bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy and Exergy Analysis of a Multi-Stage Hybrid Concentrated Solar Power Plant
Authors: Moreno-Gamboa Faustino , Nieto-Londoño César , Escudero-Atehortua Ana , Lopera Leonardo 
Published: October 2020

Abstract
The Colombian electricity sector is mainly composed of hydropower plants covering up to 70% of the total power generation. Several alternatives had been evaluated to complement Colombian’s energy mix, including solar PV and wind energy plants; however, there is no consensus about the appropriate solution in terms of the available resource, energy demand, and energy mix complementing. This work presents the performance evaluation of a hybrid thermosolar power plant at a city on the Caribbean Colombian coast, considering local environmental conditions such as ambient temperature and solar resource availability to attain the factor that constrain its optimal operating conditions. The overall energy and exergy plant efficiency is analyzed, considering an arbitrary number of stages. For instance, comparing a single-stage plant running with air with a two compression stages with inter-cooling and two expansion stages with reheating, the results indicate a 30 % higher exergy efficiency, and overall energy efficiency about 32 % larger and a fuel conversion rate around 18 % larger.
Uncovering the high burden of hypertension and its predictors among adult population in Hosanna town, southern Ethiopia: a community-based cross-sectional study
Authors: Dereje Nebiyu , Earsido Alemu , Temam Layla , Abebe Ashenafi 
Published: October 2020

ObjectiveHypertension is a global public health problem, with its burden increasing particularly in developing countries. However, it has not yet received due attention in Ethiopia. The aim of this study was to determine the prevalence and associated factors of hypertension among adult population in Hosanna town, southern Ethiopia.DesignCommunity-based cross-sectional study.SettingHosanna town, southern Ethiopia.ParticipantsAdult population aged ≥18 years (n=634) were recruited by a multistage stratified sampling technique.Outcome measuresA face-to-face interview using structured questionnaire was carried out by trained nurses. Anthropometry and blood pressure were measured following standard procedures. Hypertension status was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg in two separate measurements or reported use of prescribed antihypertensive drugs for raised blood pressure. Factors associated with hypertension were identified by multivariable binary logistic regression analysis.ResultsThe overall prevalence of hypertension was found to be 17.2% (19.3% and 14.2% among men and women, respectively). About 40% were unaware that they were hypertensive prior to the study. Older age ≥35 years (adjusted OR=3.9, 95% CI: 1.4 to 10.8), alcohol use (adjusted OR=3.4, 95% CI: 1.4 to 8.3), consumption of saturated oil (adjusted OR=6.5, 95% CI: 1.5 to 17.5) and unspecified different types of oil (adjusted OR=8.2, 95% CI: 1.9 to 25.1) and overweight/obesity (adjusted OR=2.9, 95% CI: 1.9 to 4.6) were found to be independently associated with hypertension.ConclusionsThe prevalence of both diagnosed and undiagnosed hypertension is alarmingly high in the town. These findings underscore the need to design health information provision systems on the risk factors of hypertension and promote good health practices. Blood pressure screening programmes at community levels to identify and treat undiagnosed hypertension should be considered.
Effect of clindamycin and a live biotherapeutic on the reproductive outcomes of IVF patients with abnormal vaginal microbiota: protocol for a double-blind, placebo-controlled multicentre trial
Authors: Haahr Thor , Freiesleben Nina La Cour , Pinborg Anja , Nielsen Henriette Svarre , Hartvig Vibeke , Mikkelsen Anne-Lis , Parks Thomas , Uldbjerg Niels , Jensen Jørgen Skov , Humaidan Peter 
Published: October 2020

