bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oscillatory Fouling in Condensers in Cooling Tower Systems
Authors: Li Wei 
Published: June 2019

Abstract
Oscillatory fouling in condensers using cooling tower water was recognized in 1980s, but it had not yet been theoretically analyzed. Without careful theoretical analysis, it is easy to think that oscillatory fouling phenomenon is generated from experimental uncertainty. The new analysis is to split the fouling rate into a mean variable and a fluctuating variable. The mean variable exhibits an asymptotic behavior, and the fluctuating variable exhibits an oscillatory behavior. A theoretical analysis based on the relationship of continuity is used to present fouling oscillatory behavior along the space and time dimensions simultaneously to provide the intuitive understanding in physical mechanisms driving the phenomenon. A series of long-term cooling tower water fouling tests were conducted: fouling data collected in two copper helically ribbed tubes with the same internal and external diameters and different inside geometric parameters at the same water velocity in condenser in practical cooling tower conditions present oscillatory behavior. The frequencies of the fluctuation are the same for the two tested tube geometries. The spatial and the temporal oscillatory fouling behaviors presented in the experimental results are predicted by the theoretical analysis.
Considering the methodological limitations in the evidence base of antidepressants for depression: a reanalysis of a network meta-analysis
Authors: Munkholm Klaus , Paludan-Müller Asger Sand , Boesen Kim 
Published: June 2019

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.
Does changed referral options affect the use of MRI for patients with low back pain? Evidence from a natural experiment using nationwide data
Authors: Jensen Morten Sall , Olsen Kim Rose , Morsø Lars , Søndergaard Jens , Schiøttz-Christensen Berit 
Published: June 2019

ObjectivesThis study reports lumbar MRI referral patterns in the Region of Southern Denmark (RSD) and investigates the hypothesis that we will see an increase in imaging rates (MRI rates) following new referral options to lumbar MRI in the RSD in comparison with the other regions in Denmark from 2010 to 2013.DesignA difference-in-difference (DD) analysis, using general practitioners (GPs) in other regions as control, was used to test if the new referral options had an effect on the MRI rates.SettingIn 2010, RSD introduced organisational changes affecting the referral options for lumbar MRI. First, the possibility for direct referral to lumbar MRI was introduced GPs, and second, the region gathered all local spine departments into one specialist hospital called the Spine Centre.ParticipantsWe retrieved all lumbar MRIs performed on patients aged 18+ performed on Danish hospitals from 2008 to 2013 using the registries from Statistics Denmark. We use sociodemographic information from all Danish citizens aged 18+ aggregated to GP level. Primary and secondary outcome measures: lumbar MRI scans per 1000 capita enlisted with a GP (MRI rates) were calculated based on GPs patient list. Four referral types were made to describe changes in referral patterns.ResultsIn total 183 389 patients received 240 760 lumbar MRIs in the period. The use of the direct referral option by GPs in the RSD increased by 115% in the period from 2010 to 2013 and accounted for 34% of all referrals (n=6545) in 2013. MRI rates were significantly higher in RSD following the organisational changes (DD 1.389(0.925–1.852) lumbar MRI per 1.000 enlisted with a GP).ConclusionsIntroduction of organisational changes in RSD as direct referral to lumbar MRI from GPs and chiropractors as well as establishing a Spine Centre increase the lumbar MRI rate in comparison with other regions in Denmark.
Impact of gastrointestinal conditions, restrictive diets and mental health on health-related quality of life: cross-sectional population-based study in Australia
Authors: Stocks Nigel P , Gonzalez-Chica David , Hay Phillipa 
Published: June 2019

