bluuebunny/crossref_metadata_2025_split huggingface dataset:
From political pledges to quantitative mapping of climate mitigation plans: Comparison of two European cities
Authors: Albarus Ivonne , Fleischmann Giorgia , Aigner Patrick , Ciais Philippe , Denier van der Gon Hugo , Droge Rianne , Lian Jinghui , Narvaez Rincon Miguel Andrey , Utard Hervé , Lauvaux Thomas 
Published: September 2023

Abstract

Background

Urban agglomerates play a crucial role in reaching global climate objectives. Many cities have committed to reducing their greenhouse gas emissions, but current emission trends remain unverifiable. Atmospheric monitoring of greenhouse gases offers an independent and transparent strategy to measure urban emissions. However, careful design of the monitoring network is crucial to be able to monitor the most important sectors as well as adjust to rapidly changing urban landscapes.

Results

Our study of Paris and Munich demonstrates how climate action plans, carbon emission inventories, and urban development plans can help design optimal atmospheric monitoring networks. We show that these two European cities display widely different trajectories in space and time, reflecting different emission reduction strategies and constraints due to administrative boundaries. The projected carbon emissions rely on future actions, hence uncertain, and we demonstrate how emission reductions vary significantly at the sub-city level.

Conclusions

We conclude that quantified individual cities’ climate actions are essential to construct more robust emissions trajectories at the city scale. Also, harmonization and compatibility of plans from various cities are necessary to make inter-comparisons of city climate targets possible. Furthermore, dense atmospheric networks extending beyond the city limits are needed to track emission trends over the coming decades.
Xenograft bone‐patellar tendon‐bone ACL reconstruction: a case series at 20‐year follow‐up as proof of principle
Authors: Stone Kevin R. , Walgenbach Ann W. , Turek Thomas J. , Crues John V. , Galili Uri 
Published: September 2023

AbstractPurposeACL reconstruction has a significant failure rate. To address the need for inexpensive strong tissue, a treatment process to “humanize” porcine tissue was developed and tested in primates and humans. This report describes the long‐term outcomes from the first human clinical trial using a porcine xenograft ACL reconstruction device.MethodsThe study was performed with Z‐Lig™ xenograft ACL device in 2003 as a pilot clinical feasibility study. This device was processed to slow its immune‐mediated destruction by enzymatic elimination of α‐gal epitopes and by partial crosslinking to slow the infiltration of macrophages into the biotransplant.ResultsTen patients underwent reconstruction with the Z‐Lig™ device. Five of 10 patients failed due to subsequent trauma (n = 3), arthrofibrosis (n = 1), and surgical technical error (n = 1). One patient was lost to follow‐up after the 12‐year evaluation. Each remaining patient reported a stable fully athletic knee. Physical exams are consistent with a score of less than one on the ACL stability tests. MRIs demonstrate mature remodeling of the device. There is no significant degradation in patient‐reported outcome scores, physical exams, or MRI appearance from 12 to 20‐year follow‐ups.ConclusionsThe studies in a small group of patients have demonstrated that implantation of porcine ligament bioprosthesis into patients with torn ACLs can result in the reconstruction of the bioprosthesis into autologous ACL that remains successful over 20 years. The possibility of humanizing porcine tissue opens the door to unlimited clinical material for tissue reconstructions if supported by additional clinical trials.Level of evidenceIV, case series.
Intra-tidal PaO2 oscillations associated with mechanical ventilation: a pilot study to identify discrete morphologies in a porcine model
Authors: Cronin John N. , Crockett Douglas C. , Perchiazzi Gaetano , Farmery Andrew D. , Camporota Luigi , Formenti Federico 
Published: September 2023

Abstract
Background
Within-breath oscillations in arterial oxygen tension (PaO2) can be detected using fast responding intra-arterial oxygen sensors in animal models. These PaO2 signals, which rise in inspiration and fall in expiration, may represent cyclical recruitment/derecruitment and, therefore, a potential clinical monitor to allow titration of ventilator settings in lung injury. However, in hypovolaemia models, these oscillations have the potential to become inverted, such that they decline, rather than rise, in inspiration. This inversion suggests multiple aetiologies may underlie these oscillations. A correct interpretation of the various PaO2 oscillation morphologies is essential to translate this signal into a monitoring tool for clinical practice. We present a pilot study to demonstrate the feasibility of a new analysis method to identify these morphologies.

