bluuebunny/crossref_metadata_2025 huggingface dataset:
The Hippo and Wnt signalling pathways: crosstalk during neoplastic progression in gastrointestinal tissue
Authors: Li Nianshuang , Lu Nonghua , Xie Chuan
Published: July 2019

The Hippo and Wnt signalling pathways play crucial roles in maintaining tissue homeostasis and organ size by orchestrating cell proliferation, differentiation and apoptosis. These pathways have been frequently found to be dysregulated in human cancers. While the canonical signal transduction of Hippo and Wnt has been well studied, emerging evidence shows that these two signalling pathways contribute to and exhibit overlapping functions in gastrointestinal (GI) tumorigenesis. In fact, the core effectors YAP/TAZ in Hippo signalling pathway cooperate with β‐catenin in Wnt signalling pathway to promote GI neoplasia. Here, we provide a brief review to summarize the molecular mechanisms underlying the crosstalk between these two pathways and elucidate their involvement in GI tumorigenesis, particularly focusing on the intestine, stomach and liver.
Digital and urban spaces: Oxymoron or binomial? Urban transformations in the digital era
Authors: De Falco Stefano
Published: July 2019

This is the era of the fourth industrial revolution. It is characterized by new, digital spaces in which individuals, especially digital natives, operate. It is in this new framework that digital spaces and physical urban spaces either mutually and constructively reinforce each other or destructively exclude each other. A conceptual reflection regarding Urban Constructive Interference and Urban Destructive Interference is thus explored in this work. These respective relationships between spaces consequentially affect urban transformations, particularly in consumption‐based and entertainment‐based places. These germinal relationships will become intrinsic in the fast‐paced transformations of society and urban phenomena. This paper does not linger on comprehensive coverage of case studies or an exhaustive mapping of geographic relationships between digital and urban spaces. However, it does aim to provide a critical framework concerning the drive towards a future where urban spaces are governed by digital technology.
Sarcopenia‐associated factors in Japanese patients with rheumatoid arthritis: A cross‐sectional study
Authors: Mochizuki Takeshi , Yano Koichiro , Ikari Katsunori , Okazaki Ken
Published: July 2019

Aim

To evaluate the prevalence rate and factors associated with sarcopenia in Japanese patients with rheumatoid arthritis.

Methods

We enrolled 240 consecutive patients with rheumatoid arthritis aged ≥65 years in this study. We examined clinical data: age, sex, body mass index, disease duration, rheumatoid factor positivity, anti‐cyclic citrullinated peptide antibody positivity, biological or target synthetic disease‐modifying antirheumatic drug use, methotrexate use, glucocorticoid use, C‐reactive protein level, disease activity score in 28 joints‐erythrocyte sedimentation rate, Health Assessment Questionnaire Disability Index, bone mineral density of the lumbar spine and total hip, grip strength, gait speed, and relative skeletal muscle mass index by bioelectrical impedance analysis. Sarcopenia was defined according to a consensus report by the Asian Working Group for Sarcopenia.

Results

The prevalence rate of sarcopenia was found to be 29.6%. Multivariate analysis identified the following factors to be associated with sarcopenia: age (P = 0.008; odds ratio 1.08), body mass index (P < 0.001; odds ratio 0.73), C‐reactive protein (P = 0.017; odds ratio 1.76) and hip bone mineral density (P = 0.037; odds ratio 0.61).

Conclusions

The sarcopenia‐associated factors were age, body mass index, C‐reactive protein and hip bone mineral density in Japanese patients with rheumatoid arthritis. Because the Health Assessment Questionnaire Disability Index, a standard measurement of function, cannot predict sarcopenia, the muscle mass needs to be measured while assessing changes in grip strength, body mass index, C‐reactive protein and hip bone mineral density. Geriatr Gerontol Int 2019; 19: 907–912.
Determination of Te, As, Bi, Sb and Se (TABS) in Geological Reference Materials and GeoPT Proficiency Test Materials by Hydride Generation‐Atomic Fluorescence Spectrometry (HG‐AFS)
Authors: Mansur Eduardo Teixeira , Barnes Sarah‐Jane , Savard Dany , Webb Peter C.
Published: July 2019

The study of Te, As, Bi, Sb and Se (TABS) has increased over the past years due to their use in the development of low‐carbon energy technologies. However, there is a scarcity of mass fraction values of TABS in geological reference materials. This underlines the difficulty in undertaking routine determinations of these elements. The mass fractions of TABS were determined in geological reference materials using hydride generation‐atomic fluorescence spectrometry (HG‐AFS), calibrated with standard solutions. Comparisons with literature values were used to validate the method. Samples from the GeoPT proficiency test were also analysed. For most elements, there are no assigned or even provisional values for many of the GeoPT and reference materials because of the wide range of results reported. For mass fractions above the quantification limit of the method, our results are in good agreement with the median of GeoPT results. Thus, we propose GeoPT median values as informational values for these elements. In contrast, at mass fractions < 0.5 µg g−1 median values of Se from GeoPT are systematically higher than our results. Our Se results are in agreement with the reference materials down to 0.02 µg g−1, which suggest that many of the results for Se reported in GeoPT testing are too high.
CSF Pressure, Volume, and Post‐Dural Puncture Headache: A Case‐Control Study and Systematic Review
Authors: Smith Jonathan H. , Mac Grory Brian , Butterfield Richard J. , Khokar Babar , Falk Bryce L. , Marks Lisa A.
Published: July 2019

Objectives

(1) To perform a systematic literature review to evaluate associations between post‐dural puncture headache (PDPH) and opening pressure (OP), closing pressure (CP), and volume of cerebrospinal fluid (V) removed. (2) To perform a case‐control study to evaluate pressure‐volume index (PVI) as a novel risk factor for PDPH.