IntroductionRecent studies in in vitro fertilisation (IVF) patients have associated abnormal vaginal microbiota (AVM) with poor clinical pregnancy rates of 6%–9% per embryo transfer. The biological plausibility for this finding is hypothesised to be ascending infection to the endometrium which in turn hampers embryo implantation. New molecular based diagnosis may offer advantages compared to microscopical diagnosis of AVM which has huge inter-study variability ranging from 4 to 38%; however, the important question is whether screening and treatment of AVM would improve reproductive outcomes in IVF patients. Herein, we describe a protocol for an ongoing double-blind, placebo-controlled multicentre trial of IVF patients diagnosed with AVM and randomised in three parallel groups 1:1:1.Methods and analysisThis is a drug intervention study where IVF patients will be screened for AVM, using a qPCR assay targeting Atopobium vaginae and Gardnerella vaginalis. If positive, patients will be randomised to one of the three study arms. The first arm consists of clindamycin 300 mg ×2 daily for 7 days followed by vaginal Lactobacillus crispatus CTV-05 until clinical pregnancy scan week 7–9. The second arm consists of clindamycin and placebo L. crispatus CTV-05, whereas patients in the third arm will be treated with placebo/placebo. We used a superiority design to estimate that active treatment in both arms will increase the primary outcome, clinical pregnancy rate per embryo transfer, from 20% to 40%. A potential difference between the two active arms was considered exploratory. With a power of 80% and an alpha at 5%, the sample size is estimated to be 333 patients randomised. A pre-planned interim analysis is scheduled at 167 patients randomised.Ethics and disseminationAll patients have to give informed consent. Dissemination of results is ensured in clinical trial agreements whether they be positive or not. Ethics committee, Central Denmark Region approved this protocol.Trial registration numberICH-GCP monitored trial, EudraCT 2016-002385-31; Pre-results.
Digital telemedicine interventions for patients with multimorbidity: a systematic review and meta-analysis
Authors: Kraef Christian , van der Meirschen Marc , Free Caroline 
Published: October 2020

ObjectiveTo determine the effectiveness of digital telemedicine interventions designed to improve outcomes in patients with multimorbidity.DesignSystematic review and meta-analysis of available literature.Data sourcesMEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the Database of Abstracts of Reviews of Effectiveness and hand searching. The search included articles from inception to 19 April 2019 without language restrictions. The search was updated on 7 June 2020 without additional findings.Eligibility criteriaProspective interventional studies reporting multimorbid participants employing interventions with at least one digital telemedicine component were included. Primary outcomes were patient physical or mental health outcomes, health-related quality of life scores and the utilisation of health services.ResultsOut of 5865 studies initially identified, 7 articles, reporting on 6 studies were retained (total of 699 participants). Four of these studies reported interventions including integration with usual care, two studies had interventions with no links to usual patient care. Follow-up periods lasted between 2 and 6 months. Among the studies with links to usual care, the primary outcomes were systolic blood pressure (SBP) (three studies), haemoglobin A1c (HbA1c) (three studies), total cholesterol (two studies) and self-perceived health status (one study). The evidence ranged from very low to moderate certainty. Meta-analysis showed a moderate decrease in SBP (8 mm Hg (95% CI 4.6 to 11.4)), a small to moderate decrease in HbA1c (0.46 mg/dL (95% CI 0.25 to 0.67)) and moderate decrease in total cholesterol (cholesterol 16.5 mg/dL (95% CI 8.1 to 25.0)) in the intervention groups. There was an absence of evidence for self-perceived health status. Among the studies with no links to usual care, time to hospitalisation (median time to hospitalisation 113.4 days intervention and 104.7 days control group, absolute difference 12.7 days) and the Minnesota Living with Heart Failure Questionnaire (intervention group 35.2 score points, control group 23.9 points, absolute difference 11.3, 95% CI 5.5 to 17.1) showed small reductions. The Personal Health Questionnaire (PHQ-8) showed no evidence of improvement (intervention 7.6 points, control 8.6 points, difference 1.0 points, 95% CI −22.9% to 11.9%).ConclusionDigital telemedicine interventions provided moderate evidence of improvements in measures of disease control but little evidence and no demonstrated benefits on health status. Further research is needed with clear descriptions of conditions, interventions and outcomes based on patients’ and healthcare providers’ preferences.PROSPERO registration numberCRD42019134872.
Dance for people with chronic respiratory disease: a qualitative study
Authors: Philip Keir Elmslie James , Lewis Adam , Williams Sian , Buttery Sara Catherine , Polkey Michael I , Man William , Fancourt Daisy , Hopkinson Nicholas S 
Published: October 2020