Methods
Seven domestic pigs (average weight 31.1 kg) were studied under general anaesthesia with muscle relaxation and mechanical ventilation. Three underwent saline-lavage lung injury and four were uninjured. Variations in PEEP, tidal volume and presence/absence of lung injury were used to induce different morphologies of PaO2 oscillation. Functional principal component analysis and k-means clustering were employed to separate PaO2 oscillations into distinct morphologies, and the cardiorespiratory physiology associated with these PaO2 morphologies was compared.

Results
PaO2 oscillations from 73 ventilatory conditions were included. Five functional principal components were sufficient to explain ≥ 95% of the variance of the recorded PaO2 signals. From these, five unique morphologies of PaO2 oscillation were identified, ranging from those which increased in inspiration and decreased in expiration, through to those which decreased in inspiration and increased in expiration. This progression was associated with the estimates of the first functional principal component (P < 0.001, R2 = 0.88). Intermediate morphologies demonstrated waveforms with two peaks and troughs per breath. The progression towards inverted oscillations was associated with increased pulse pressure variation (P = 0.03).

Conclusions
Functional principal component analysis and k-means clustering are appropriate to identify unique morphologies of PaO2 waveform associated with distinct cardiorespiratory physiology. We demonstrated novel intermediate morphologies of PaO2 waveform, which may represent a development of zone 2 physiologies within the lung. Future studies of PaO2 oscillations and modelling should aim to understand the aetiologies of these morphologies.
European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context
Authors: Zanini Daniela Sacramento , Peixoto Evandro Morais , de Andrade Josemberg Moura , Fernandes Iorhana Almeida , da Silva Maynara Priscila Pereira 
Published: September 2023

AbstractHealth literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald’s omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.
Cardiovascular disease prevention should start in early life
Authors: Noubiap Jean Jacques , Nyaga Ulrich Flore 
Published: September 2023

AbstractAdolescence and young adulthood are critical periods for building the foundation of cardiovascular health. Unfortunately, the incidence of cardiovascular disease has substantially increased in adolescents and young adults in the last three decades. Multilevel interventions are needed to preserve ideal cardiovascular health in this population.
Assessing aetiological overlap between child and adult attention-deficit hyperactivity disorder symptoms in an extended family design
Authors: Wechsler Daniel L. , Rijsdijk Fruhling V. , Adamo Nicoletta , Eilertsen Espen M. , Ahmadzadeh Yasmin I. , Badini Isabella , Hannigan Laurie J. , Ystrom Eivind , McAdams Tom A. 
Published: September 2023

Background
Several longitudinal studies have cast doubt on the aetiological overlap between child and adult attention-deficit hyperactivity disorder (ADHD). However, a lack of genetically sensitive data following children across adulthood precludes direct evaluation of aetiological overlap between child and adult ADHD.

Aims
We circumvent the existing gap in longitudinal data by exploring genetic overlap between maternal (adult) and offspring (child) ADHD and comorbid symptoms in an extended family cohort.

Method
Data were drawn from the Norwegian Mother, Father and Child Cohort Study, a Norwegian birth registry cohort of 114 500 children and their parents. Medical Birth Registry of Norway data were used to link extended families. Mothers self-reported their own ADHD symptoms when children were aged 3 years; reported children's ADHD symptoms at age 5 years; and children's ADHD, oppositional defiant disorder (ODD), conduct disorder, anxiety and depression symptoms at age 8 years. Genetic correlations were derived from Multiple-Children-of-Twins-and-Siblings and extended bivariate twin models.

