bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling building infiltration using the airflow network model approach calibrated by air-tightness test results and leak detection
Authors: Heim Dariusz , Miszczuk Artur 
Published: February 2020

This paper presents a computational approach to air infiltration modelling and simulation validated by the blower door test results. In order to evaluate the potential of the airflow network method, three simulation models of the infiltration test were developed and calibrated by field measurements of leaked air change rate per hour at 50 Pa. Models were developed for existing building designs and constructed in low-energy standards differing in construction type and tightness. All leaks were precisely measured during field tests, defined as openings or cracks, numerically described and included in the model. The simulation results of calibrated models for other pressure differences revealed that the models’ accuracy is satisfactory. The differences between field tests and simulation results do not exceed 2.5%. Additionally, the calibrated models were used to estimate the infiltration heat losses of buildings in three different locations under continental climatic conditions. The results were compared with the steady-state method calculations made for the same building models and climatic conditions. It was proved that the steady-state method gives higher results of heat demand to cover infiltration losses than the simulation method. The final results depend on building location and vary between four and nine times. Practical application: The computational modelling and building performance simulations are increasingly commonly used in engineering design. The proposed method of air-tightness modelling and calibration can be used at any phase of a building’s lifecycle, from design and construction to exploitation and maintenance. Using the proposed techniques, it is possible to estimate more realistic processes of air infiltration and its effect on a building’s energy consumption in comparison with the steady-state method. Moreover, the analysis includes the dynamic effect of boundary conditions (external air temperature, wind speed and direction), as well as the effects of the building site and the surroundings.
Prevalence, potential risk factors and mortality rates of acute respiratory distress syndrome in Chinese patients with sepsis
Authors: Li Shilei , Zhao Danna , Cui Jie , Wang Lizeng , Ma Xiaohua , Li Yong 
Published: February 2020

Objective To investigate the prevalence, risk factors and mortality rate for acute respiratory distress syndrome (ARDS) in Chinese patients with sepsis. Methods This prospective study was based on data from consecutive patients with sepsis who attended Cangzhou Central Hospital between January 2017 and May 2019 and who developed ARDS. Multivariate logistic regression was used to identify risk factors associated independently with ARDS development. Results Of the 150 sepsis patients, 41 (27%) developed ARDS. Smoking history, presence of chronic obstructive pulmonary disease (COPD), the C-reactive protein (CRP) levels and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were associated with developing ARDS. Moreover, combination of the four factors had an even better predictive value for risk of ARDS than each factor alone. 28-day mortality was higher in sepsis patients with ARDS compared with those without ARDS. Conclusions In Chinese patients with sepsis, ARDS is relatively common and is associated with increased mortality. Smoking, COPD, CRP levels and APACHE II scores may be useful in predicting sepsis patients who may be at risk of developing ARDS.
Nitrate partially inhibits lipopolysaccharide-induced inflammation by maintaining mitochondrial function
Authors: Yang Yang , Li Shaoqing , Qu Yi , Wang Xue , An Wei , Li Zhilin , Han Zhengxue , Qin Lizheng 
Published: February 2020

Objective Nitrate has been reported to protect cells via the nitrate-nitrite-nitric oxide (NO) pathway. Most studies tend to use nitrite to investigate the mechanisms of this pathway. However, the latest studies have confirmed that mammals can directly degrade nitrate via xanthine oxidoreductase (XOR). The hypothesis is that nitrate could play a protective role in inflammatory responses independent of bacterial nitrate reductases. Methods Mouse RAW264.7 macrophages were pre-incubated with sodium nitrate (10, 100, and 500 µM) for 2 hours, and then treated with lipopolysaccharide (LPS) for 2 hours to induce inflammation. The Quantikine Immunoassay was used to measure interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations in the supernatant. The fluorescence intensity ratio of red/green from JC-1 was used to assay mitochondrial membrane potential. The fluorescence intensity of MitoSOX Red was used to indicate the generation of mitochondrial reactive oxygen species. Results Nitrate partially reduced IL-6 and TNF-α secretion via reducing NF-κB signaling in LPS-induced macrophages. Nitrate also reduced the generation of mitochondrial reactive oxygen species by regulating mitochondrial function. These effects depended on XOR-derived NO but were independent of inducible nitric oxide synthase-derived NO. Conclusion Nitrate regulates mitochondrial function via XOR-derived NO to partially inhibit LPS-induced inflammation.
Effect of Normal Saline Injections on Lateral Epicondylitis Symptoms: A Systematic Review and Meta-analysis of Randomized Clinical Trials
Authors: Acosta-Olivo Carlos Alberto , Millán-Alanís Juan Manuel , Simental-Mendía Luis Ernesto , Álvarez-Villalobos Neri , Vilchez-Cavazos Félix , Peña-Martínez Víctor Manuel , Simental-Mendía Mario 
Published: February 2020

