bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Go back to your country”: Exploring nurses' experiences of workplace conflict involving patients and patients' family members in two Canadian cities
Authors: Boateng Godfred O. , Brown Kyrah K. 
Published: July 2021

AbstractThis study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in‐depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse–patient and nurse–patient's family member conflicts in direct care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de‐escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health‐care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers.
Input and output in distributive theory
Authors: Eyal Nir , Herlitz Anders 
Published: July 2021

AbstractDistributive theories evaluate distributions of goods based on candidate recipients’ characteristics, e.g. how well off candidates are, how deserving they are, and whether they fare below sufficiency. But such characteristics vary across possible worlds, so distributive theories may differ in terms of the world which for them settles candidates’ characteristics. This paper examines how distributive theories differ in terms of whether candidate recipients’ relevant characteristics are grounded in the possible world that would take place if the distributor does not intervene (call it the “input” world) or if they are grounded in each possible world that the distributor can bring about through different decisions (call each an “output” world). We illustrate the importance of this distinction in relation to one distributive theory, prioritarianism. As we show, both input and output versions of prioritarianism are plausible interpretations of the literature, and there are good reasons to take input prioritarianism seriously. Ultimately, however, we argue that input prioritarianism should be rejected.
Tolerance to high temperature at reproductive stage: Trade‐offs between phenology, grain yield and yield‐related traits in wild and cultivated barleys
Authors: Bahrami Forouzan , Arzani Ahmad , Rahimmalek Mehdi 
Published: July 2021

AbstractHigh‐temperature stress at the reproductive stage poses a substantial constraint on cereal production worldwide. This study was conducted to assess tolerance to terminal high‐temperature stress in 45 wild (Hordeum vulgare ssp. spontaneum) genotypes, four cultivars (H. vulgare ssp. vulgare), 98 F3 and 79 BC1F2 families derived from hybridization of a high‐temperature tolerant wild genotype and a susceptible cultivar ‘Mona’. Results of analysis of variance showed significant genotypic and high‐temperature stress effects on all the traits studied. Approximately one quarter of the wild genotypes originating from a warmer climate were slightly affected by high‐temperature stress. Grain yield strongly correlated (p < .01) with stress tolerance, yield stability and heat tolerance indices. The reduction in the reproduction period caused by high temperature was much higher in cultivated genotypes than in wild ones. Grain number and weight were the most effective yield components to screen high‐temperature tolerant F3 and BC1F2 families. In conclusion, strategies like escape/avoidance are being used primarily to cope with heat stress by cultivars, whereas adaptive strategies such as tolerance are being implemented by wild barley.
More sophisticated than a drink cooler or an old sphygmomanometer but still not adequate for prehospital blood: A market review of commercially available equipment for prehospital blood transport and administration
Authors: Martin Silver M. , Fisher Andrew D. , Meledeo Michael A. , Wampler David , Nicholson Susannah E. , Raczek Katherine , April Michael D. , Weymouth Wells L. , Bynum James , Schauer Steven G. 
Published: July 2021

AbstractBackgroundHemorrhage is the leading cause of death in trauma patients with most fatalities occurring before reaching a higher level of care—this applies to both the civilian setting and the military combat setting. Hemostatic resuscitation with increased emphasis on blood transfusion while limiting use of crystalloids has become routine in trauma care. However, the prehospital setting—especially in combat—presents unique challenges with regard to storage, transport, and administration. We sought to evaluate available technology on the market for storage and administration technology that is relevant to the prehospital setting.Study design and methodsWe conducted a market review of available technology through subject–matter expert inquiry, reviews of published literature, reviews of Federal Drug Administration databases, internal military publications, and searches of Google.ResultsWe reviewed and described a total of 103 blood transporters, 22 infusers, and 6 warmers.ConclusionsThe risk of on‐scene fatality in trauma patients and recent developments in trauma care demonstrate the need for prehospital transfusion. These transfusions have been logistically prohibited in many operations. We have reviewed the current commercially available equipment and recommended pursuit of equipment that improves accessibility to field transfusion. Current technology has limited applicability for the prehospital setting and is further limited for the military setting.
Evaluation of trauma‐induced coagulopathy in the fibrinogen in the initial resuscitation of severe trauma trial
Authors: Peng Henry T. , Nascimento Barto , Rhind Shawn G. , da Luz Luis , Beckett Andrew 
Published: July 2021