ObjectivesTo explore the experiences and perceived impact on health and well-being related to participation in a dance group for people with chronic respiratory disease (CRD).DesignAn exploratory qualitative study using thematic analysis of semistructured interviews.SettingA community dance group in a UK health centre.ParticipantsConvenience sample of long-term dance group participants.InterventionWeekly community dance sessions designed for people with breathlessness, lasting 75 min, led by a trained community dance leader.ResultsConvenience sample of eight participants, six females, aged 57–87 years (mean 75), with a median 2-year attendance at weekly dance sessions. Long-term attendance was driven by strongly held beliefs regarding the health and well-being benefits of participation. Four key themes were identified: dance as (1) a holistically beneficial activity, with physical and psychosocial health benefits including improved or maintained physical fitness and psychological well-being, and reduced need for healthcare; (2) an integral part of their life; (3) an enjoyable activity; and (4) a source of deep social cohesion.ConclusionsDance group participants perceived a broad range of health benefits of relevance to the biopsychosocial impacts of their respiratory disease. The themes identified are useful in the ongoing planning and evaluation of dance as a holistic complex intervention for people with CRD. Further research is required to assess the extent of health impacts identified, and how dance might be most effectively placed as an option in the management of CRD.Trial registration numberNCT04006015.
Factors associated with advanced stage at diagnosis of cervical cancer in Addis Ababa, Ethiopia: a population-based study
Authors: Dereje Nebiyu , Gebremariam Alem , Addissie Adamu , Worku Alemayehu , Assefa Mathewos , Abraha Aynalem , Tigeneh Wondemagegnehu , Kantelhardt Eva Johanna , Jemal Ahmedin 
Published: October 2020

ObjectiveTo describe the patterns and factors associated with advanced stage at diagnosis of cervical cancer among Addis Ababa residents, Ethiopia.DesignA population-based cross-sectional study.SettingSeven major hospitals or diagnostic facilities in Addis Ababa, Ethiopia.ParticipantsAll histopathology-confirmed patients with incident cervical cancer diagnosed from 1 January 2017 to 30 June 2018 among Addis Ababa residents.Outcome measuresThe proportion of patients with cervical cancer diagnosed at early stage (stage I/II) and advanced stage (stage III/IV) of the disease according to International Federation of Gynaecology and Obstetrics staging criteria, and adjusted prevalence ratio (APR) for factors associated with advanced-stage diagnosis using a Poisson regression with robust variance model.ResultsThe mean age of the study participants was 52.9 (±13.3) years. Nearly two-thirds (60.4%, 95% CI: 53.8% to 66.5%) of patients with cervical cancer were diagnosed at an advanced stage. Advanced stage at diagnosis was significantly associated with paying medical bill out of pocket (APR=1.44, 95% CI: 1.08 to 1.91), diagnostic interval >90 days (APR=1.31, 95% CI: 1.04 to 1.71), practicing religion as a remedy or not taking immediate action following symptom recognition (APR=1.25, 95% CI: 1.08 to 1.91) and visiting more than three different health facilities prior to diagnostic confirmation (APR=1.24, 95% CI: 1.07 to 1.51).ConclusionsOur findings of the high proportion of advanced-stage diagnosis of cervical cancer in Addis Ababa and its strong associations with out-of-pocket medical bill, seeking care out of conventional medicine settings and multiple visits to healthcare facilities before diagnostic confirmations underscore the need for public policies to improve the affordability of cancer care and enhance community awareness about the severity of the disease and referral system, in addition to expanding cervical cancer screening.
Analysis of health administration data to inform health service planning for paediatric palliative care
Authors: Bowers Alison Pauline , Bradford Natalie , Chan Raymond Javan , Herbert Anthony , Yates Patsy 
Published: October 2020