Background: Lateral epicondylitis, or tennis elbow, is a painful degenerative disorder that commonly occurs in adults between 40 and 60 years of age. Normal saline (NS) injections have been used as placebo through a large number of randomized controlled trials (RCTs) focused on the treatment of lateral epicondylitis. Purpose: This meta-analysis of RCTs aimed to assess the therapeutic effect of NS injections on lateral epicondylitis symptoms and compare results with established minimal clinically important difference criteria. Study Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, Web of Science, and Scopus databases were searched for clinical trials reporting pain and joint function with the visual analog scale, Patient-Rated Tennis Elbow Evaluation, and Disabilities of the Arm, Shoulder and Hand in patients with lateral epicondylitis. The meta-analysis was conducted with a random effects model and generic inverse variance method. Heterogeneity was tested with the I2 statistic index. Results: A total of 15 RCTs included in this meta-analysis revealed a significant improvement in pain (mean difference, 3.61 cm [95% CI, 2.29-4.92 cm]; P < .00001; I2 = 88%; visual analog scale) and function (mean difference, 25.65 [95% CI, 13.30-37.99]; P < .0001; I2 = 82%; Patient-Rated Tennis Elbow Evaluation / Disabilities of the Arm, Shoulder and Hand) after NS injection (≥6 months). Conclusion: NS injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis. New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT. Registration: CRD42019127547 (PROSPERO).
Ischemic Therapy in Musculoskeletal Medicine
Authors: Ramme Austin J. , Rourke Brennan J. , Larson Christopher M. , Bedi Asheesh 
Published: February 2020

Background: The competitive environment of athletics has promoted the exploration of any technology application that may offer an edge with performance and recovery from injury. Ischemic therapy is one such technology that has rapidly been incorporated into training rooms and physical therapy clinics worldwide. This therapy modality is reported to increase an athlete’s ability to improve muscle mass, strength, and endurance. Purpose: To provide the sports medicine physician with an understanding of the current state of ischemic therapy technology, including treatment specifications, known physiological effects, hypothesized mechanisms, biochemical effects, athletic applications, medical applications, animal models, and future research recommendations. Study Design: Literature review. Methods: A computer-based search of the PubMed database was used to perform a comprehensive literature review on musculoskeletal ischemic therapy. Results: The current research on ischemic therapy is largely composed of case series with varying equipment, methods, and therapy specifications. The publication of case series has value in identifying this technology for future research, but the results of these studies should not be justification for application to athletes without validation of safety and effectiveness. Conclusion: To date, ischemic therapy remains unvalidated, and the mechanism by which it improves muscle performance is not clear.
Lactate Measurements and Their Association With Mortality in Pediatric Severe Sepsis in India: Evidence That 6-Hour Level Performs Best
Authors: Alam Areesha , Gupta Sarika 
Published: February 2020