Background

According to the International Classification of Headache Diagnoses, 3rd Edition (ICHD‐3), the diagnosis of PDPH requires documentation of intracranial hypotension. However, this remains an unproven concept.

Methods

A systematic literature review was conducted, searching Cochrane Database of Systematic Reviews, Ovid EMBASE, OVID MEDLINE, Scopus, and Web of Science. Study inclusion required a comparison of headache incidence following a LP as a function of OP, CP, and/or V.

A retrospective, case‐control study with 1:1 matching was conducted utilizing ICHD‐3 criteria. Patients with factors that could influence CSF pressure were excluded.

Results

In our case‐control study, we did not identify a paired difference in either median (95% CI) elastance (0.05 [−0.09, 0.11], P = .503) or PVI (4.53 [−7.98, 19.97], P = .678). We identified 22 references, evaluating V (n = 14), OP (n = 11), and/or CP (n = 4). There was no convincing evidence for an association of PDPH with either OP or CP. A minority of studies documenting an association with V included patients with high‐volume CSF removal, and/or stratified patients by the timing of the headache onset.

Conclusions

The overall risk of PDPH does not appear to be influenced by OP, CP, V or PVI. PDPH may be related to V in instances of high‐volume removal, and depend on the timing of outcome assessment. Future revision of criteria should consider the existence of immediate and delayed PDPH subtypes, and not presume intracranial hypotension as a mandatory feature.
Oral health care provided by nurses for hospitalized patients in Korea
Authors: Lee Ye‐Ji , Noh Hie‐Jin , Han Sun‐Young , Jeon Hyun‐Sun , Chung Won‐Gyun , Mun So‐Jung
Published: July 2019

Objectives

To investigate registered nurses’ awareness and implementation of oral health care in patients who are hospitalized in general wards or intensive care units (ICUs) in South Korea.

Methods

This research was performed as a descriptive survey of 149 nurses working in nine general hospitals with at least 100 beds in major Korean cities.

Results

Approximately half (40.9%) of the survey respondents reported providing oral health care for hospitalized patients but that relevant protocols were not available at most hospitals or wards (89.5%). Nurses working in an ICU were significantly more likely to provide oral health care than those working in general wards (83.9% vs 15.1%; P < .001). Most respondents (83.2%) were aware of the importance of providing oral health care for hospitalized patients; however, the proportion considering that such care should be provided by dental hygienists was greater than that considering it should be provided by nurses (36.4% vs 26.0%; P < .001). Agreement that oral health care should be provided for hospitalized patients by dental hygienists was highest in nurses working in ICUs (53.3%; P < .001).

Conclusions

According to this survey, oral healthcare provision is generally low in hospitalized patients and differs between ICUs and general wards. Most respondents considered that dental hygienists should provide oral health care for hospitalized patients. There is an opportunity for nurses and dental hygienists to work collaboratively towards development of an evidence‐based protocol for oral health care in hospitalized patients.
Composition‐dependent intrinsic defect structures in pyroclore RE2B2O7 (RE = La, Nd, Gd; B = Sn, Hf, Zr)
Authors: Yang Lan , Wang Peiying , Zhang Chengguan , Liu Yuchen , Cui Yuanyuan , Zhang Liangmiao , Liu Bin
Published: July 2019

Point defects are closely correlated with various properties of pyrochlore oxides and therefore play a key role on their engineering applications. Here, the native point defect complexes in RE2B2O7 (RE = La, Nd, Gd; B = Sn, Hf, Zr) under stoichiometric and nonstoichiometric compositions are studied by first‐principles calculations. The O Frenkel defect complex is predicted to be the predominant defect structure in stoichiometric zirconates and hafnates, whereas the cation antisite defect complex is the predominant one in stannates. In the case of BO2 excess, the formation of the B‐RE antisite defect together with the RE vacancy and the oxygen interstitial is energetically favorable, whereas the RE‐B antisite defect together with the oxygen vacancy and the RE interstitial is preferable under the RE2O3 excess environments. Additionally, the formation energies of the native defect complexes are greatly affected by the B‐site and/or RE‐site cations. The strategy on tailoring the intrinsic defect structures of these pyrochlore oxides is proposed. It is expected to guide the experiments on the defect‐related property optimization through stoichiometric and nonstoichiometric compositions, so as to meet the specific engineering requirements and promote their commercial applications.
SrAl12O19: Fe3+ @3‐aminopropyl triethoxysilane: Ambient aqueous stable near‐infrared persistent luminescent nanocomposites
Authors: Kang Ru , Dou Xiaojing , Lian Huiwang , Li Yang
Published: July 2019

