bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Heat Stress Exposure among Construction Workers in the Hot Desert Climate of Saudi Arabia
Authors: Al-Bouwarthan Mohammed , Quinn Margaret M , Kriebel David , Wegman David H 
Published: April 2019

AbstractObjectivesExcessive heat exposure poses significant risks to workers in hot climates. This study assessed the intensity and duration of heat stress exposure among workers performing residential construction in southeastern Saudi Arabia (SA) during the summer, June–September 2016. Objectives were to: identify work factors related to heat stress exposure; measure environmental heat exposure at the construction sites; assess the heat stress risk among workers using the wet bulb globe temperature (WBGT) index; and determine if temperature-humidity indices can be appropriate alternatives to WBGT for managing heat stress risk at the construction sites.MethodsWorksite walkthrough surveys and environmental monitoring were performed, indoors and outdoors, at 10 construction sites in Al-Ahsa Province. A heat stress exposure assessment was conducted according to the American Conference of Governmental Industrial Hygienists (ACGIH®) guidelines, which uses the WBGT index. WBGT measurements from two instruments were compared. Alternative heat stress indices were compared to the WBGT: the heat index (HI) and humidex (HD) index.ResultsConstruction workers were exposed to excessive heat stress, indoors and outdoors over a large part of the work day. Complying with a midday outdoor work ban (12–3 p.m.) was not effective in reducing heat stress risk. The highest intensity of exposure was outdoors from 9 a.m. to 12 p.m.; a period identified with the highest hourly mean WBGT values (31–33°C) and the least allowable working time according to ACGIH® guidelines. Comparison of the alternative indices showed that the HI is more reliable than the HD as a surrogate for the WBGT index in the climate studied.ConclusionThe extreme heat exposure represents a serious risk. The severity of heat stress and its impact are projected to increase due to climate change, emphasizing the need for immediate improvement of the current required protective measures and the development of occupational heat stress exposure guidelines in SA.
The Effects of Graded Levels of Calorie Restriction: XIV. Global Metabolomics Screen Reveals Brown Adipose Tissue Changes in Amino Acids, Catecholamines, and Antioxidants After Short-Term Restriction in C57BL/6 Mice
Authors: Green Cara L , Mitchell Sharon E , Derous Davina , Wang Yingchun , Chen Luonan , Han Jing-Dong J , Promislow Daniel E L , Lusseau David , Douglas Alex , Speakman John R 
Published: April 2019

Abstract
Animals undergoing calorie restriction (CR) often lower their body temperature to conserve energy. Brown adipose tissue (BAT) is stimulated through norepinephrine when rapid heat production is needed, as it is highly metabolically active due to the uncoupling of the electron transport chain from ATP synthesis. To better understand how BAT metabolism changes with CR, we used metabolomics to identify 883 metabolites that were significantly differentially expressed in the BAT of C57BL/6 mice, fed graded CR (10%, 20%, 30%, and 40% CR relative to their individual baseline intake), compared with mice fed ad libitum (AL) for 12 hours a day. Pathway analysis revealed that graded CR had an impact on the TCA cycle and fatty acid degradation. In addition, an increase in nucleic acids and catecholamine pathways was seen with graded CR in the BAT metabolome. We saw increases in antioxidants with CR, suggesting a beneficial effect of mitochondrial uncoupling. Importantly, the instigator of BAT activation, norepinephrine, was increased with CR, whereas its precursors l-tyrosine and dopamine were decreased, indicating a shift of metabolites through the activation pathway. Several of these key changes were correlated with food anticipatory activity and body temperature, indicating BAT activation may be driven by responses to hunger.
Mental Health Before and After Retirement—Assessing the Relevance of Psychosocial Working Conditions: The Whitehall II Prospective Study of British Civil Servants
Authors: Fleischmann Maria , Xue Baowen , Head Jenny 
Published: April 2019

Abstract

Objectives
Retirement could be a stressor or a relief. We stratify according to previous psychosocial working conditions to identify short-term and long-term changes in mental health.

Method
Using data from the Whitehall II study on British civil servants who retired during follow-up (n = 4,751), we observe mental health (General Health Questionnaire [GHQ] score) on average 8.2 times per participant, spanning up 37 years. We differentiate short-term (0–3 years) and long-term (4+ years) changes in mental health according to retirement and investigate whether trajectories differ by psychosocial job demands, work social support, decision authority, and skill discretion.