ObjectivesTo assess the relationship between gastrointestinal conditions, restrictive diets, mental health and health-related quality of life (HRQoL).DesignCross-sectional population-based face-to-face survey.SettingSouth Australia.ParticipantsA representative sample of 2912 consenting adults (48.9±18.1 years; 50.9% females) investigated in 2015.Primary and secondary outcome measuresParticipants self-reported diagnosis of gastrointestinal conditions, mental health and current use of restrictive diets. The physical component score (PCS) and mental component score (MCS) of HRQoL were investigated (Study Short Form 12 V.1 questionnaire). Linear regression models were used to test the associations, adjusting for (1) sociodemographic variables, (2) mental health status and (3) lifestyle and body mass index.ResultsThe prevalence of restrictive diets (36.1%; 95% CI 33.9 to 38.3) was higher among those with any self-reported gastrointestinal condition (60.7% vs 31.3% for those without these conditions; p<0.001). PCS was lower among those with a gastrointestinal condition (mean difference=−3.4; 95% CI −4.5 to −2.4) or on a restrictive diet (mean difference=−1.9; 95% CI −2.7 to −1.1), with a similar pattern, but with a smaller effect, observed for MCS. Being on a restrictive diet did not modify the relationship between having a gastrointestinal condition and reduced HRQoL. However, having a gastrointestinal condition was associated with a 2.4 points lower PCS (95% CI −3.5 to −1.3) among those without a mental health problem, while for those affected by a mental health condition this reduction was greater (mean difference=−5.9; 95% CI −8.7 to −3.1). For MCS, there was no evidence of interaction between mental health and gastrointestinal conditions.ConclusionsOne-third of Australian adults are restricting their diet, and this is associated with lower HRQoL. Being on a restrictive diet was not associated with a better HRQoL among individuals with a gastrointestinal condition. Mental health problems were associated with a stronger adverse relationship between gastrointestinal diseases and physical HRQoL. Health professionals should be alert to these associations when trying to improve health outcomes for patients.
Connor-Davidson Resilience Scale: validation study in a Portuguese sample
Authors: Faria Anjos Joana , Heitor dos Santos Maria João , Ribeiro Maria Teresa , Moreira Sergio 
Published: June 2019

ObjectiveThe objective of this paper was to evaluate the structural validity and convergent validity of the first Portuguese version of the Connor-Davidson Resilience Scale (CD-RISC).SettingsThe data sets come from two studies conducted in Portugal, respectively, from the Resilience Effect in Coping with Trauma (RECT) project and from the Health Impact Assessment of Employment Strategies (HIAES) project.ParticipantsThe sample is composed of 476 participants from the RECT project and 405 participants from the HIAES project. In both projects, convenience samples were used.MeasuresThe original CD-RISC items were translated to Portuguese and were used in a survey along with additional psychosocial and biomedical measures.ResultsIndependent exploratory factorial analysis (EFA) with each of the two samples revealed that the best solution in both samples had three factors consistent with the self-efficacy, spirituality and social support factors from the original scale. A Confirmatory factor analysis using the two samples together and specifying the three factors from the EFA revealed a good overall fit and, comparatively, better fit than a model specified with the five factors from the original scale. The study of the convergent validity revealed that bivariate correlations between the three factors and validated measures of stress, life satisfaction, mental health and physical health are globally consistent with previous research.ConclusionsThis study makes available to the broad Community of Portuguese Language Countries a validated measure of resilience extensively used for research and intervention. The results encourage future studies using this translated version of CD-RISC to explore further the three-factor structure found here and to test the convergent validity with new samples.
Carrier prevalence and risk factors for colonisation of multiresistant bacteria in Danish emergency departments: a cross-sectional survey
Authors: Skjøt-Arkil Helene , Mogensen Christian Backer , Lassen Annmarie Touborg , Johansen Isik S , Chen Ming , Petersen Poul , Andersen Karen V , Ellermann-Eriksen Svend , Møller Jørn M , Ludwig Marc , Fuglsang-Damgaard David , Nielsen Finn Erland , Petersen Dan B , Jensen Ulrich S , Rosenvinge Flemming S 
Published: June 2019

ObjectivesThe aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistantStaphylococcus aureus(MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors.DesignMulticentre descriptive and analytic cross-sectional survey.SettingEight EDs and four clinical microbiology departments in Denmark.ParticipantsAdults visiting the ED.Main outcome measuresSwabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients.ResultsWe included 5117 patients in the study. Median age was 68 years (54–77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa.ConclusionEvery 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad.Trial registration numberNCT03352167;Post-results.
Health-related quality of life and caregiver perspectives in glioblastoma survivors: a mixed-methods study
Authors: Piil Karin , Christensen Ib Jarle , Grunnet Kirsten , Poulsen Hans Skovgaard 
Published: June 2019