Near‐infrared (NIR) persistent luminescent nanoparticles (N‐PLNPs) endow a long‐term in vivo imaging with deep tissue penetration and high signal to noise ratio. However, synthesis route and applicable afterglow center for N‐PLNPs are still limited. Here, we report on a new synthesis by employing chemical precipitation as the central pivot, which is simpler and has controllable and reproducible routes than the existing technique. We also introduce Fe3+ ion as a new member to join the group of afterglow emitters. Although its NIR luminescence is ubiquitous, its NIR afterglow is still almost never reported. In this paper, SrAl12O19: Fe3+ N‐PLNPs display a NIR persistent luminescence from 750 to 1000 nm, which is assigned to 4T1(4G)→6A1(6S) transition of Fe3+. Furthermore, a surface‐amination technique is proposed to improve the stability of SrAl12O19: Fe3+ N‐PLNPs in aqueous solution. After encapsulating the N‐PLNPs with 3‐aminopropyl triethoxysilane (APTES), SrAl12O19: Fe3+ @APTES nanocomposites exhibit a hydrophilic stability beyond 20 days in aqueous solution. The results make them valuable in studying the biological functions of biomolecules and monitoring cellular networks in their native contexts.
Transformation All the Way Down? European Union Integration and the Professional Socialization of Municipal Health Officials in Serbia
Authors: Fagan Adam , Sircar Indraneel
Published: July 2019

This article assesses whether different types of exposure to European Union (EU) modes of socialization are associated with differences in attitudes towards corruption, using Serbia as case study. Drawing on a survey of Serbian municipal health‐care officials, the article complements existing research on the impact of EU conditionality on attitudes at the national level, while also contributing to the understanding of the impact of domestic variables on Europeanization. Thus, the article's contribution to the wider literature is to interrogate the premise that in order to deliver substantive reform, attitudes and practices need to be changed via exposure to EU tutelage and processes. Our data suggest that the type of interaction that officials have with the EU and its processes matters. While those involved in EU harmonization activities were significantly more critical of clientelistic behaviour, there is no significant association between attitudes and doing daily EU‐related work or attending EU training.
Experimental investigation of solar‐assisted heat pump dryer with heat recovery for the drying of chili peppers
Authors: Naemsai Thanwit , Jareanjit Jaruwat , Thongkaew Kunlapat
Published: July 2019

This research investigated the performance of a solar‐assisted heat pump dryer (SAHPD) with heat recovery to reduce the amount of thermal energy needed for drying chili peppers. The dryer selected for the experimental study consisted of a heat pump, a greenhouse cover and multi trays. It was found that the SAHPD with recovery gave better drying performance than a traditional dying method. The dryer system can offer drying time, drying efficiency, coefficient of performance and specific energy consumption of approximately 24 hr, 33.2%, 3.17, and 2.21 kWh/kg, respectively. Furthermore, the SAHPD with heat recovery provided a higher drying performance than without the heat recovery although the ambient condition changed. Base on the economic analysis, the payback period and net present value of the SAHPD with heat recovery were approximately 1.9 years and 915.60 USD. The SAHPD with two drying rooms also yielded better drying performance than the SAHPD with one room.

Practical applications

Drying is the process of moisture reduction to a safe limit of moisture content, which allows agriculture to extend the shelf life of the crops by restraining the growth of microorganism. In chili peppers drying process, a solar assisted heat pump drying as one of hybrid solar dryers is preferred because heat and mass transfer rate are rather high and it offers the ability to operate both daytime and nighttime. However, the exhausted air to the ambient still has considerable thermal energy. Thus, the heat recovery system has been employed to design and fabricate inside the dryer. Findings of this research contribute to the evaluation of heat recovery in a typical solar assisted heat pump dryer in terms of drying efficiency and economic feasibility in order to be a guideline for small and medium‐sized enterprises.
Reducing Barriers to Mental Health Care: Bringing Evidence‐Based Psychotherapy Home
Authors: Borson Soo , Korpak Anna , Carbajal‐Madrid Pedro , Likar Denise , Brown Gretchen A. , Batra Romilla
Published: July 2019

OBJECTIVES

Barriers to treatment for depression and anxiety are prevalent among older adults and caregivers living in the community. We designed and implemented an evidence‐based psychotherapy program to reduce obstacles to care.

DESIGN

A practice improvement initiative providing no‐fee evidence‐based mental health care at home in clients' primary languages.

SETTING

Independence at Home, a community service of SCAN Health Plan in Southern California.

PARTICIPANTS

Diverse older adults and adult caregivers of older people with age‐related disability (mainly dementia).

INTERVENTION

Redesign of an existing supportive counseling program to improve access to validated models of psychotherapy for depression and anxiety.

MEASUREMENTS

We describe program content, phases of development, equity in participation from referral to program completion, clinical outcomes, and estimated direct program delivery costs.

RESULTS

Insights successfully served demographically diverse clients experiencing a broad range of barriers to mental health care. A total of 211 clients completed therapy using one of three evidence‐based approaches in the first 33 months of operation (2015‐2018). Clinical efficacy was high and equivalent across demographic groups and therapy models. Depression, anxiety, quality of life, self‐rated disability, and patient activation all improved significantly. We supported therapists' transition to the new model, modified workflows, and used clinical outcome data and therapist focus groups to improve referral, selection, and enrollment processes and simplify treatment assignment. With program maturation, treatment duration and direct costs both declined.