Purpose: To investigate association of static and dynamic lactate indices with early mortality (within 48 hours of admission), as well as need for vasopressors and mechanical ventilation in pediatric severe sepsis/shock. To explore optimal cutoffs of lactate indices. We hypothesized that dynamic indices are superior to static indices in predicting early mortality. Methods: This prospective cohort study involved children (aged <14 years) admitted in emergency department, tertiary care teaching hospital in North India with severe sepsis/shock (2015-2016). Arterial lactate was measured at admission (X0) and after 6 hours (X6). Primary outcome of the measurement was early mortality. Association between lactate indices— lactate at 0 hours (Lac0), lactate after 6 hours (Lac6), time-weighted average (LacTW), delta (ΔLac), clearance (LacCl%) and early mortality, need for vasopressors, and mechanical ventilation—was assessed using Student t test/Mann-Whitney test. Area under the receiver operating characteristic curve (AUROC) for early mortality deduced for all lactate indices and compared with reference (Lac0). Optimal cutoffs (maximizing both sensitivity and specificity) and their positive predictive value (PPV) and negative predictive value (NPV) were determined. Results: During the study period, 116 children were assessed. Septic shock was present at admission in 56.9% children; 50% of children died during the next 48 hours. Lac0, Lac6, and LacTW were significantly higher, and LacCl% was lower in nonsurvivors versus survivors (all P < .001). Lac6 (0.837 [0.76-0.91]) had significantly higher AUROC (95% confidence interval) than Lac0 (0.77; P = .03). Abnormal lactate metrics (higher Lac0, Lac6, LacTW, and lower LacCl%) were associated with vasopressors need and mechanical ventilation. On logistic regression, Lac6 emerged as an independent predictor of early mortality as well as vasopressor and mechanical ventilation need. The optimal cutoff of Lac6 for identifying early mortality with good sensitivity, specificity, PPV, and NPV was ≥2.65 (76, 85, 83, 78). Conclusions: Lactate6 is the best marker associated with early mortality and higher level of care in severe sepsis/septic shock in resource-poor regions.
Differences in the presentation of stage 1 macular holes illustration by optical coherence tomography
Authors: Bentaleb Machkour Zaïnab , Garweg Justus G , Bandello Francesco , Denis Philippe , Kodjikian Laurent 
Published: February 2020

Objective: To present two different phases of progression of Gass stage 1 foveolar detachment to lamellar or full-thickness macular holes revealed with spectral domain optical coherence tomography. Design: This is an observational study. Participants: The medical records of four patients (four eyes) with foveolar detachment that had evolved into stage 1 macular holes were compared. The patients manifested neither co-existing myopia nor any other ocular pathology. Methods: At each consultation, best-corrected visual acuity, dilated fundus examination, and spectral domain optical coherence tomography were performed to ascertain whether the foveolar detachment was associated with posterior vitreal detachment. Results: In two of the eyes, and at an early phase of the disease, an incomplete posterior vitreal detachment and vitreal adhesion at the head of the optic nerve were observed. In the other two cases, the traction was not antero-posterior but tangential and had been effected by thickening of the inner limiting membrane or by the presence of a discrete epiretinal membrane in the papillomacular area; the posterior vitreal detachment was complete. In the former two cases and in one of the latter, the foveolar detachments had progressed to full-thickness macular holes. The visual acuities were better in the latter than in the former two eyes. Conclusion: Two different pathological mechanisms appear to underlie the formation of macular holes: The optical coherence tomography–guided classification of Gass stage 1 macular hole as an antero-posterior traction with a triangular foveolar detachment has to be distinguished from a tangential traction and a complete posterior vitreal detachment. Tangential traction is typically associated with a more dome-shaped or irregular foveolar detachment and a hyper-reflective band at the vitreoretinal interface.
Prostaglandin analogues: A double-edged sword in orbital glaucoma disease management
Authors: Joganathan Varajini , Cannon Paul S , Mercieca Karl 
Published: February 2020