BackgroundThe purpose of antineoplastic treatment of high-grade glioma (HGG) is to achieve progression-free survival with delayed neurological and cognitive deterioration. Health-related quality of life (HRQOL) has become increasingly important next to more traditional outcome measures such as progression-free survival. However, the clinical outcome of long-term, HGG survivors and their caregivers’ quality of life is poorly understood.ObjectiveThis study aims to address HRQOL and perspectives on the daily life experiences of long-term survivors (LTS) with HGG and their caregivers.MethodsThis mixed-methods study applies a convergent design using identical sampling. Separate telephone interviews with patients diagnosed for more than 3 years and their caregivers were conducted. Patients filled out self-reported questionnaires; the Hospital Anxiety and Depression Scale, the Functional Assessment of Cancer Therapy (FACT), General and Brain (FACT-Br), and the Leisure Time Physical Activity Questionnaire.ResultsThree themes shared by patients and their caregivers were identified: searching for meaningful activities, selecting information that enhances self-management strategies and protection for safety reasons. Ten per cent showed moderate depressive symptoms, which is lower compared with the newly diagnosed. The HRQOL scores seem to be rated higher than the normative sample. The FACT-Br total score indicated that a previously identified significant increase in the emotional well-being of 1-year survivors was the same or improved. A central finding is that the LTS expressed frustration and sadness due to their reduced ability to manage work and daily life activities. Caregivers are challenged throughout the entire trajectory, and patient safety issues are a key concern for them.ConclusionsThe LTS desire participation in satisfying, meaningful activities that consider their cognitive and physical capacities. Advance care planning must be a key component in future research, as discussing life strategies can enhance positive beliefs, which are apparently imperative to their well-being.Trial registration numberClinical Trial.gov:NCT02965144
Earlier identification of seriously ill patients: an implementation case series
Authors: Lakin Joshua R , Desai Meghna , Engelman Kyle , O'Connor Nina , Teuteberg Winifred G , Coackley Alison , Kilpatrick Laurel B , Gawande Atul , Fromme Erik K 
Published: June 2019

ObjectiveTo describe the strategies used by a collection of healthcare systems to apply different methods of identifying seriously ill patients for a targeted palliative care intervention to improve communication around goals and values.MethodsWe present an implementation case series describing the experiences, challenges and best practices in applying patient selection strategies across multiple healthcare systems implementing the Serious Illness Care Program (SICP).ResultsFive sites across the USA and England described their individual experiences implementing patient selection as part of the SICP. They employed a combination of clinician screens (such as the ‘Surprise Question’), disease-specific criteria, existing registries or algorithms as a starting point. Notably, each describes adaptation and evolution of their patient selection methodology over time, with several sites moving towards using more advanced machine learning–based analytical approaches.ConclusionsInvolving clinical and programme staff to choose a simple initial method for patient identification is the ideal starting place for selecting patients for palliative care interventions. However, improving and refining methods over time is important and we need ongoing research into better patient selection methodologies that move beyond mortality prediction and instead focus on identifying seriously ill patients—those with poor quality of life, worsening functional status and medical care that is negatively impacting their families.
Trends in antidepressant prescriptions in children and young people in England, 1998–2017: protocol of a cohort study using linked primary care and secondary care datasets
Authors: Jack Ruth H , Hollis Chris , Coupland Carol , Morriss Richard , Knaggs Roger David , Cipriani Andrea , Cortese Samuele , Hippisley-Cox Julia 
Published: June 2019

IntroductionIncreasing numbers of children and young people (CYP) are receiving prescriptions for antidepressants. This is the protocol of a study aiming to describe the trends and variation in antidepressant prescriptions in CYP in England, and to examine the indications for the prescriptions recorded and whether there was contact with secondary care specialists on or around the time of the first antidepressant prescription.Methods and analysisAll eligible CYP aged between 5 and 17 years in 1998–2017 from the QResearch primary care database will be included. Incidence and prevalence rates of any antidepressant prescription in each year will be calculated. We will examine four different antidepressant classes: selective serotonin reuptake inhibitors, tricyclic and related antidepressants, serotonin and norepinephrine reuptake inhibitors and other antidepressants, as well as for individual drugs. Linked primary and secondary care data (hospital episode statistics) in the year before and up to 6 months after the first antidepressant prescription will be examined for CYP whose first antidepressant prescription was in 2006–2017. Whether there were records of indications and being seen by psychiatric or paediatric specialists will be identified. Trends over time and differences by region, deprivation and ethnicity will be examined using Poisson regression.DiscussionThis large, population-based study will give an up-to-date picture of antidepressant prescribing in CYP and identify any variation. Understanding what indications are recorded when CYP are being prescribed antidepressants, and whether this was done in partnership with secondary care specialists, will provide evidence of whether appropriate guidelines are being followed.
Emergency medical service delays in ST-elevation myocardial infarction: a meta-analysis
Authors: Alrawashdeh Ahmad , Nehme Ziad , Williams Brett , Stub Dion 
Published: June 2019