CONCLUSION

The Insights model could add value to healthcare organizations seeking to provide effective, equitable mental health services for older adults and caregivers who have difficulty accessing care for depression, anxiety, or difficult life challenges. J Am Geriatr Soc 67:2174–2179, 2019
Post‐Discharge Mortality of Older Adults with Traumatic Brain Injury or Other Trauma
Authors: Albrecht Jennifer S. , Al Kibria Gulam Muhammed , Greene Christina R. , Dischinger Patricia , Ryb Gabriel E.
Published: July 2019

OBJECTIVES

Prior studies of mortality following traumatic brain injury (TBI) have not focused specifically on older adults compared with a non‐TBI trauma cohort or included specific causes of death. The objectives of this study were, among adults aged 65 years and older, to (1) generate standardized mortality ratios (SMRs) by cause of death for TBI and a non‐TBI trauma cohort compared with a general population, and (2) assess risk of mortality associated with TBI compared with a non‐TBI trauma cohort.

DESIGN

Retrospective cohort study of adults aged 65 years and older who were treated at an urban trauma center from 1997 to 2008.

MEASUREMENTS

Data from the trauma registry were linked to the National Death Index through 2008 to obtain date and cause of death. We identified individuals with TBI and non‐TBI trauma and calculated age‐ and sex‐adjusted SMRs by comparing with the state general population. We next compared time to mortality between individuals with TBI (n = 852) and non‐TBI trauma (n = 1050), adjusting for potential confounders.

RESULTS

Compared with the age‐ and sex‐adjusted state general population, older adults with TBI (SMR = 8.1; 95% confidence interval [CI] = 7.4‐9.0) and non‐TBI trauma (SMR = 6.7; 95% CI = 6.1‐7.4) were at a greatly increased risk of mortality. Highest SMRs in both cohorts were observed for accidents. In adjusted Cox regression models, TBI was not associated with increased risk of all‐cause mortality (hazard ratio = 1.03; 95% CI = .87‐1.23) compared with non‐TBI trauma.

CONCLUSION

This study provides evidence that, over a 4‐year follow‐up of older adults, any moderate to severe injury is associated with increased mortality risk. Specifically, older injured adults are at high risk of death from accidental and therefore preventable causes, suggesting that intervention could reduce mortality. J Am Geriatr Soc 67:2382–2386, 2019
Complicating categories: Personae mediate racialized expectations of non‐native speech
Authors: D'Onofrio Annette
Published: July 2019

This paper examines how American listeners’ expectations of non‐native English speech from speakers of East Asian descent can be modulated by the persona invoked by a speaker's visual display. While prior work has typically linked expectations of non‐native speaker status with East Asian‐ness broadly construed, this study indicates that US listeners’ expectations can be tied to more particular manifestations of this racialized identity, themselves informed by raciolinguistic ideologies. In a lexical recall task with persona‐based photographic primes, different visual styles embodied by the same Korean individual induced contrasting expectations of “foreign accented” speech, which corresponded to significant differences in how well the speech was remembered. Ultimately, I argue that models of sociolinguistic perception should include cognitive representations of social constructs like personae, not only to better capture the detailed nature of listeners’ sociolinguistic expectations, but also to avoid perpetuating homogenizing treatments of racialized groups’ language practices.
Being in a space of sharing decision‐making for dignified mental care
Authors: Beyene Lise Sæstad , Severinsson Elisabeth , Hansen Britt Sætre , Rørtveit Kristine
Published: July 2019

Accessible summary

What is known on the subject?

Several studies describe barriers and facilitators for implementing shared decision‐making in mental care, yet a deeper understanding of the meaning of shared decision‐making in this context is lacking.

Shared decision‐making is aimed at facilitating patients' active participation in their care.

Mental care is intended to empower the patients by increasing their responsibility and self‐awareness and helping them to use their own resources.

Too much focus on the patients' independence, responsibility and choice may hinder the patients getting the help they need.

What this paper adds to existing knowledge?

The meaning of SDM can be understood as a continuous relational process between the patients and MHCPs in search of dignified care.

Practising shared decision‐making is a challenging process which requires the MHCPs to possess high professional competence.

What are the implications for practice?

Mental healthcare professionals should be conscious of their own role in the asymmetrical power relationship in decision‐making and use their professional competence for their patients' benefit.

Clinical supervision can be a tool for developing professional competence and is considered important when assisting mental healthcare professionals practising shared decision‐making for dignified care.

Introduction

Several studies describe barriers and facilitators for implementing shared decision‐making in mental care. However, a deeper understanding of the meaning of shared decision‐making in this context is lacking. Shared decision‐making is aimed at facilitating patients' active participation in their care by placing them at the centre of care. Too much focus on the patients' autonomy may hinder them getting the help they need. A comprehensive understanding of shared decision‐making is needed for its implementation.

Aim/research question

To interpret the meaning of shared decision‐making in mental care as perceived by patients and mental healthcare professionals. The research question was: What is the meaning of shared decision‐making in mental care?

Method

A hermeneutic inductive design with a thematic interpretative analysis of data was performed from in‐depth interviews with 16 patients and multistage focus group interviews with eight mental healthcare professionals.

Results

The overall theme being in a space of sharing decision‐making for dignified mental care was described by the three themes engaging in a mental room of values and knowledge, relating in a process of awareness and comprehension and responding anchored in acknowledgement.