Results
Phenotypic correlations between adult ADHD symptoms and child ADHD, ODD, conduct disorder, anxiety and depression symptoms at age 8 years were underpinned by medium-to-large genetic correlations (child ADHD: rG = 0.55, 95% CI 0.43−0.93; ODD: rG = 0.80, 95% CI 0.46−1; conduct disorder: rG = 0.44, 95% CI 0.28−1; anxiety: rG = 0.72, 95% CI 0.48−1; depression: rG = 1, 95% CI 0.66−1). These cross-generational adult–child genetic correlations were of a comparable magnitude to equivalent child–child genetic correlations with ADHD symptoms at age 5 years.

Conclusions
Our findings provide genetically sensitive evidence that ADHD symptoms in adulthood share a common genetic architecture with symptoms of ADHD and four comorbid disorders at age 8 years. These findings suggest that in the majority of cases, ADHD symptoms in adulthood are not aetiologically distinct from in childhood.
Virtual Reality Distraction for Reducing Acute Postoperative Pain After Hip Arthroplasty: A Randomized Trial
Authors: Araujo-Duran Jorge , Kopac Orkun , Montalvo Campana Mateo , Bakal Omer , Sessler Daniel I. , Hofstra Richard L. , Shah Karan , Turan Alparslan , Ayad Sabry 
Published: September 2023

BACKGROUND:
Relaxation and distraction provided by virtual reality presentations might be analgesic and reduce the need for opioid analgesia. We tested the hypothesis that a virtual reality program (AppliedVR) decreases acute postoperative pain and opioid requirements in patients recovering from hip arthroplasty. We also evaluated whether virtual reality distraction improves patient mobility and reduces the need for antiemetics.

METHODS:
We evaluated 106 adults who were recovering from elective primary total hip arthroplasty. Participating patients were randomized to 2- to 8-minute-long 3-dimensional immersive virtual reality relaxation and distraction video presentations (eg, guided breathing exercises, games, mindfulness) or to 2-dimensional presentations of nature short films (eg, forest wildlife) with neutral music that was chosen to be neither overly relaxing nor distracting, presented through identical headsets. Our primary outcome was pain after virtual reality or sham video presentations, adjusted for pretreatment scores. Secondary outcomes included total opioid consumption, pain scores obtained per routine by nurse staff, perception of video system usability, and pain 1 week after hospital discharge.

RESULTS:
Fifty-two patients were randomized to virtual reality distraction and relaxation, and 54 were assigned to 2-dimensional sham presentations. Virtual reality presentations were not found to affect pain scores before and after presentations, with an estimated difference in means (virtual reality minus sham video) of −0.1 points (95% confidence interval [CI], −0.5 to 0.2; P = .391) on a 0 to 10 scale, with 10 being the worst. The mean (standard error [SE]) after-intervention pain score was estimated to be 3.4 (0.3) in the virtual reality group and 3.5 (0.2) in the reference group. Virtual reality treatment was not found to affect postoperative opioid consumption in morphine milligram equivalents, with an estimated ratio of geometric means (virtual reality/sham video) of 1.2 (95% CI, 0.6–2.1; P = .608). Virtual reality presentations were not found to reduce pain scores collected every 4 hours by nursing staff, with an estimated difference in means of 0.1 points (95% CI, −0.9 to 0.7; P = .768).

CONCLUSIONS:
We did not observe statistically significant or clinically meaningful reductions in average pain scores or opioid consumption. As used in our trial, virtual reality did not reduce acute postoperative pain.
Intermittent hypoxia differentially affects metabolic and oxidative stress responses in two species of cyprinid fish
Authors: Falfushynska Halina , Sokolova Inna M. 
Published: September 2023