Introduction: The authors describe benefits of the recognised adverse effects of prostaglandin analogues on periocular structures in patients with unilateral proptosis and intraocular pressure rise. This case points to intentional consideration of prostaglandin analogue therapy in this selected cohort of patients with secondary ocular hypertension and proptosis. Case description: A 70-year-old gentleman who presented with a 1-week history of a red and painful right eye associated with tortuous and dilated episcleral blood vessels. Visual acuity was unaffected. A diagnosis of idiopathic orbital inflammatory disease was made by extraocular muscle biopsy. Two weeks later, the patient presented with worsening pain, reduced vision and raised intraocular pressure. The secondary ocular hypertension was successfully treated with topical preserved eye drops, including latanoprost, a prostaglandin analogue. Over 6 months, the patient developed drop intolerance and punctate keratopathy leading to therapy non-adherence. Interestingly, the patient reported improvement in periocular appearance related to prostaglandin-associated periorbitopathy. Ocular surface disease and intraocular pressures were subsequently managed with preservative-free eye drops. Conclusion: Secondary ocular hypertension is not an uncommon consequence of orbital disease. Prostaglandin analogue can act as a double-edged sword in the management of raised intraocular pressure by reducing eye pressure at the cost of developing adverse effects of prostaglandin-associated periorbitopathy. These adverse effects however can be beneficial in the aesthetic rehabilitation of proptosis and associated exposure keratopathy in patients with unilateral orbital disease and probably should be sought as first line treatment in those with proptosis and raised intraocular pressure.
Autologous internal limiting membrane transplant for recurrent idiopathic macular holes
Authors: Rossi Tommaso , Trillo Carlandrea , Ripandelli Guido 
Published: February 2020

Purpose: To report a series of recurrent idiopathic macular holes treated by means of a free autologous internal limiting membrane flap and compare visual and anatomic results to a control group undergoing further internal limiting membrane peeling and novel gas tamponade. Methods: Retrospective surgical series of 15 consecutive patients receiving autologous internal limiting membrane flap compared to 14 patients operated on for internal limiting membrane peeling enlargement. Autologous internal limiting membrane flap was created after brilliant blue G staining, internal limiting membrane lifting, perfluorocarbon bubble injection and creation of a wide internal limiting membrane free flap translocated underneath perfluorocarbon liquid, to the macular hole bed. Both groups were tamponated with 20% SF6 and positioned face down for 4 h a day for 3 days. Results: Macular hole closed in 14/15 (93.3%) patients of the autologous internal limiting membrane group and 9/14 (64.2%) controls (p < 0.05). Visual acuity increased from 0.05 ± 0.03 to 0.23 ± 0.13 Snellen in the autologous internal limiting membrane group and from 0.05 ± 0.03 to 0.14 ± 0.10 Snellen of controls (p < 0.05 for both). Vision of the autologous internal limiting membrane group improved more than controls at 1 month (p = 0.043) and 3 months (p = 0.045). Inner segment/outer segment interruption at 3 months was smaller in the autologous internal limiting membrane group than controls, reducing from 1230 ± 288 µm at baseline to 611 ± 245 and 547 ± 204 µm at 3 months versus 1196 ± 362, 745 ± 222 and 705 ± 223 µm, respectively (p < 0.05). Conclusion: Autologous internal limiting membrane flap can effectively close recurrent idiopathic macular holes with a higher closure rate, smaller residual inner segment/outer segment line interruption and higher visual acuity at 3 months than previous standard of care.
An Electronic Aerosol Delivery System for Functional Magnetic Resonance Imaging
Authors: Hobkirk Andréa L , Bitzer Zachary , Goel Reema , Sica Christopher T , Livelsberger Craig , Yingst Jessica , Houser Kenneth R , Rupprecht Sebastian , Trushin Neil , Karunanayaka Prasanna , Foulds Jonathan , Richie John P , Spreen Lauren , Hoglen Brianna , Wang Jianli , Elias Ryan J , Yang Qing X 
Published: February 2020