AbstractBackgroundCoagulopathic bleeding is frequently present after major trauma. However, trauma‐induced coagulopathy (TIC) remains incompletely understood. This laboratory analysis of blood samples derived from our completed trial on fibrinogen in the initial resuscitation of severe trauma (FiiRST) was conducted to evaluate TIC and associated responses to fibrinogen replacement.Study design and methodsWe conducted a retrospective evaluation of TIC in 45 FiiRST trial patients based on rotational thromboelastometry (ROTEM), international normalized ratio (INR), and biomarkers for hemostasis and endotheliopathy. Whole blood was analyzed by ROTEM. Plasma was analyzed for INR and biomarkers.ResultsOverall, 19.0% and 30.0% of the FiiRST trial patients were coagulopathic on admission defined by EXTEM maximum clot firmness out of the range of 40–71 mm and INR >1.2, respectively. The FiiRST patients showed lower fibrinogen, factor II and V levels, protein C and antiplasmin activities, higher activated protein C, tissue plasminogen activator, d‐dimer, and thrombomodulin concentrations at admission than healthy controls. Most of the biomarkers changed their activities during 48‐h hospitalization, but were at abnormal levels even 48‐h after admission. The fibrinogen treatment reduced hypofibrinogenemia and increased factor XIII level, but had no significant effects on other biomarkers levels. Limited development of endotheliopathy was indicated by syndean‐1, thrombomodulin, and sE‐selectin.ConclusionsAbout 19%–30% of the trauma patients in the FiiRST trial were coagulopathic on hospital admission depending on the definition of TIC. Analyses of the TIC biomarkers demonstrated that hemostasis would not return to normal after 48‐h hospitalization, and fibrinogen replacement improved hypofibrinogenemia.
Refrigeration of apheresis platelets in platelet additive solution (PAS‐E) supports in vitro platelet quality to maximize the shelf‐life
Authors: Johnson Lacey , Vekariya Shuchna , Wood Ben , Tan Shereen , Roan Christopher , Marks Denese C. 
Published: July 2021

AbstractBackgroundRefrigeration, or cold‐storage, of platelets may be beneficial to extend the limited shelf‐life of conventionally stored platelets and support transfusion protocols in rural and military areas. The aim of this study was to compare the morphologic, metabolic, and functional aspects of apheresis platelets stored at room‐temperature (RT) or cold conditions, in either plasma or supplemented with platelet additive solution (PAS).Study design and methodsDouble‐dose apheresis platelets were collected in either 100% plasma or 40% plasma/60% PAS‐E using the Trima apheresis platform. One component from each group was either stored at RT (20–24°C) or refrigerated (2–6°C). Platelets were tested over a 21‐day period.ResultsThe platelet concentration decreased by approximately 30% in all groups during 21 days of storage (p > .05). Cold‐storage reduced glycolytic metabolism, and the pH was maintained above the minimum specification (>6.4) for 21 days only when platelets were stored in PAS. The surface phenotype and the composition of the supernatant were differentially affected by temperature and storage solution. Functional responses (aggregation, agonist‐induced receptor activation, clotting time) were improved during cold‐storage, and the influence of residual plasma was assay dependent.ConclusionIn vitro platelet quality is differentially affected by storage time, temperature, and solution. Cold‐storage, particularly in PAS, better maintains key metabolic, phenotypic, and functional parameters during prolonged storage.
Massive transfusions and severe hypocalcemia: An opportunity for monitoring and supplementation guidelines
Authors: Hall Chad , Nagengast Andrea K. , Knapp Chris , Behrens Brandon , Dewey Elizabeth N. , Goodman Andrew , Bommiasamy Aravind , Schreiber Martin 
Published: July 2021

AbstractBackgroundMassive transfusion protocols (MTPs) are associated with severe hypocalcemia, contributing to coagulopathy and mortality in severely injured patients. Severity of hypocalcemia following massive transfusion activation and appropriate treatment strategies remain undefined.Study design and methodsThis was a retrospective study of all MTP activations in adult trauma patients at a Level 1 trauma center between August 2016 and September 2017. Units of blood products transfused, ionized calcium levels, and amount of calcium supplementation administered were recorded. Primary outcomes were ionized calcium levels and the incidence of severe ionized hypocalcemia (iCa ≤1.0 mmol/L) in relation to the volume of blood products transfused.ResultsSeventy‐one patients had an MTP activated during the study period. The median amount of packed red blood cells (PRBCs) transfused was 10 units (range 1–52). A total of 42 (59.1%) patients had periods of severe hypocalcemia. Patients receiving 13 or more units of PRBC had a greater prevalence of hypocalcemia with 83.3% having at least one measured ionized calcium ≤1.0 mmoL/L (p = .001). The number of ionized calcium levels checked and the amount of supplemental calcium given in patients who experienced hypocalcemia varied considerably.DiscussionSevere hypocalcemia commonly occurs during MTP activations and correlates with the number of packed red blood cells transfused. Monitoring of ionized calcium and amount of calcium supplementation administered is widely variable. Standardized protocols for recognition and management of severe hypocalcemia during massive transfusions may improve outcomes.
Hemorrhagic shock and hemostatic resuscitation in canine trauma
Authors: Edwards Thomas H. , Rizzo Julie A. , Pusateri Anthony E. 
Published: July 2021