ABSTRACT
Oxygen fluctuations are common in freshwater habitats and aquaculture and can impact ecologically and economically important species of fish like cyprinids. To gain insight into the physiological responses to oxygen fluctuations in two common cyprinid species, we evaluated the impact of short-term intermittent hypoxia on oxidative stress and metabolic parameters (including levels of prooxidants and oxidative lesions, antioxidants, mitochondrial enzyme activities, mitochondrial swelling, markers of apoptosis, autophagy and cytotoxicity) in silver carp Hypophthalmichthys molitrix and gibel carp Carassius gibelio. During hypoxia, gibel carp showed higher baseline levels of antioxidants and less pronounced changes in oxidative and metabolic biomarkers in the tissues than silver carp. Reoxygenation led to a strong shift in metabolic and redox-related parameters and tissue damage, indicating high cost of post-hypoxic recovery in both species. Species-specific differences were more strongly associated with oxidative stress status, whereas metabolic indices and nitrosative stress parameters were more relevant to the response to hypoxia-reoxygenation. Overall, regulation of energy metabolism appears more critical than the regulation of antioxidants in the response to oxygen deprivation in the studied species. Further research is needed to establish whether prioritizing metabolic over redox regulation during hypoxia-reoxygenation stress is common in freshwater cyprinids.
Antibiotic versus surgery in the treatment of acute appendicitis in the pregnant population: A systematic review and meta-analysis
Authors: Candrawinata Valeska , Hanafi Ricarhdo , Baskoro Bernard Agung , Irawan Andry , Ekapatria Christofani , Christina Natalia Maria , Koerniawan Heru Sutanto , Halim Freda 
Published: September 2023

Introduction: Acute appendicitis is the most common surgical emergency in pregnant women. There has been a wide variance in clinical practice worldwide, with some favoring an antibiotic-only approach while others prefer surgery as the first-line management. Therefore, we designed the current analysis to synthesize the available evidence on the efficacy and safety of antibiotics versus surgery management. Methods: We searched PubMed, Scopus, EuropePMC, and Cochrane Central from March 4, 1904 until November 25, 2022, to look for studies comparing antibiotics and surgery in pregnant patients with acute appendicitis. We only included studies that provided a comparison between the two treatments. Measured outcomes included preterm delivery, fetal loss, maternal death, and complications, defined as those arising from the pathological processes or treatment, including, but not limited to, sepsis or septic shock, pneumonia, venous thromboembolism (VTE), and surgical site infection. The results were compared using an odds ratio and 95% confidence interval. We also performed a sensitivity analysis by excluding studies with a serious risk of bias. Results: We included five non-randomized studies for the analysis. We found that patients in the antibiotic group had a lower risk of preterm labor (OR 0.63 [95% CI 0.43–0.92]; p 0.02) but a higher risk of complications (OR 1.79 [95% CI 1.19–2.69]; p 0.005). We did not find any difference in the other outcomes. Conclusion: The increased risk of complications should caution clinicians about using antibiotics as the first-line management. More studies are required to identify patients who would benefit the most before antibiotics could be adopted as a treatment for acute appendicitis in pregnant patients.
Knowledge and awareness of stroke in the United Arab Emirates: a cross-sectional study of the general population
Authors: Jirjees Feras , Al-Obaidi Hala , Barakat Muna , Kharaba Zelal , AlSalamat Husam , Khidhair Zainab , Alfoteih Yassen , Eltayib Eyman , Mansour Sara , Hallit Souheil , Malaeb Diana , Hosseini Hassan 
Published: September 2023

Background: The study aimed to assess stroke knowledge among the general population in the United Arab Emirates (UAE) and determine the factors associated with stroke awareness among people. Methods: A cross-sectional study was conducted in the UAE between September and November 2021. The general population has self-administered an online bilingual survey (Arabic and English) distributed via social media platforms. The questionnaire covered general knowledge about stroke risk factors, consequences of stroke, and responding to somebody with acute stroke attack. Results: A total of 545 surveys were completed, with more than half of the participants being female (58.5%), married (55.4%) and employed (59.4%). The majority were less than 50 years old (90.5%) and had a university degree (71.0%). Many of the participants (70.8%) had a good general knowledge of stroke; however, around 20% of the participants were able to recognize all symptoms and risk factors of stroke. The most common sources of stroke-related information were the internet/social media (53.6%). Females were better able to correctly identify at least one stroke symptom and outcome than males (p=0.008). University education has significantly affected participants' ability to identify early stroke symptoms (p=0.001) correctly. In addition, diabetic people were more likely to recognize at least one stroke outcome than non-diabetic people (p=0.039). Conclusions: The knowledge of stroke was good among highly educated people and females. However, the awareness of all stroke risk factors, symptoms, consequences and risk factors was inadequate among the general population of the UAE. Thus, there is still a gap between recognition of the relevant stroke and taking action among people.
Hydrothermal carbonization (HTC) of dairy waste: effect of temperature and initial acidity on the composition and quality of solid and liquid products
Authors: Khalaf Nidal , Shi Wenxuan , Fenton Owen , Kwapinski Witold , Leahy J.J. 
Published: September 2023