Background: Public health concerns over the addictive potential of electronic cigarettes (e-cigs) have heightened in recent years. Brain function during e-cig use could provide an objective measure of the addictive potential of new vaping products to facilitate research; however, there are limited methods for delivering e-cig aerosols during functional magnetic resonance imaging (fMRI). The current study describes the development and feasibility testing of a prototype to deliver up to four different e-cig aerosols during fMRI. Methods: Standardized methods were used to test the devices’ air flow variability, nicotine yield, and free radical production. MRI scans were run with and without the device present to assess its safety and effects on MRI data quality. Five daily smokers were recruited to assess plasma nicotine absorption from e-liquids containing nicotine concentrations of 8, 11, 16, 24, and 36 mg/ml. Feedback was collected from participants through a semi-structured interview and computerized questionnaire to assess comfort and subjective experiences of inhaling aerosol from the device. Results: Nicotine yield captured from the aerosol produced by the device was highly correlated with the nicotine concentration of the e-liquids used (R2 = 0.965). Nicotine yield was reduced by a mean of 48% and free radical production by 17% after traveling through the device. The e-liquid containing the highest nicotine concentration tested (36 mg/ml) resulted in the highest plasma nicotine boost (6.6 ng/ml). Overall, participants reported that the device was comfortable to use and inhaling the e-cig aerosols was tolerable. The device was determined to be safe for use during fMRI and had insignificant effects on scan quality. Conclusions: With the current project, we were able to design a working prototype that safely and effectively delivers e-cig aerosols during fMRI. The device has the potential to be used to assess brain activation during e-cig use and to compare brain reactivity to varying flavors, nicotine concentrations, and other e-cig characteristics.
A cross-sectional analysis of 2017 stroke symptoms recognition at the US regional level
Authors: Tran Lam , Tran Phoebe , Tran Liem 
Published: February 2020

Objectives Stroke symptom recognition is critical in reducing time to treatment, but it is not known whether the increased support for stroke education programs during the last several years has led to an improvement in regional stroke symptom recognition levels since they were last assessed in the mid-2010s. Methods We used the most current estimates of recognition from the 2017 National Health Interview Survey to examine regional recognition levels for individual stroke symptoms and correct identification of all five stroke symptoms. Results Recognition of individual stroke symptoms was ≥76% in all regions, but correct identification of all stroke symptoms was lower ranging from 68.8 to 70.2%. Recognition of sudden numbness or weakness of face, arm, or leg, especially on one side (Northeast: 94.9%, Midwest: 95.8%, South: 93.8%, West: 94.5%) was the highest and recognition of sudden headache with no known cause (Northeast: 77.6%, Midwest: 76.4%, South: 77.7%, West: 76.5%) was the lowest for all regions. Discussion We observed similar stroke symptom recognition levels in each US region with little improvement since the mid-2010s. Additional effort should be made to increase recognition of sudden headache with no known cause in US regions with current high prevalence of stroke risk factors.
Circulating angiopoietin-2 and the risk of mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis of 10 prospective cohort studies
Authors: Li Fengyuan , Yin Rulan , Guo Qiang 
Published: February 2020

Background: Angiopoietin-2 (Ang-2), as one of the ligands of endothelial receptor Tie2, is known to be significant for vessel maturation and stabilization after birth. Previous studies showed the relationship between Ang-2 level and the risk of mortality in patients with acute respiratory distress syndrome (ARDS). However, the link between circulating Ang-2 and the risk of mortality in patients with ARDS varied in different investigations. Results: We performed a systematic review and meta-analysis of all available cohort studies regarding the association between baseline circulating Ang-2 and mortality in patients with ARDS. Among the 10 eligible studies, pooled odds ratio (OR) showed that high Ang-2 level contributed to ARDS mortality [OR = 1.56, 95% confidence interval (CI): 1.30–1.89, I2 = 76.2%]. Stratified analysis revealed that higher circulating Ang-2 was related to a 30% higher risk in the high-quality scores group (OR = 1.68, 95% CI: 1.33–2.68, I2 = 62.4%). The I2 of the bad compliance group decreased from 76.2% to 8.5%, which suggested that compliance is a significant source of heterogeneity. This association may be blunted by potential bias, although the results was not meaningfully changed by omitting only one study at a time. Further subgroup analysis and meta-regression support that compliance of patients also affects the results significantly, compared with the publication year, follow-up duration, the samples, or population characteristics. Conclusion: Participants with higher baseline Ang-2 were at a higher risk for future risk of mortality in patients with ARDS. Higher circulating Ang-2 levels could independently predict the risk of mortality in patients with ARDS. However, further large scale prospective cohorts or even interventional studies are warranted to evaluate the diagnostic power of Ang-2 and its causative role on ARDS outcome. The reviews of this paper are available via the supplemental material section.