Results
Each year, mental health slightly improved before retirement (−0.070; 95% CI [−0.080, −0.059]; higher values on the GHQ score are indicative of worse mental health), and retirees experienced a steep short-term improvement in mental health after retirement (−0.253; 95% CI [−0.302, −0.205]), but no further significant long-term changes (0.017; 95% CI [−0.001, 0.035]). Changes in mental health were more explicit when retiring from poorer working conditions; this is higher psychosocial job demands, lower decision authority, or lower work social support.

Discussion
Retirement was generally beneficial for health. The association between retirement and mental health was dependent on the context individuals retire from.
Risk of Psychological Distress Among Community-Dwelling Older Adults Experiencing Spousal Loss in Ghana
Authors: Gyasi Razak M , Phillips David R 
Published: April 2019

Abstract

Background
Spousal loss, common in older age, has been linked to negative mental health outcomes and well-being, yet the mechanisms linking spousal loss and mental health are still unclear.

Objective
To investigate whether physical activity, social support, and gender modify the psychological distress effects of marital loss among community-dwelling older persons in Ghana.

Methods
Data from a 2016/2017 Ageing, Health, Psychological Well-being, and Health-seeking Behavior Study (N = 1,200) were examined. OLS regression models examined associations between spousal loss and psychological distress outcomes and interaction terms.

Results
Spousal loss (widowhood and divorce/separation) was associated with psychological distress (measured by the Kessler Psychological Distress Scale [KPDS-10]) for the full sample (β = .798, p &lt; .001), women (β = .831, p &lt; .001) and for men (β = .533, p &lt; .05). After adjusting for potential confounders, the associations between spousal loss and psychological distress persisted for the full sample (β = .727, p &lt; .001) and females only (β = .730, p &lt; .001). In particular, when experiencing spousal loss, those with meaningful social support (β = −.856, p &lt; .005) and engaged in physical activity (β = −.258, p &lt; .001) were less likely to be psychologically distressed.

Conclusions
Spousal loss precipitates an independent risk of psychological distress in older age particularly among women, but social support and physical activity engagements moderate the relationship. These findings support the premise that providing opportunities to improve social support and regular physical activity may buffer the effects of psychological distress among older persons experiencing spousal loss. Providing support for older adults in times of divorce and widowhood, and working towards changes in social attitudes towards divorce are important considerations.
Multilayered artificial neural network for performance prediction of an adiabatic solar liquid desiccant dehumidifier
Authors: Oyieke Andrew Y A , Inambao Freddie L 
Published: April 2019

Abstract
In this study, a multi-layered artificial neural network (ANN) algorithm was developed and trained to predict the performance of a solar powered liquid desiccant air conditioning (LDAC) system particularly the adiabatic packed tower dehumidifier using Lithium Bromide (LiBr) desiccant. A reinforced technique of supervised learning based on error correction principle rule coupled with perceptron convergence theorem was applied to create the algorithm. The parameters such as temperature, flow rates and humidity ratio of both air and desiccant fluid were fed as inputs to the ANN algorithm and their respective outputs used to determine dehumidifier effectiveness and moisture removal rate (MRR). The ANN model when subjected to validity tests using vapour pressure of LiBr desiccant solution at specific random temperatures and concentrations, gave astounding outcomes with precise estimation to R2 values of 0.9999 for all desiccant concentration levels. Due to the variation in solar radiation, the MRR and effectiveness fluctuated with the change in desiccant and air temperatures, giving maximum differences of 0.2 g/s and 1.8% respectively between the predicted and measured values depicting a perfect match. With respect to humidity ratio, MRR was accurately predicted by ANN algorithm with maximum difference of 3.4969% while the mean variation was −0.5957%. With respect to air temperature, the dehumidifier effectiveness was perfectly predicted by the ANN algorithm to an average accuracy of 0.53% and extreme positive deviation of 4.14%. The MRR was replicated to a mean variation of 0.013% and highest point difference of 0.08%. In all the above cases, the mean and maximum differences between the ANN model and experimental values were far below the allowable limit of ± 5%, hence the algorithm was deemed to be successful and could find use in air conditioning scenarios. The ANN algorithm’s capability and flexibility test of processing unforeseen inputs was accurate with negligible deviations and prospects of predicting the desiccant’s vapour pressure, dehumidifier effectiveness and MRR within all ranges of temperature and concentration which then eliminates the need for use of charts.
Music Therapy as a Psychospiritual Ministry of Intercession During Imminent Death
Authors: Potvin Noah , Flynn Cathleen 
Published: April 2019