BackgroundHealth service planning in paediatric palliative care is complex, with the diverse geographical and demographic characteristics adding to the challenge of developing services across different nations. Accurate and reliable data are essential to inform effective, efficient and equitable health services.AimTo quantify health service usage by children and young people aged 0–21 years with a life-limiting condition admitted to hospital and health service facilities in Queensland, Australia during the 2011 and 2016 calendar years, and describe the clinical and demographic characteristics associated with health services usage.DesignRetrospective health administrative data linkage of clinical and demographic information with hospital admissions was extracted using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision Australian Modification (ICD-10-AM) diagnostic codes. Data were analysed using descriptive statistics.Setting/participantsIndividuals aged 0–21 years with a life-limiting condition admitted to a Queensland Public Hospital and Health Service or private hospital.ResultsHospital admissions increased from 17 955 in 2011 to 23 273 in 2016, an increase of 5318 (29.6%). The greatest percentage increase in admissions were for those aged 16–18 years (58.1%, n=1050), and those with non-oncological conditions (36.2%, n=4256). The greatest number of admissions by ICD-10-AM chapter for 2011 and 2016 were by individuals with neoplasms (6174, 34.4% and 7206, 31.0% respectively). Overall, the number of admissions by Indigenous children and young people increased by 70.2% (n=838).ConclusionsAdministrative data are useful to describe clinical and demographic characteristics and quantify health service usage. Available data suggest a growing demand for health services by children eligible for palliative care that will require an appropriate response from health service planners.
Exploiting B-cell Receptor Stereotypy to Design Tailored Immunotherapy in Chronic Lymphocytic Leukemia
Authors: Rovida Alessandra , Maccalli Cristina , Scarfò Lydia , Dellabona Paolo , Stamatopoulos Kostas , Ghia Paolo 
Published: October 2020

Abstract

Purpose:
Approximately 30% of patients with chronic lymphocytic leukemia (CLL) can be grouped into subsets with stereotyped B-cell receptor immunoglobulin (BcR IG) displaying remarkable similarity in the heavy complementarity-determining region 3 (VH CDR3). Here, we investigated whether the consensus VH CDR3 sequences from CLL stereotyped subsets can be exploited for immunotherapy approaches.

Experimental Design:
Immunogenic epitopes from the consensus VH CDR3 sequence of the clinically aggressive subsets #1 and #2 and from Eμ-TCL1 mice, which spontaneously develop CLL with BcR IG stereotypy, were identified and used to generate specific HLA class I– and II–restricted T cells in vitro. T-cell reactivity was assayed in vitro as IFNγ production. Bone marrow–derived dendritic cells loaded with the peptides were used as vaccination strategy to restrain leukemia development in the Eμ-TCL1 mouse model.

Results:
These stereotyped epitopes were naturally processed and presented by CLL cells to the VH CDR3–specific T cells. Furthermore, we validated the efficacy of VH CDR3 peptide–based immunotherapy in the Eμ-TCL1 transplantable mouse model. Immunization of mice against defined VH CDR3 peptide epitopes, prior to the challenge with the corresponding leukemia cells, resulted in the control of CLL development in a significant fraction of mice, and increased overall survival.

Conclusions:
Our data highlight the immunogenicity of stereotyped VH CDR3 sequences and support the feasibility and efficacy of their use for novel cancer vaccine in CLL. Such approach has the advantage to generate “off-the-shelf” therapeutic vaccines for relevant groups of patients belonging to stereotyped subsets.
See related commentary by Seiffert, p. 659
Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017
Authors: Mori Makoto , Wang Yun , Murugiah Karthik , Khera Rohan , Gupta Aakriti , Vallabhajosyula Prashanth , Masoudi Frederick A. , Geirsson Arnar , Krumholz Harlan M. 
Published: October 2020

Background
The likelihood of undergoing reoperative coronary artery bypass graft surgery (CABG) is important for older patients who are considering first‐time CABG. Trends in the reoperative CABG for these patients are unknown.

Methods and Results
We used the Medicare fee‐for‐service inpatient claims data of adults undergoing isolated first‐time CABG between 1998 and 2017. The primary outcome was time to first reoperative CABG within 5 years of discharge from the index surgery, treating death as a competing risk. We fitted a Cox regression to model the likelihood of reoperative CABG as a function of patient baseline characteristics. There were 1 666 875 unique patients undergoing first‐time isolated CABG and surviving to hospital discharge. The median (interquartile range) age of patients did not change significantly over time (from 74 [69–78] in 1998 to 73 [69–78] in 2017); the proportion of women decreased from 34.8% to 26.1%. The 5‐year rate of reoperative CABG declined from 0.77% (95% CI, 0.72%–0.82%) in 1998 to 0.23% (95% CI, 0.19%–0.28%) in 2013. The annual proportional decline in the 5‐year rate of reoperative CABG overall was 6.6% (95% CI, 6.0%–7.1%) nationwide, which did not differ across subgroups, except the non‐white non‐black race group that had an annual decline of 8.5% (95% CI, 6.2%–10.7%).