AbstractHemorrhage is a significant cause of death among military working dogs and in civilian canine trauma. While research specifically aimed at canine trauma is limited, many principles from human trauma resuscitation apply. Trauma with significant hemorrhage results in shock and inadequate oxygen delivery to tissues. This leads to aberrations in cellular metabolism, including anaerobic metabolism, decreased energy production, acidosis, cell swelling, and eventual cell death. Considering blood and endothelium as a single organ system, blood failure is a syndrome of endotheliopathy, coagulopathy, and platelet dysfunction. In severe cases following injury, blood failure develops and is induced by inadequate oxygen delivery in the presence of hemorrhage, tissue injury, and acute stress from trauma. Severe hemorrhagic shock is best treated with hemostatic resuscitation, wherein blood products are used to restore effective circulating volume and increase oxygen delivery to tissues without exacerbating blood failure. The principles of hemostatic resuscitation have been demonstrated in severely injured people and the authors propose an algorithm for applying this to canine patients. The use of plasma and whole blood to resuscitate severely injured canines while minimizing the use of crystalloids and colloids could prove instrumental in improving both mortality and morbidity. More work is needed to understand the canine patient that would benefit from hemostatic resuscitation, as well as to determine the optimal resuscitation strategy for these patients.
Preoperative anemia management program reduces blood transfusion in elective cardiac surgical patients, improving outcomes and decreasing hospital length of stay
Authors: Cahill Christine M. , Alhasson Bassam , Blumberg Neil , Melvin Amber , Knight Peter , Gloff Marjorie , Robinson Renee , Akwaa Frank , Refaai Majed A. 
Published: July 2021

AbstractBackgroundAnemia is an independent risk factor for hospitalization, readmission, prolonged length of stay (LOS), diminished quality of life, and mortality. A multidisciplinary program was implemented to manage anemia preoperatively as a patient blood management (PBM) initiative.Methods and MaterialsFrom March 2016 to August 2018, 240 patients were screened for anemia during their preoperative cardiovascular visit. About 52/240 (22%) were found to be anemic and met out inclusion criteria. Also, 45/52 (87%) had iron deficiency anemia and 7 (13%) had anemia without iron deficiency. A similar historical cohort of patients undergoing elective cardiovascular surgery with hemoglobin (Hb) < 12 g/dl from September 2014 to February /2016 (n = 52) served as control group. The primary outcome was perioperative red blood cell (RBC) transfusion. Secondary outcomes were date‐of‐surgery Hb, intensive care unit (ICU) and hospital LOS, complication rates, and transfusion cost.ResultsThe two most common treatments were IV iron ± folate (n = 36/45; 80%) and oral iron (n = 9/45; 20%). As compared to historical patients, study patients had significantly higher day‐of‐surgery Hb (10.6 ± 1.4 vs. 9.8 ± 1.3 g/dl, p < .001), lower utilization of RBC transfusion (0.86 ± 1.4 vs. 2.78 ± 2.4, p < .001), fewer days in the ICU (2.1 ± 2.0 vs. 4.0 ± 3.5, p = .002), and shorter total LOS (6.9 ± 4.8 vs. 12.9 ± 6.8, p < .0001). Study patients also showed lower overall complication rates (p < .0001). Analysis of RBC acquisition cost and transfusion cost also showed significant saving of 69% ($293 vs. $945 and $656 vs. $2116, respectively).ConclusionWhen corrected for type of procedures and surgeon, our pilot anemia program in elective cardiovascular surgeries showed higher day‐of‐surgery Hb and significant reduction in RBC transfusion rates, ICU and hospital LOS, and overall complication rates.
New driving force for China’s import growth: Assessing the role of cross‐border e‐commerce
Authors: Ma Shuzhong , Guo Xueyao , Zhang Hongsheng 
Published: July 2021

AbstractThis paper investigates the role of cross‐border e‐commerce on China's import growth, using the promulgation of cross‐border e‐commerce‐related policies since 2012 as a quasi‐natural experiment and using the ‘Cross‐border E‐commerce Retail Import Commodity List’ to identify cross‐border e‐commerce industries. Our difference‐in‐difference results show that cross‐border e‐commerce has significantly boosted China's import growth. Dynamic effects show that while China's imports were low prior to 2012, cross‐border e‐commerce has increased China's imports significantly since 2012, verifying the validity of our baseline results. Placebo tests and a series of robustness checks further confirm the validity and robustness of the baseline results. Further analysis reveals that cross‐border e‐commerce has mainly promoted imports from developed countries, and primarily facilitated imports of clothing, food and daily necessities. Mechanism analysis shows that cross‐border e‐commerce not only stimulated both the intensive and extensive margins in import growth, but also reduced cultural distances and increased China's imports from countries with larger cultural distances substantially. However, geographical and institutional distances still matter and exhibit significantly negative effects on China's cross‐border e‐commerce imports.
Comparison of venous hemoglobin saturation measurements obtained by in vivo oximetry and calculated from blood gas analysis in critically ill dogs
Authors: Walton Rebecca A. L. , Hansen Bernie 
Published: July 2021