AbstractImminent death is a critical stage in end-of-life care requiring a shared attention to the preparatory needs of both patient and caregiver(s). For many patients and caregivers who identify as Christian, the Holy Spirit can be an integral resource capable of facilitating a healthy death experience. Music therapy, as a resource-oriented practice, has the potential to be a ministry facilitating access to the Holy Spirit for patients and caregivers to use for unique purposes. Drawing from both music therapy and theological concepts and identifying their intersections, this paper frames an ethical and effective model of music therapy as ministry as shaped through three unique stakeholder roles: music therapist as minister of intercessory prayer; patient as vertically transcendental worshiper; and caregiver(s) as horizontally transcendental worshiper. These roles are implicitly and simultaneously assumed, fulfilling the functions necessary for a holistic, comprehensive plan of care to be enacted during a time-limited stage of urgent need such as imminent death. Theoretical postulations related to each stakeholder role are posited and discussed in context of clinical practice. Future examinations of music therapy as ministry through other faith lenses have the potential to yield additional psychospiritual functions of music therapy at the end of life, including identifying additional resources music therapy can address with Christian patients in end-of-life care settings.
Superior performance and high service stability for GeTe-based thermoelectric compounds
Authors: Xing Tong , Song Qingfeng , Qiu Pengfei , Zhang Qihao , Xia Xugui , Liao Jincheng , Liu Ruiheng , Huang Hui , Yang Jiong , Bai Shengqiang , Ren Dudi , Shi Xun , Chen Lidong 
Published: April 2019

ABSTRACT
GeTe-based compounds have been intensively studied recently due to their superior thermoelectric performance, but their real applications are still limited so far due to the drastic volume variation that occurs during the rhombohedral–cubic phase transition, which may break the material or the material/electrode interface during service. Here, superior performance and high service stability for GeTe-based thermoelectric compounds are achieved by co-doping Mg and Sb into GeTe. The linear coefficient of thermal expansion before phase transition is greatly improved to match that after phase transition, yielding smooth volume variation around the phase transition temperature. Likewise, co-doping (Mg, Sb) in GeTe successfully tunes the carrier concentration to the optimal range and effectively suppresses the lattice thermal conductivity. A peak zT of 1.84 at 800 K and an average zT of 1.2 in 300–800 K have been achieved in Ge0.85Mg0.05Sb0.1Te. Finally, a Ni/Ti/Ge0.85Mg0.05Sb0.1Te thermoelectric uni-leg is fabricated and tested, showing quite good service stability even after 450 thermal cycles between 473 K and 800 K. This study will accelerate the application of GeTe-based compounds for power generation in the mid-temperature range.
A Conservative Disposition and Constitutional Change
Authors: Gee Graham , Webber Grégoire 
Published: April 2019

Abstract
What is a conservative disposition? And can it supply any insights into the UK’s changing constitution? We offer answers to these questions by identifying core elements of a conservative disposition and exploring how it offers contingent guidance to public lawyers striving to make sense of a changing constitution. Our goal is to show why a conservative disposition remains relevant to public lawyers, in large measure because, rather than despite, the constitution is changing. We examine the disposition’s relationship with change and review how a conservative disposition offers open-ended guidance on when to pursue change, how to pursue it, how much of it to pursue at any point in time and what reasons should motivate it. After evaluating arguments against the relevance of a conservative disposition to constitutional thought, we relate conservative arguments to two important proposals for constitutional reform: the withdrawal of the UK from the European Convention on Human Rights and a written constitution.
Idiopathic intracranial hypertension
Authors: Boyter Elizabeth 
Published: April 2019

ABSTRACT
Idiopathic intracranial hypertension is a rare disorder of elevated intracranial pressure with normal cerebrospinal fluid composition and without intracranial pathology. This condition primarily affects obese women of childbearing age and frequently causes headaches, vision loss, diplopia, tinnitus, and nausea. The incidence of idiopathic intracranial hypertension is rising along with obesity rates. Primary care and ED clinicians must recognize the signs and symptoms of idiopathic intracranial hypertension and intervene promptly to control symptoms and to preserve vision. This article reviews the clinical presentation and management of patients with idiopathic intracranial hypertension.
Prediction of Success in External Cephalic Version for Breech Presentation at Term
Authors: Isakov Ofer , Reicher Lee , Lavie Anat , Yogev Yariv , Maslovitz Sharon 
Published: April 2019

OBJECTIVE:
To design a clinically based predictive model for the likelihood of successful external cephalic version (ECV).