Conclusions
Over a recent 20‐year period, the Medicare fee‐for‐service patients experienced a significant decline in the rate of reoperative CABG. In this cohort of older adults, the rate of declining differed across demographic subgroups.
Effects of sensory mode in prey discrimination and predatory behaviour of rock lizards
Authors: Recio Pablo , Rodríguez-Ruiz Gonzalo , Martín José 
Published: October 2020

Abstract
An essential part of foraging ecology is to understand the processes of detection, recognition and discrimination of prey, as well as the sensorial modalities involved. Often, predators do not rely on a single sensory system but on multiple interacting senses. Specifically, lizards mainly use vision and vomerolfaction for prey pursuit. Here, we used an experimental approach to study how the Carpetan rock lizard, Iberolacerta cyreni, responds to different types of stimuli (chemical, visual, or both combined) from two prey species. The number of individuals approaching the prey and the number of attacks differed between treatments, however, we did not find differences in latency time, number of individuals attacking the prey or number of tongue flicks. Our results suggested that visual cues combined with chemical stimuli enhanced detection of both prey species and that prey discrimination occurred posteriorly and independently of using any or both types of stimuli.
Recent shifts in taxonomic compositions of water frog populations (Anura: Pelophylax) inhabiting fish ponds in southern Poland
Authors: Jośko Paulina , Pabijan Maciej 
Published: October 2020

Abstract
In Central Europe, water frog species coexist in assemblages consisting of Pelophylax lessonae, P. ridibundus and their hybridogenetic hybrid, P. esculentus. Population compositions are poorly understood, partly because of difficulties in distinguishing hybrids from parentals by means of morphology alone. Environmental change and human-mediated, cryptic introductions of non-native water frog species have modified local assemblages. In this contribution we examined the structure of nine water frog populations inhabiting mostly large fish ponds in the Upper Vistula river valley of southern Poland using morphology and PCR-based genotyping of single loci in the nuclear and mitochondrial genomes. We found four different water frog population compositions: two with only P. ridibundus, one composed of P. lessonae and P. esculentus, three with P. ridibundus and P. esculentus, and three containing all three water frog taxa. Historical data show that the area was previously inhabited by lessonae-esculentus populations. We propose that both ecological and genetic replacement by expanding P. ridibundus may have contributed to the decline of the former. Overall, 18% of P. ridibundus frogs contained introgressed P. lessonae mtDNA, however, the frequency of introgressants was most pronounced in populations with a high proportion of P. esculentus. Exotic water frogs were not detected in the study area. Our results bear significance for water frog population dynamics and conservation in Central Europe and highlight the importance of long-term monitoring for the detection of changes in population composition in these amphibians.
Computing Swedish Salafism: An Example of a Digital Humanities Approach to Collecting, Organizing, and Analyzing Data on Web-based Salafi Missionary Activity in Sweden
Authors: Svensson Jonas 
Published: October 2020

Abstract
The aim of this article is to exemplify how computer-aided methods can assist researchers in the study of religions to collect, organize, and perform rudimentary analysis on web-based material. For this, the article uses the case of the Swedish Salafi website darulhadith.com, perhaps the largest provider of Islamic texts in Swedish online. The results show how the computer-aided methods can greatly facilitate the gathering of information on publication patterns and affiliations that can serve as a basis for further, in-depth studies of content and context. The article discusses possible avenues for assessing levels of impact and suggests further ways in which the content of the material gathered can be explored using computer-aided methods.
Enriching the Cognitive Account of Common Ground
Authors: Berio Leda , Vosgerau Gottfried 
Published: October 2020

Abstract
Classical notions of Common Ground have been criticized for being cognitively demanding given their appeal to complex meta-representations. The authors here propose a distinction between Immediate Common Ground, containing information specific to the communicative situation, and General Common Ground, containing information that is not situation-specific. This distinction builds on previous work by Horton and Gerrig [2016], extending the idea that common cognitive processes are part of the establishment and use of common ground. This is in line with the idea that multiple cognitive resources are involved in dialogue and avoids appealing to special-purpose representations for Common Ground purposes.