HRS. This framework consists of four categories of defining the research question, conducting research, translating the research results, and promoting the use of evidence. The work is proposed actions in response to the COVID-19 crisis and improving a HRS's resilience. While COVID-19 has serious harm to the health and broader socio-economic consequences, this threat should be accounted for as an opportunity to make research systems more accountable and responsible in the timely production and utilization of knowledge. It is time to seriously think about how HRS can build a better back to be resilient to potential shock and prepare for unforeseen emerging conditions.
Corticosteroid therapy in critically ill patients with COVID-19: a multicenter, retrospective study
Authors: Li Yiming , Meng Qinghe , Rao Xin , Wang Binbin , Zhang Xingguo , Dong Fang , Yu Tao , Li Zhongyi , Feng Huibin , Zhang Jinpeng , Chen Xiangyang , Li Hunian , Cheng Yi , Hong Xiaoyang , Wang Xiang , Yin Yimei , Zhang Zhongheng , Wang Dawei 
Published: December 2020

Abstract
Background
Corticoid therapy has been recommended in the treatment of critically ill patients with COVID-19, yet its efficacy is currently still under evaluation. We investigated the effect of corticosteroid treatment on 90-day mortality and SARS-CoV-2 RNA clearance in severe patients with COVID-19.

Methods
294 critically ill patients with COVID-19 were recruited between December 30, 2019 and February 19, 2020. Logistic regression, Cox proportional-hazards model and marginal structural modeling (MSM) were applied to evaluate the associations between corticosteroid use and corresponding outcome variables.

Results
Out of the 294 critically ill patients affected by COVID-19, 183 (62.2%) received corticosteroids, with methylprednisolone as the most frequently administered corticosteroid (175 accounting for 96%). Of those treated with corticosteroids, 69.4% received corticosteroid prior to ICU admission. When adjustments and subgroup analysis were not performed, no significant associations between corticosteroids use and 90-day mortality or SARS-CoV-2 RNA clearance were found. However, when stratified analysis based on corticosteroid initiation time was performed, there was a significant correlation between corticosteroid use (≤ 3 day after ICU admission) and 90-day mortality (logistic regression adjusted for baseline: OR 4.49, 95% CI 1.17–17.25, p = 0.025; Cox adjusted for baseline and time varying variables: HR 3.89, 95% CI 1.94–7.82, p < 0.001; MSM adjusted for baseline and time-dependent variants: OR 2.32, 95% CI 1.16–4.65, p = 0.017). No association was found between corticosteroid use and SARS-CoV-2 RNA clearance even after stratification by initiation time of corticosteroids and adjustments for confounding factors (corticosteroids use ≤ 3 days initiation vs no corticosteroids use) using MSM were performed.

Conclusions
Early initiation of corticosteroid use (≤ 3 days after ICU admission) was associated with an increased 90-day mortality. Early use of methylprednisolone in the ICU is therefore not recommended in patients with severe COVID-19.
Comparative effects of flow vs. volume-controlled one-lung ventilation on gas exchange and respiratory system mechanics in pigs
Authors: Wittenstein Jakob , Scharffenberg Martin , Ran Xi , Keller Diana , Michler Pia , Tauer Sebastian , Theilen Raphael , Kiss Thomas , Bluth Thomas , Koch Thea , Gama de Abreu Marcelo , Huhle Robert 
Published: December 2020

Abstract
Background
Flow-controlled ventilation (FCV) allows expiratory flow control, reducing the collapse of the airways during expiration. The performance of FCV during one-lung ventilation (OLV) under intravascular normo- and hypovolaemia is currently unknown. In this explorative study, we hypothesised that OLV with FCV improves PaO2 and reduces mechanical power compared to volume-controlled ventilation (VCV). Sixteen juvenile pigs were randomly assigned to one of two groups: (1) intravascular normovolaemia (n = 8) and (2) intravascular hypovolaemia (n = 8). To mimic inflammation due to major thoracic surgery, a thoracotomy was performed, and 0.5 μg/kg/h lipopolysaccharides from Escherichia coli continuously administered intravenously. Animals were randomly assigned to OLV with one of two sequences (60 min per mode): (1) VCV–FCV or (2) FCV–VCV. Variables of gas exchange, haemodynamics and respiratory signals were collected 20, 40 and 60 min after initiation of OLV with each mechanical ventilation mode. The distribution of ventilation was determined using electrical impedance tomography (EIT).

Results
Oxygenation did not differ significantly between modes (P = 0.881). In the normovolaemia group, the corrected expired minute volume (P = 0.022) and positive end-expiratory pressure (PEEP) were lower during FCV than VCV. The minute volume (P ≤ 0.001), respiratory rate (P ≤ 0.001), total PEEP (P ≤ 0.001), resistance of the respiratory system (P ≤ 0.001), mechanical power (P ≤ 0.001) and resistive mechanical power (P ≤ 0.001) were lower during FCV than VCV irrespective of the volaemia status. The distribution of ventilation did not differ between both ventilation modes (P = 0.103).

Conclusions
In a model of OLV in normo- and hypovolemic pigs, mechanical power was lower during FCV compared to VCV, without significant differences in oxygenation. Furthermore, the efficacy of ventilation was higher during FCV compared to VCV during normovolaemia.
Effects of higher PEEP and recruitment manoeuvres on mortality in patients with ARDS: a systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials
Authors:   For the PROVE Network: PROtective Ventilation Network, Ball Lorenzo , Serpa Neto Ary , Trifiletti Valeria , Mandelli Maura , Firpo Iacopo , Robba Chiara , Gama de Abreu Marcelo , Schultz Marcus J. , Patroniti Nicolò , Rocco Patricia R. M. , Pelosi Paolo 
Published: December 2020

Abstract
Purpose
In patients with acute respiratory distress syndrome (ARDS), lung recruitment could be maximised with the use of recruitment manoeuvres (RM) or applying a positive end-expiratory pressure (PEEP) higher than what is necessary to maintain minimal adequate oxygenation. We aimed to determine whether ventilation strategies using higher PEEP and/or RMs could decrease mortality in patients with ARDS.

Methods
We searched MEDLINE, EMBASE and CENTRAL from 1996 to December 2019, included randomized controlled trials comparing ventilation with higher PEEP and/or RMs to strategies with lower PEEP and no RMs in patients with ARDS. We computed pooled estimates with a DerSimonian-Laird mixed-effects model, assessing mortality and incidence of barotrauma, population characteristics, physiologic variables and ventilator settings. We performed a trial sequential analysis (TSA) and a meta-regression.

Results
Excluding two studies that used tidal volume (VT) reduction as co-intervention, we included 3870 patients from 10 trials using higher PEEP alone (n = 3), combined with RMs (n = 6) or RMs alone (n = 1). We did not observe differences in mortality (relative risk, RR 0.96, 95% confidence interval, CI [0.84–1.09], p = 0.50) nor in incidence of barotrauma (RR 1.22, 95% CI [0.93–1.61], p = 0.16). In the meta-regression, the PEEP difference between intervention and control group at day 1 and the use of RMs were not associated with increased risk of barotrauma. The TSA reached the required information size for mortality (n = 2928), and the z-line surpassed the futility boundary.

Conclusions
At low VT, the routine use of higher PEEP and/or RMs did not reduce mortality in unselected patients with ARDS.

Trial registration
PROSPERO CRD42017082035.