METHODS:
This single-center retrospective study was conducted from February 2016 to July 2018 and included all candidates for ECV between 36 and 41 weeks of gestation. Variables with a potential effect on ECV success were collected. These variables include: body mass index, amniotic fluid index, gestational age, parity, location of placenta, fetal trunk posture, time in breech presentation before the procedure and the ultrasonographically measured size of the amniotic fluid preceding the fetal presenting part (fore-bag). Variables' association with ECV success was evaluated using a multivariate logistic regression and a decision tree predicting ECV outcome was developed using 75% of the patients and validated on the remaining 25%.

RESULTS:
Overall, 250 pregnant women were identified and opted for a trial of ECV by a single operator, with a success rate of 64.8%. Body mass index, size of fore-bag, and parity were independent determinants of the version success, whereas other variables had no statistically significant effect on the success rate. Our decision tree model divided the cohort into five subgroups according to various combinations of the three variables. When evaluated on the internal validation set, the C-Index of the tree was 0.933 (0.863–1) and the prediction accuracy was 91.9% (86.5%–97.3%).

CONCLUSION:
A prediction model composed of three easily measurable variables enables accurate prediction of successful ECV at term. Fore-bag was identified as the most important discriminator. Our model holds in internal validation and it can be used to support patient counseling and decision making for ECV but should be externally validated.
Concurrent Ipsilateral Tibial Shaft and Distal Tibial Fractures in Pediatric Patients: Risk Factors, Frequency, and Risk of Missed Diagnosis
Authors: Sheffer Benjamin W. , Villarreal Eric D. , Ochsner Mims G. , Sawyer Jeffrey R. , Spence David D. , Kelly Derek M. 
Published: April 2019

Background:
The purpose of this study was to determine the frequency of concurrent ipsilateral distal tibial fractures with tibial shaft fractures in the pediatric population; to identify patient and fracture characteristics that increase the likelihood of a concurrent fracture; and determine if any of these concurrent distal tibial fractures were missed on initial radiographic examination.

Methods:
Retrospective chart review was done to identify patients 5 to 17 years old who were treated for a tibial shaft fracture at a large, Level 1 free-standing children’s hospital and an outpatient orthopaedic practice between 2008 and 2016. Patient and fracture characteristics were recorded.

Results:
Of 517 fractures (515 patients), 22 (4.3%) had concurrent ipsilateral distal tibial fractures: 11 triplane, 5 medial malleolar, 3 bimalleolar, and 2 Tillaux (Salter-Harris III) ankle fractures, and 1 Salter-Harris II distal tibial fracture. Age was the only patient characteristic significantly associated with a second, more distal fracture: patients with both fractures were older (12.7 y) than those with an isolated tibial shaft fracture (11 y). There was no difference in the rate of distal tibial fractures between high-energy and low-energy mechanisms of injury and no differences in the rate of open injuries or the presence of a fibular fracture. Patients with a tibial shaft fracture at the junction of the middle and distal thirds were significantly more likely to have a concurrent distal tibial fracture; oblique and spiral fracture patterns were more frequent in the group with concurrent distal tibial fractures than in the isolated tibial shaft fracture group.

Conclusions:
In our series, 36% of the concurrent distal tibial fractures were not diagnosed until chart review for this study, which suggests the need for ankle-specific imaging in certain patients. We recommend ankle-specific imaging when an oblique or spiral tibial shaft fracture is located at the junction of the middle and distal thirds of the tibia or in patients in whom a distal tibial fracture is suspected because of pain, swelling, or bruising.

