bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractThis 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 applicationsDrying 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

OBJECTIVESBarriers 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.DESIGNA practice improvement initiative providing no‐fee evidence‐based mental health care at home in clients' primary languages.SETTINGIndependence at Home, a community service of SCAN Health Plan in Southern California.PARTICIPANTSDiverse older adults and adult caregivers of older people with age‐related disability (mainly dementia).INTERVENTIONRedesign of an existing supportive counseling program to improve access to validated models of psychotherapy for depression and anxiety.MEASUREMENTSWe describe program content, phases of development, equity in participation from referral to program completion, clinical outcomes, and estimated direct program delivery costs.RESULTSInsights 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.CONCLUSIONThe 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

OBJECTIVESPrior 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.DESIGNRetrospective cohort study of adults aged 65 years and older who were treated at an urban trauma center from 1997 to 2008.MEASUREMENTSData 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.RESULTSCompared 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.CONCLUSIONThis 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

AbstractThis 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 summaryWhat 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.

AbstractIntroductionSeveral 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 questionTo 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?MethodA 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.ResultsThe 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.DiscussionBalancing 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 practiceOrganized 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

AbstractOne 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

SummaryCryptococcus 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

SummaryEvidence 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

AbstractBackgroundThere is no consensus about the ideal cervical ripening method to use for induction of labour.ObjectiveTo compare in current practice the effectiveness and safety of four cervical ripening methods.MethodsWe 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.ResultsCompared 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).ConclusionsIn 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

AbstractPost‐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

ObjectiveTo 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.MethodsThis 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.ResultsA 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).ConclusionThe 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?