Discussion

Balancing the patients' need for assistance with autonomy, while safeguarding their dignity, is a challenging process requiring mental healthcare professionals to possess professional competence.

Implications for practice

Organized professional development of the carers' professional competence is important to facilitate shared decision‐making.
Lactation and maternal risk of diabetes: Evidence from the Mexican Teachers' Cohort
Authors: Mazariegos Mónica , Ortiz‐Panozo Eduardo , Stern Dalia , González de Cosío Teresita , Lajous Martin , López‐Ridaura Ruy
Published: July 2019

One postpartum behaviour that may be protective against diabetes is lactation due to its potential role in resetting maternal metabolism after pregnancy. However, the role of lactation in maternal risk of diabetes has not been investigated in Latin American populations, where rates of breastfeeding are suboptimal and diabetes incidence is increasing. Therefore, our aim was to estimate the association between mean duration of lactation per child and maternal incidence of diabetes. We followed 66,573 women from the Mexican Teachers' Cohort free of diabetes at baseline. Incident diabetes was ascertained through triennial questionnaires and lactation history was asked in baseline questionnaire. We used Cox proportional hazards regression models to estimate the hazard ratio (HR) for diabetes by mean duration of lactation per child. We examined the dose–response association between lactation per child and diabetes with restricted cubic splines. We found that 3,168 incident cases of diabetes were diagnosed during 157,510 person years of follow‐up. In comparison with women who did not breastfed, women with a mean lactation per child of 3 to <6 months and 6 to <12 months had HRs of 0.81 (95% CI [0.65, 0.99]) and 0.73 (95% CI [0.59, 0.91]), respectively (p for quadratic term 0.004). There was no further decline in risk of diabetes after ≥12 months of lactation per child. The dose–response association between lactation and diabetes was linear up to 9 months of lactation. Our findings suggest that lactation is associated with reduced incidence of diabetes, indicating considerable potential for diabetes prevention on a population level.
Identification of Cryptococcus antigen in human immunodeficiency virus‐positive Turkish patients by using the Dynamiker® lateral flow assay
Authors: Karaman Evrim , Ilkit Macit , Kuşçu Ferit
Published: July 2019

Cryptococcus neoformans causes life‐threatening meningoencephalitis, particularly in human immunodeficiency virus (HIV)‐positive individuals with low CD4 levels (<100 cells/μL). Although the burden of cryptococcal meningoencephalitis (CM) in Turkey is low (0.13 cases per 100 000 persons), asymptomatic individuals at risk of cryptococcosis should be screened for antigenemia to prevent the disease and/or promote early CM diagnosis. A lateral flow assay (LFA) is used to detect Cryptococcus antigen (CrAg) in cerebrospinal fluid and serum. We determined Cryptococcus antigenemia prevalence in serum samples of HIV‐positive and HIV‐negative adult patients by using Dynamiker® CrAg‐LFA, a point‐of‐care dipstick test. Patients’ demographic data, CD4 count, HIV‐RNA levels and anti‐retroviral therapy status were recorded. CrAg was detected in 28 (11%) of 254 HIV‐positive patients screened but not in 100 HIV‐negative control individuals; a significant difference was observed in the CrAg‐LFA positivity rate between HIV‐positive and HIV‐negative groups (x2 = 11.970; P < .05). In CrAg‐positive patients, the median CD4 level was 666 cells/μL (115‐1344 cells/μL), with a median viral load of 23 copies/mL (0‐3.69 × 106 copies/mL). In HIV‐positive CrAg‐negative patients, the median CD4 level was 633 cells/μL (31‐2953 cells/μL) and the median viral load was 12 copies/mL (0‐1.95 × 106 copies/mL; P > .05). Results indicate that HIV‐positive patients with both low (<200 cells/μL) and high (>200 cells/μL) CD4 counts should be screened for asymptomatic cryptococcal antigenemia. HIV‐associated asymptomatic cryptococcosis is not uncommon in Turkey, which warrants systematic screening. Updated strategies for CM prevention among HIV‐positive patients should be used even in non‐endemic countries.
A systematic review and meta‐analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years
Authors: Sharma Vishal , Coleman Susanne , Nixon Jane , Sharples Linda , Hamilton‐Shield Julian , Rutter Harry , Bryant Maria
Published: July 2019

Evidence for the health impact of obesity has largely focussed on adults. We estimated the population prevalence and prevalence ratio of obesity‐associated comorbidities in children and adolescents aged 5 to 18 years. Five databases were searched from inception to 14 January 2018. Population‐based observational studies reporting comorbidity prevalence by weight category (healthy weight/overweight/obese) in children and adolescents aged 5 to 18 years from any country were eligible. Comorbidity prevalence, stratified by weight category, was extracted and prevalence ratios (relative to healthy weight) estimated using random effects meta‐analyses. Of 9183 abstracts, 52 eligible studies (1 553 683 participants) reported prevalence of eight comorbidities or risk markers including diabetes and nonalcoholic fatty liver disease (NAFLD). Evidence for psychological comorbidities was lacking. Meta‐analyses suggested prevalence ratio for prediabetes (fasting glucose ≥ 100 mg/dL) for those with obesity relative to those of a healthy weight was 1.4 (95% confidence interval [CI], 1.2‐1.6) and for NAFLD 26.1 (9.4‐72.3). In the general population, children and adolescents with overweight/obesity have a higher prevalence of comorbidities relative to those of a healthy weight. This review provides clinicians with information when assessing children and researchers a foundation upon which to build a comprehensive dataset to understand the health consequences of childhood obesity.
Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching
Authors: Blanc‐Petitjean Pauline , Carbonne Bruno , Deneux‐Tharaux Catherine , Salomé Marina , Goffinet François , Le Ray Camille ,   for the MEDIP study group
Published: July 2019

Background

There is no consensus about the ideal cervical ripening method to use for induction of labour.

