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| 2. |
- Carraminana, Albert, et al.
(author)
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Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV)
- 2019
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In: Journal of Cardiothoracic and Vascular Anesthesia. - : W B SAUNDERS CO-ELSEVIER INC. - 1053-0770 .- 1532-8422. ; 33:9, s. 2492-2502
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Journal article (peer-reviewed)abstract
- Objective: The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. Design: International, multicenter, prospective, randomized controlled clinical trial. Setting: A network of university hospitals. Participants: The study comprises 1,380 patients scheduled for thoracic surgery. Interventions: The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. Measurements and Main Results: Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients. (C) 2019 Published by Elsevier Inc.
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| 3. |
- Cruz, Raquel, et al.
(author)
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Novel genes and sex differences in COVID-19 severity
- 2022
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In: Human Molecular Genetics. - : Oxford University Press. - 0964-6906 .- 1460-2083. ; 31:22, s. 3789-3806
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Journal article (peer-reviewed)abstract
- Here, we describe the results of a genome-wide study conducted in 11 939 coronavirus disease 2019 (COVID-19) positive cases with an extensive clinical information that were recruited from 34 hospitals across Spain (SCOURGE consortium). In sex-disaggregated genome-wide association studies for COVID-19 hospitalization, genome-wide significance (P < 5 × 10−8) was crossed for variants in 3p21.31 and 21q22.11 loci only among males (P = 1.3 × 10−22 and P = 8.1 × 10−12, respectively), and for variants in 9q21.32 near TLE1 only among females (P = 4.4 × 10−8). In a second phase, results were combined with an independent Spanish cohort (1598 COVID-19 cases and 1068 population controls), revealing in the overall analysis two novel risk loci in 9p13.3 and 19q13.12, with fine-mapping prioritized variants functionally associated with AQP3 (P = 2.7 × 10−8) and ARHGAP33 (P = 1.3 × 10−8), respectively. The meta-analysis of both phases with four European studies stratified by sex from the Host Genetics Initiative (HGI) confirmed the association of the 3p21.31 and 21q22.11 loci predominantly in males and replicated a recently reported variant in 11p13 (ELF5, P = 4.1 × 10−8). Six of the COVID-19 HGI discovered loci were replicated and an HGI-based genetic risk score predicted the severity strata in SCOURGE. We also found more SNP-heritability and larger heritability differences by age (<60 or ≥60 years) among males than among females. Parallel genome-wide screening of inbreeding depression in SCOURGE also showed an effect of homozygosity in COVID-19 hospitalization and severity and this effect was stronger among older males. In summary, new candidate genes for COVID-19 severity and evidence supporting genetic disparities among sexes are provided.
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| 4. |
- de la Porte, Caroline, et al.
(author)
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An examination of ‘instrumental resources’ in earmarked parental leave : The case of the work-life balance directive
- 2023
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In: Journal of European Social Policy. - : Sage Publications. - 0958-9287 .- 1461-7269. ; 33:5, s. 525-539
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Journal article (peer-reviewed)abstract
- This article examines factors that could contribute to explaining variation in take-up of leave among fathers in the light of the EU’s Work–Life Balance Directive (WLBD). The WLBD seeks to equalize care responsibilities between fathers and mothers, especially through reserved leave, with high compensation. The article begins with a cross-country overview of take-up of leave among eligible fathers, considering earmarking and the degree of compensation. Our results show variation, which cannot fully be explained by policy design (presence of high compensation with reserved leave for fathers). The article then theorizes that instrumental resources – information and accessible administrative application procedures – could be a missing link to understand the actual shift from de jure to de facto social rights. The article then carries out embedded case studies on these two aspects of instrumental resources, using original qualitative data collected during the implementation of the WLBD. The most striking finding is that countries with similar formal implementation of earmarked paid parental leave, display significant differences in commitment to instrumental resources. Put differently, the WLBD is being implemented differently, not regarding formal social rights, but on instrumental resources. This finding is important because it means that EU-initiated legislation on parental leave, could lead to differences in outcomes, that is, take-up of leave among fathers. The implication of our findings is that decision-makers and policy actors at EU level and in member states, should focus more on instrumental resources in the implementation process. This is particularly important for enhancing the de facto legitimacy of the EU in social policy, given that EU social regulation is increasing via the European Pillar of Social Rights.
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| 5. |
- Donis, Daphne, et al.