Level of Evidence:
Level III—retrospective comparative study.
Tamoxifen use as a malignancy risk factor in postmenopausal women with endometrial polyps
Authors: Yela Daniela Angerame , Ikejiri Thales Akio , Machado Carolina Ribeiro , Mutta Danielle , Benetti-Pinto Cristina Laguna 
Published: April 2019

Abstract

Objective:
We analyzed tamoxifen use as a malignancy risk factor in women with endometrial polyps.

Methods:
This retrospective study included 675 women who underwent hysteroscopic polypectomy in 2010 to 2015 at the University of Campinas. Women were divided into tamoxifen use (n = 169) and no tamoxifen use (n = 506) groups. The primary outcome was endometrial cancer prevalence. Dependent variables included age, parity, years since menopause, presence of abnormal uterine bleeding, endometrial pattern on hysteroscopy, and endometrial thickness.

Results:
There were seven cases of endometrial cancer in the tamoxifen use group (4.14%) and 41 in the no tamoxifen use group (8.1%; P = 0.083). On performing multivariate analysis, tamoxifen use was not a risk factor for endometrial cancer (prevalence ratio 0.51, 95% confidence interval [CI] 0.23-1.14, P = 0.101). The no tamoxifen use group had an increased prevalence of malignancy when women presented with abnormal uterine bleeding (prevalence ratio 3.9, 95% CI 2.08-7.29, P < 0.001), age >60 years (prevalence ratio 2.1, 95% CI 1.12-3.93, P = 0.021), or nulliparous status (prevalence ratio 3.13, 95% CI 1.55-6.35, P = 0.002). The tamoxifen use group had increased prevalence of malignancy when women were >60 years (prevalence ratio 7.85, 95% CI 1.05-58.87, P = 0.006) or nulliparous (prevalence ratio 8.36, 95% CI 2.32-30.11, P < 0.001).

Conclusion:
Tamoxifen use was not related with a higher prevalence of endometrial cancer in women with endometrial polyps. Abnormal uterine bleeding, age > 60 years, and nulliparous status were associated with malignancy.
Recovery From Malnutrition Among Refugee Children Following Participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) Program in Massachusetts, 1998-2010
Authors: Smock Laura , Martelon MaryKate , Metallinos-Katsaras Elizabeth , Nguyen Thinh , Cochran Jennifer , Geltman Paul L. 
Published: April 2019

Objectives:
(1) To examine patterns of catch-up growth and anemia correction in refugee children younger than 5 years after participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) program, and (2) to identify factors associated with recovery from growth abnormalities.

Design:
Records on 1731 refugee children younger than 5 years who arrived in Massachusetts between 1998-2010 were matched to WIC program records and then restricted to 779 children who had at least 2 WIC visits. Kaplan-Meier curves and Cox proportional hazards models were used to examine how sex affected time to recovery from malnutrition and anemia. Factors associated with recovery were analyzed in SAS using multivariate logistic regression.

Setting:
Massachusetts.

Participants:
Refugee children younger than 5 years on arrival, who visited a WIC program at least twice between 1998 and 2010.

Main Outcome Measures:
(1) Proportion of children who recovered from low height-for-age (stunting), low weight-for-age, low weight-for-height (wasting), and anemia; (2) odds ratios for factors associated with recovery; and (3) Kaplan-Meier curves showing recovery over time from low height-for-age, low weight-for-age, and low weight-for-height.

Results:
The number of WIC visits was associated with recovery from stunting, wasting, low weight-for-age, and anemia; results reached statistical significance for stunting (odds ratio [OR] = 8.64; 95% confidence interval [CI], 2.25-33.19), low weight-for-age (OR = 5.28; 95% CI, 1.35-20.73), and anemia (OR = 6.50; 95% CI, 2.69-15.69). Female sex was associated with recovery from stunting, wasting, and low weight-for-age, whereas male sex was associated with recovery from anemia; the associations were statistically significant between female sex and stunting (OR = 9.14; 95% CI, 1.93-43.29), wasting (OR = 14.78; 95% CI, 1.57-138.85), and low weight-for-age (OR = 4.29; 95% CI, 1.09-16.79).

Conclusions:
Children who remained engaged in WIC may recover better from malnutrition than children with fewer WIC visits, although there are limitations to the available data.
These findings suggest that those working with refugee families should prioritize outreach toward initiating and maintaining WIC program enrollment for eligible refugee children.