Objective

To compare in current practice the effectiveness and safety of four cervical ripening methods.

Methods

We performed a matched comparative study using data from the MEDIP prospective population‐based cohort conducted during one month in 2015 in all maternity units of seven French perinatal networks (3042 consecutive women with a live fetus and induction of labour). We analysed 1671 women with singleton cephalic fetus, unscarred uterus, and bishop score <7. Dinoprostone vaginal pessary (reference) was compared to dinoprostone vaginal gel, misoprostol vaginal tablet, and balloon catheter. Effectiveness outcomes were the need for more than one induction agent, oxytocin use, failure to achieve vaginal delivery within 24 hours (VD < 24 hours), and caesarean delivery. Safety outcomes were meconium‐stained amniotic fluid, uterine hyperstimulation, NICU admission, and post‐partum haemorrhage. Coarsened exact matching was used to balance confounders among the groups. Outcomes were compared using multivariable logistic regression models.

Results

Compared to the dinoprostone pessary (N = 1142, 68.3%), dinoprostone gel (N = 335, 20.1%) was associated with less failure to achieve VD < 24 hours (adjusted OR 0.66, 95% CI 0.47, 0.91). Misoprostol (N = 103, 6.2%) was associated with less need of more than one induction agent (aOR 0.56, 95% CI 0.34, 0.92) and less oxytocin use (aOR 0.60, 95% CI 0.37, 0.99). The balloon catheter (N = 91, 5.4%) was associated with more failure to achieve VD < 24 hours (aOR 2.62, 95% CI 1.37, 5.01), more caesarean delivery (aOR 1.84, 95% CI 1.09, 3.08), and less meconium‐stained amniotic fluid (aOR 0.12, 95% CI 0.02, 0.70). Uterine hyperstimulation rates seemed lower with the balloon catheter (1.2% vs 4.2% for the pessary).

Conclusions

In current practice, no cervical ripening method appears clearly superior to the others considering all effectiveness and safety outcomes.
Processing of affective words in adolescent PTSD—Attentional bias toward social threat
Authors: Klein Fabian , Schindler Sebastian , Neuner Frank , Rosner Rita , Renneberg Babette , Steil Regina , Iffland Benjamin
Published: July 2019

Post‐traumatic stress disorder (PTSD) is associated with a hypersensitivity to potential threat. This hypersensitivity manifests through differential patterns of emotional information processing and has been demonstrated in behavioral and neurophysiological experimental paradigms. However, the majority of research has been focused on adult patients with PTSD. To examine possible differences in underlying neurophysiological patterns for adolescent patients with PTSD after childhood sexual and/or physical abuse (CSA/CPA), ERP correlates of emotional word processing in 38 healthy participants and 40 adolescent participants with PTSD after experiencing CSA/CPA were studied. The experimental paradigm consisted of a passive reading task with neutral, positive (e.g., paradise), physically threatening (e.g., torment), and socially threatening (i.e., swearing, e.g., son of a bitch) words. A modulation of P3 amplitudes by emotional valence was found, with positive words inducing less elevated amplitudes over both groups. Interestingly, in later processing, the PTSD group showed augmented early late positive potential (LPP) amplitudes for socially threatening stimuli, while there were no modulations within the healthy control group. Also, region‐specific emotional modulations for anterior and posterior electrode clusters were found. For the anterior LPP, highest activations have been found for positive words, while socially and physically threatening words led to strongest modulations in the posterior LPP cluster. There were no modulations by group or emotional valence at the P1 and EPN stage. The findings suggest an enhanced conscious processing of socially threatening words in adolescent patients with PTSD after CSA/CPA, pointing to the importance of a disjoined examination of threat words in emotional processing research.
Prevention of Suicidal Behavior with Telemedicine in Patients with a Recent Suicide Attempt: Is a 6‐month Intervention Long Enough?
Authors: Gabilondo Andrea , Aristegi Edurne , Gonzalez‐Pinto Ana , Martin Zurimendi José , Mateos Del Pino Maider , Roca Raquel , Zorrilla Iñaki , Iruin Alvaro
Published: July 2019

Objective

To analyze the results of a 6‐month telephone follow‐up program for the prevention of suicidality in adult patients discharged from three general hospitals after a suicide attempt. Results are compared with traditional programs lasting 12 months or more.

Methods

This is a prospective, multicenter, study with the control group. Patients in the intervention group received five protocolized telephone calls which were added to their usual treatment. Those in the control group only received usual treatment. Each patient was followed up for 12 months.

Results

A total of 123 patients were included in the intervention group and 463 in the control group. 57.7% received at least three calls. Patients in the intervention group took longer to perform a reattempt (p = .05). The percentage of those who did a reattempt (p = .67) and the number of reattempts per patient (p = .66) did not differ between groups. Those in the intervention group showed higher percentages of adherence to the outpatient follow‐up (p < .001).