(author)
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Stratification strength and light climate explain variation in chlorophyll a at the continental scale in a European multilake survey in a heatwave summer
- 2021
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In: Limnology and Oceanography. - : John Wiley & Sons. - 0024-3590 .- 1939-5590. ; 66:12, s. 4314-4333
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Journal article (peer-reviewed)abstract
- To determine the drivers of phytoplankton biomass, we collected standardized morphometric, physical, and biological data in 230 lakes across the Mediterranean, Continental, and Boreal climatic zones of the European continent. Multilinear regression models tested on this snapshot of mostly eutrophic lakes (median total phosphorus [TP] = 0.06 and total nitrogen [TN] = 0.7 mg L-1), and its subsets (2 depth types and 3 climatic zones), show that light climate and stratification strength were the most significant explanatory variables for chlorophyll a (Chl a) variance. TN was a significant predictor for phytoplankton biomass for shallow and continental lakes, while TP never appeared as an explanatory variable, suggesting that under high TP, light, which partially controls stratification strength, becomes limiting for phytoplankton development. Mediterranean lakes were the warmest yet most weakly stratified and had significantly less Chl a than Boreal lakes, where the temperature anomaly from the long-term average, during a summer heatwave was the highest (+4 degrees C) and showed a significant, exponential relationship with stratification strength. This European survey represents a summer snapshot of phytoplankton biomass and its drivers, and lends support that light and stratification metrics, which are both affected by climate change, are better predictors for phytoplankton biomass in nutrient-rich lakes than nutrient concentrations and surface temperature.
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| 6. |
- Mantzouki, Evanthia, et al.
(author)
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Temperature Effects Explain Continental Scale Distribution of Cyanobacterial Toxins
- 2018
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In: Toxins. - : MDPI. - 2072-6651. ; 10:4
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Journal article (peer-reviewed)abstract
- Insight into how environmental change determines the production and distribution of cyanobacterial toxins is necessary for risk assessment. Management guidelines currently focus on hepatotoxins (microcystins). Increasing attention is given to other classes, such as neurotoxins (e.g., anatoxin-a) and cytotoxins (e.g., cylindrospermopsin) due to their potency. Most studies examine the relationship between individual toxin variants and environmental factors, such as nutrients, temperature and light. In summer 2015, we collected samples across Europe to investigate the effect of nutrient and temperature gradients on the variability of toxin production at a continental scale. Direct and indirect effects of temperature were the main drivers of the spatial distribution in the toxins produced by the cyanobacterial community, the toxin concentrations and toxin quota. Generalized linear models showed that a Toxin Diversity Index (TDI) increased with latitude, while it decreased with water stability. Increases in TDI were explained through a significant increase in toxin variants such as MC-YR, anatoxin and cylindrospermopsin, accompanied by a decreasing presence of MC-LR. While global warming continues, the direct and indirect effects of increased lake temperatures will drive changes in the distribution of cyanobacterial toxins in Europe, potentially promoting selection of a few highly toxic species or strains.
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| 7. |
- Ramos Martín, Nuria, et al.
(author)
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Health and safety at work : achievements, shortcomings, and policy options
- 2023
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Reports (peer-reviewed)abstract
- This working paper presents a comparative study on the health and safety conditions workers face in two sectors (construction and PHS/domestic work) and concerning the extent to which workers in these sectors can effectively exercise their social rights concerning OSH. Also, it examines how the main EU acquis on occupational health and safety at work has been transposed and applied and what its impact has been in terms of available power resources for workers in the two sectors. It explains the way the respective Directives foster effective social rights for workers through legislation and collective agreements. The study includes seven EU member states, namely, Denmark, France, the Netherlands, Spain, Germany, Poland, and Ireland. We combine legal analysis with document analysis, semi-structured interviews, and descriptive statistics from national sources.According to our research, in general terms, the national transposing legislation of the OSH is in conformity with the studied EU OSH Directives. Our research also shows that, in many of the country cases, compliance with the OSH Directives minimum requirements is better in large establishments than in SMEs. However, there are some cases where the national legislation goes beyond the requirements of the EU framework directive. For example, in certain EU Member States domestic workers are included in the definition of ‘worker’ when transposing the Framework Directive, setting a broader personal scope of application than the Directive. But still, the workers in the two sectors face many health and safety problems and lack sufficient power resources to deal with them. Based on our analysis we present a series of policy recommendations that can help to improve this situation and strengthen the power resources of workers in the two sectors.
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