ObjectivesTo evaluate emergency medical services (EMS) delays and their impact on time to treatment and mortality in patients with ST-elevation myocardial infarction (STEMI).MethodWe collected data on EMS time intervals from published studies across five electronic databases. The primary EMS interval was the time in minutes between first medical contact and arrival at hospital door (FMC-to-door time). Secondary intervals were other components of EMS delay. Weighted means were measured using random-effects models. Meta-regression was used to identify factors associated with EMS delays and to assess the impact of EMS delay on the proportion of patients treated within90 min and mortality.ResultsTwo independent reviewers included 100 studies (125 343 patients) conducted in 20 countries. The weighted mean FMC-to-door time was 41 min (n=101 646; 95% CI 39 to 43, range 21–88). However, substantial heterogeneity was observed with each interval, which could be explained by region and urban classification, distance to hospital and method of ECG interpretation. In a meta-regression adjusted for door-to-balloon time, a 10 min increase in FMC-to-door time was associated with a 10.6% (95% CI 7.6% to 13.5%; p<0.001) reduction in the proportion of patients treated within 90 min. Shorter EMS delay was significantly associated with lower short-term mortality in patients receiving prehospital thrombolysis (p=0.018).ConclusionEMS delays account for half of the total system delay in STEMI. There is a fourfold global variation in EMS delays, which are not completely explained by differences in system characteristics. Reducing unexplained variation could yield improvements in the time to treatment and outcome of STEMI patients.PROSPERO registration numberCRD42017074118.
The concept of electric charge and the hypothesis of magnetic poles
Authors: Finkelstein Robert J. 
Published: June 2019

We examine a generic field theory in which the field particle has two couplings. It is of particular interest when these are the electroweak, [Formula: see text], and the hypothetical magnetoweak, [Formula: see text]. The new field operators are obtained by replacing the field operators [Formula: see text] of the Standard Model or of similar models by [Formula: see text] where [Formula: see text] is an element of the [Formula: see text]-dimensional representation of the SLq(2) algebra, which is also the knot algebra. The new field is assumed to exist in two phases distinguished by two values of [Formula: see text]: [Formula: see text] and [Formula: see text] which label the electroweak and magnetoweak phases, respectively. We assume that the observed leptons and quarks are mainly composed of [Formula: see text]-preons and are in agreement with the observed charge spectrum of leptons and quarks. It is now proposed that there is also a [Formula: see text]-phase where [Formula: see text]-leptons and [Formula: see text]-quarks are composed of mainly [Formula: see text]-preons. It is assumed that the [Formula: see text]-charge is very large compared to the [Formula: see text]-charge and the mass of the [Formula: see text]-charged particle is even larger since the mass of all of these particles is partially determined by the eigenvalues of [Formula: see text], a polynomial in [Formula: see text], that multiplies the Higgs mass term and where [Formula: see text] Since these values of [Formula: see text] indicate that particles in the [Formula: see text]-phase are much more massive, they should be harder to produce or to observe. Since the remote parts of the universe are at increasingly higher temperatures, magnetic poles are perhaps most likely to be found in deep probes of space as well as in high energy accelerators. The section entitled “Introduction” was added only after it was generally realized that the birth of the present universe was probably due to a nuclear explosion.
First records of Thryaplax Castro, 2007 and Calocarcinus Calman, 1909 (Crustacea: Decapoda: Brachyura) from the Kermadec Islands, New Zealand
Authors: AHYONG SHANE T. 
Published: June 2019

Among the Brachyura from the Kermadec Islands in the invertebrate collection of the National Institute of Water and Atmospheric Research, Wellington, New Zealand (NIWA), are two specimens representing two deep-water species previously not known from the region. Both specimens were collected at the same station, together with the paratypes of the parthenopid crab, Garthambrus tani Ahyong, 2008. The new records are reported below to formally document their occurrence at the Kermadec Islands, New Zealand; both also represent the first records of their respective genera from New Zealand waters. Measurements of specimens, in millimetres, refer to carapace length (cl) and carapace width (cw).