Conclusion

The intervention was well accepted and showed improved percentages of adherence to outpatient follow‐up; however, the results in the prevention of suicidality were worse than those obtained by programs lasting 12 months or more. It is advisable to maintain the telephone follow‐up for a minimum of 12 months.
Endometrial cancer and obesity
Authors: Kitson Sarah J , Crosbie Emma J
Published: July 2019

Key content

Of the 20 most common tumour types, endometrial cancer has the strongest association with obesity.

Endometrial cancer should be considered in young, obese women with irregular or heavy menstrual bleeding.

To reduce the risk of postoperative complications, surgery for endometrial cancer should be performed using minimal access techniques whenever possible.

For women who are unfit for, or who decline, surgery, alternative treatments include progestins or radiotherapy, but these have lower efficacy and are associated with a higher risk of disease relapse.

Obesity is associated with reduced overall survival following endometrial cancer because of increased cardiovascular mortality; it may also affect disease‐specific survival.

Learning objectives

To further understanding of the mechanisms through which obesity drives endometrial carcinogenesis.

To improve understanding of the potential difficulties associated with the management of endometrial cancer in obese women.

To increase knowledge of alternative treatment options for women who are unfit for, or who decline, standard endometrial cancer management.

Ethical issues

The number of young, premenopausal women with endometrial cancer is increasing – how should these women be managed?

Should super‐obese women with endometrial cancer only be treated in cancer centres?

After treating a woman's endometrial cancer, how should she be counselled her about her weight and cardiovascular disease risk?
Human macrophage response to microbial supernatants from diabetic foot ulcers
Authors: Deusenbery Carly B. , Kalan Lindsay , Meisel Jacquelyn S. , Gardner Sue E. , Grice Elizabeth A. , Spiller Kara L.
Published: July 2019

Diabetic foot ulcers (DFUs) are a major clinical problem exacerbated by prolonged bacterial infection. Macrophages, the primary innate immune cells, are multifunctional cells that regulate diverse processes throughout multiple phases of wound healing. To better understand the influence of microbial species on macrophage behavior, we cultured primary human monocyte‐derived macrophages from four donors for 24 hours in media conditioned by bacteria and fungi (Pseudomonas aeruginosa, Corynebacterium amycolatum, Corynebacterium striatum, Staphylococcus aureus, Staphylococcus simulans, and Candida albicans) isolated from the DFUs of six patients. The effects of these microbe‐derived signals on macrophage behavior were assessed by measuring the gene expression of a panel of 25 genes related to macrophage phenotype, angiogenesis, bacterial recognition, and cell survival, as well as secretion of two inflammatory cytokines using NanoString multiplex analysis. Principal component analysis showed that macrophage gene expression and protein secretion were affected by both microbial species as well as human donor. S. simulans and C. albicans caused up‐regulation of genes associated with a proinflammatory (M1) phenotype, and P. aeruginosa caused an increase in the secretion of the proinflammatory cytokine and M1 marker tumor necrosis factor‐alpha (TNFα). Together, these results suggest that macrophages respond to secreted factors from microbes by up‐regulating inflammatory markers, and that the effects are strongly dependent on the monocyte donor. Ultimately, increased understanding of macrophage–microbe interactions will lead to the development of more targeted therapies for DFU healing.
A Political Economy Analysis of Income Diversification Activities of Rural Households in the Northern Region of Ghana
Authors: Salifu Gamel Abdul-Nasser , Anaman Kwabena Asomanin
Published: July 2019

This study analysed income diversification activities of 1,194 rural households in the Northern Region of Ghana using data from the sixth round of the Ghana Living Standards Survey (GLSS) undertaken by the Government of Ghana, through the Ghana Statistical Service. We found that 92% of rural households were engaged in farm activities affirming agriculture as the dominant profession of rural households in the region. The number of income-generating activities undertaken by these households was significantly related to the size of the household, previous apprenticeship training acquired by the household head, ownership of a motor bike/car, and ownership by the household of specific physical assets which also provide information, communication and entertainment services, namely mobile phone, radio and television sets. The share of wage-based income in the total household income was significantly related to the age of the household. The overall income diversification index was positively influenced by the level of remittances and the number of rooms in the house; the latter allowed for increased possibility of renting rooms in the house to workers. We also established that overall income diversification index was associated with decreasing total household consumption expenditures and reduced food security at relatively low levels. However, this index was linked to increasing household consumption expenditures and improved food security at relatively higher levels. Our findings suggest that income diversification could be an important poverty-reducing measure if well-designed Community and State support programmes for rural households are implemented in the region under conditions of peace and good security.
Experimental Study of the Static and Dynamic Characteristics of a Long (L/D = 0.75) Labyrinth Annular Seal Operating Under Two-Phase (Liquid/Gas) Conditions
Authors: Shrestha Hari , Childs Dara W. , Tran Dung L. , Zhang Min
Published: July 2019