AbstractObjectiveTo compare in vivo central venous hemoglobin saturation measurement (ScvO2) using a fiber optic catheter with saturation calculated from blood gas analysis in critically ill dogs.DesignProspective observational study.SettingUniversity veterinary teaching hospital intensive care unit.AnimalsA convenience sample of 20 dogs with severe illness.InterventionsDogs were instrumented with either a central venous catheter with an integrated fiber optic cable or a conventional catheter with a fiber optic probe inserted through its distal port. Baseline saturation was measured with the fiber optic system (FSO2), then monitored continuously. Central venous blood was collected for analysis and FSO2 was recorded by the principal investigator (PI) or nursing staff participating in data collection (staff) at baseline and at 1, 2, 3, and 6 hours. Hemoglobin oxygen saturation (SO2) values calculated using human Bohr coefficients were taken directly from the analyzer (GPSO2), and were also calculated using temperature‐correction and canine Bohr coefficients (RSO2).Measurements and Main ResultsNinety‐seven paired measurements from 20 dogs were analyzed. FSO2 obtained by the PI (n = 41) had better agreement with both GPSO2 (concordance correlation coefficient ρc = 0.926 vs 0.5562) and RSO2 (ρc = 0.75 for PI vs 0.54) than did staff (n = 56). RSO2 values were always smaller than GPSO2. FSO2 ‐ GPSO2 differences were smaller when measurements were collected by the PI versus Staff (mean difference 0.21 vs −6.6, respectively, P < 0.02). Thirty‐six of 41 FSO2 values obtained by PI were within 5% of GPSO2.ConclusionsConcordance between FSO2 and either calculation method was low, but was better when performed by PI. The larger difference between methods when using RSO2 suggests a positive bias by FSO2. Difficulty obtaining stable measurements may have contributed to the poor concordance between methods within Staff.
Treatment and outcome of eight horses with limb cellulitis and septic tendonitis or desmitis
Authors: Cooper Hannah E. , Davidson Elizabeth J. , Slack Joann , Ortved Kyla F. 
Published: July 2021

AbstractObjectiveTo report the clinical features, treatment, and outcome in horses with cellulitis and concurrent septic tendonitis and/or desmitis.Study DesignShort case series.MethodsMedical records from 2000 to 2019 were reviewed, identifying horses with cellulitis and concurrent septic tendonitis and/or desmitis based on sonographic examination and positive bacterial culture. Signalment, ultrasonographic results, bacterial culture, treatment, duration of hospitalization, and complications were recorded. Long‐term outcome data were obtained from follow‐up examinations and/or telephone interviews. Successful outcome was defined as return to intended use.ResultsEight horses met the inclusion criteria. All infections occurred in hindlimbs, with septic suspensory ligament in six of eight horses, and septic superficial digital flexor tendon in one of eight horses. Surgical debridement was performed in six of eight horses. All horses were treated with systemic and regional intravenous antimicrobials and were discharged from the hospital. Long‐term follow‐up was available in seven of eight horses. Of these, four horses returned to their intended athletic function, two horses returned to their intended function as a broodmare or pasture pet, and one horse is still rehabilitating.ConclusionSeptic tendonitis or desmitis is a rare but possible sequela of limb cellulitis. Based on the findings in this study, prognosis for return to athletic function is fair to good for horses diagnosed with cellulitis and concurrent septic tendonitis or desmitis.
Decay Heat Characterization for the European Sodium Fast Reactor
Authors: Jiménez-Carrascosa Antonio , García-Herranz Nuria , Krepel Jiri , Margulis Marat , Baker Una , Shwageraus Eugene , Fridman Emil , Gregg Robert 
Published: July 2021

Abstract
In this work, a detailed assessment of the decay heat power for the commercial-size European sodium-cooled fast reactor (ESFR) at the end of its equilibrium cycle has been performed. The summation method has been used to compute very accurate spatial- and time-dependent decay heat by employing state-of-the-art coupled transport-depletion computational codes and nuclear data. This detailed map provides basic information for subsequent transient calculations of the ESFR. A comprehensive analysis of the decay heat has been carried out and interdependencies between decay heat and different parameters characterizing the core state prior to shutdowns, such as discharge burnup or type of fuel material, have been identified. That analysis has served as a basis to develop analytic functions to reconstruct the spatial-dependent decay heat power for the ESFR for cooling times within the first day after shutdown.