Background: Hydrothermal carbonization (HTC) of dairy processing waste was performed to investigate the effect of temperature and initial pH on the yield and composition of the solid (hydrochar) and liquor produced. All hydrochars met the EU requirements of organo-mineral solid fertilizers defined in the Fertilizing Products Regulation in terms of phosphorus (P) and mineral content. Methods: Laboratory scale HTC was performed using pressurized reactors, and the products (solid and liquid) were collected, stored and analyzed for elemental composition and nutrient content using Inductively coupled plasma optical emission spectroscopy (ICP-OES), ultraviolet-visible spectrophotometry (UV-Vis) and other analytic techniques. Results: Maximum hydrochar yield (60.67%) was observed at T=180℃ and pH=2.25, whereas the maximum P-recovery was 80.38% at T=220℃ and pH=4.6. The heavy metal content of the hydrochars was mostly compliant with EU limitations, except for Ni at T=220℃ and pH=8.32. Meanwhile, further study of Chromium (Cr) species is essential to assess the fertilizer quality of the hydrochars. For the liquid product, the increase in temperature beyond 200℃, coupled with an increase in initial acidity (pH=2.25) drove P into the liquor. Simultaneously, increasing HTC temperature and acidity increased the concentration of NO 3 - and NH 4 + in the liquid products to a maximum of 278 and 148 mg/L, respectively, at T=180℃ and pH=4.6. Furthermore, no direct relation between final pH of liquor and NH 4 + concentration was observed. Conclusions: HTC allows for the production of hydrochar as a potential fertilizer material that requires further processing. Adjusting HTC conditions enhanced P-recovery in the hydrochar, while retrieving higher nitrate concentrations in the liquid product. Optimizing HTC for the production of qualified hydrochars requires further treatment of Cr content, studying the availability of P in the products and enhancing the hydrochar yield for economic feasibility.
Understanding Syrian migration in Lebanon: a methodological framework
Authors: Trovato Maria Gabriella , Al-Akl Nayla , Ali Dana 
Published: September 2023

Background: Wars, crises, and climate change are just a few of the worldwide concerns that have resulted in the forced relocation of millions of people. After 12 years of conflict in Syria, millions of Syrians are still displaced in the neighbouring countries, and their conditions have worsened due to the economic and socio-political crisis of the region. This paper reports on a study conducted in Lebanon as part of the EU Horizon-funded project ADMIGOV – Advancing Alternative Migration Governance. It describes the methodological framework used to study Syrian migration in Lebanon and sheds light on the phenomenon's patterns, challenges, and impacts. Methods: In our study, we opted for a mixed method. It is built on a large corpus of primary data collected over the course of years of intensive, in-depth fieldwork and the author's immersion in the community. Alongside observations, quantitative and qualitative phone interviews were conducted to obtain the perceptions of displaced Syrians living in informal tented settlements in rural Lebanon and an incomplete building in the city of Saida. This interview data is accompanied by primary and secondary data sources, including the findings of other European research projects, statistics from UNHCR and IOM, and academic and press articles. Results: Our research revealed the difficulties Syrians displaced in Lebanon encounter while navigating the challenging situation they are trapped in. The weakness of public institutions and their failure to guarantee the observance of basic human rights has compromised displaced safety. Moreover, even though the development interventions and aid assistance have been necessary for Syrians' survival, they proved inadequate and insufficient, evidencing the inefficiencies of most projects. Conclusions: The findings contribute to an enriched understanding of the situation of Syrians in Lebanon and offer insights for policymakers, practitioners, and researchers working in the field of forced migration and humanitarian responses.