A two-phase annular-seal stand at the Turbomachinery Laboratory of Texas A&M University is utilized to experimentally investigate a labyrinth seal operating under two-phase flow conditions (a mixture of silicone oil and air). A long labyrinth seal (length-to-diameter ratio L/D = 0.75, diameter D = 114.729 mm, and radial clearance Cr = 0.213 mm) is tested at a supply pressure of 62 bars-g with inlet gas volume fraction GVFi ranging from 90 to 100%. Tests were conducted at three pressure ratios PR (0.3, 0.4, 0.5), three rotating speeds (5, 10, 15 krpm), six GVFi (90%, 92%, 94%, 96%, 98%, and 100%), and three inlet-preswirl inserts, namely, zero, medium, and high. Specifically, the ratio between the fluid's circumferential velocity and the shaft surface's velocity are in ranges of 0.0–0.2, 0.5–1.6, and 0.5–2.7 for the zero, medium, and high preswirls respectively. The direct dynamic stiffness KΩ is negative. As GVFi decreases (more liquid), KΩ becomes more negative for the zero preswirl. The effect of changing GVFi on KΩ for the medium and high preswirls is not as clear as for the zero preswirl. For the zero preswirl, as GVFi decreases, the cross-coupled dynamic stiffness kΩ and direct damping C damping increase. However, the effective damping Ceff values converge to almost the same positive value for higher frequencies. Hence, there is no significant effect of change in GVFi for the zero preswirl. For the high preswirl, as GVFi decreases, kΩ decreases and C increases. As GVFi decreases, Ceff becomes less negative and eventually becomes positive for frequencies higher than Ωc. This result indicates that at certain frequencies, the presence of liquid can make the labyrinth seals with high preswirl more stable. For the seal tested, a compressor running at 15 krpm and PR (ratio of seal exit pressure and seal inlet pressure) = 0.5 with the first critical speed of 7500 rpm (125 Hz) would experience an increase in stability with presence of liquid in the flow stream for the medium and high preswirls. However, for the range of GVFi considered here, if swirl brakes are used in a compressor application to reduce the preswirl, there would be no impact of liquid presence on the stability of the compressor. Concerning static measurements, leakage rate m˙ increases with decreases in GVFi but remains unchanged with increasing preswirl.
An Artificial Neural Network Approach for Generating High-Resolution Designs From Low-Resolution Input in Topology Optimization
Authors: Napier Nicholas , Sriraman Sai-Aksharah , Tran Huy T. , James Kai A.
Published: July 2019

We address a central issue that arises within element-based topology optimization. To achieve a sufficiently well-defined material interface, one requires a highly refined finite element mesh; however, this leads to an increased computational cost due to the solution of the finite element analysis problem. By generating an optimal structure on a coarse mesh and using an artificial neural network to map this coarse solution to a refined mesh, we can greatly reduce computational time. This approach resulted in time savings of up to 85% for test cases considered. This significant advantage in computational time also preserves the structural integrity when compared with a fine-mesh optimization with limited error. Along with the savings in computational time, the boundary edges become more refined during the process, allowing for a sharp transition from solid to void. This improved boundary edge can be leveraged to improve the manufacturability of the optimized designs.
Prediction of Dilution and Its Impact on the Metallurgical and Mechanical Behavior of a Multipass Steel Weldment
Authors: Sun Y. L. , Hamelin C. J. , Flint T. F. , Vasileiou A. N. , Francis J. A. , Smith M. C.
Published: July 2019

A three-pass groove weld made by gas-tungsten arc welding in a 20-mm thick SA508 steel plate is modeled to predict the thermal, metallurgical, and mechanical behavior. The dilution for each pass is estimated as the proportion of base material in the weld metal, based on the predicted cross-sectional areas for the fusion zone (FZ) associated with each individual pass. The temperature predictions are consistent with the thermocouple measurement data and cross-weld macrographs. The predicted microstructures are qualitatively compared with the observed microstructures in cross-weld optical micrographs. The measured hardness is then used to quantitatively validate the predictions for postweld microconstituents (e.g., the ferrite, bainite, and martensite fractions), based on a hardness-microstructure correlation. The predicted residual stresses are compared with those measured by neutron diffraction. The results show that the dilution significantly affects the metallurgical and mechanical properties of weld metal (either as-deposited or reheated), and its consideration notably improves the predictions for microstructure and residual stress in the multipass steel weldment. Furthermore, the increase in dilution promotes the formation of martensite, which enhances the hardness, and leads to lower tensile stresses (or higher compressive stresses) in the weld metal. Such behavior arises due to the higher hardenability of the base material employed in this study, coupled with delayed austenite decomposition on cooling.
Effect of Plastic Hardening Models on Fatigue Life Simulation of Pipeline Elbows Under Operating Pressure and Cyclic Bending
Authors: Zhu Xian-Kui
Published: July 2019

This paper presents a numerical study of plastic hardening models used in the stress, strain, and fatigue life simulations of a pipeline elbow under operating pressure and cyclic in-plane bending. To determine more accurate stresses, strains, and fatigue life of the elbow in cyclic loading, the material plastic hardening response and the Bauschinger effect need to be considered properly in the numerical simulation. The isotropic, kinematic, and combined isotropic/kinematic hardening models are, thus, evaluated in the elastic-plastic finite element analysis (FEA) of a benchmark beam. On this basis, those plastic hardening models are applied to simulate the elbow under combined loading of constant internal pressure and cyclic in-plane bending. With the FEA results and selected fatigue models that are commonly used in the pipeline industry, fatigue life of the elbow is predicted for each hardening model. As such, the appropriate plastic hardening model and fatigue life model to predict fatigue life of the elbow are determined.