bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental study of the unsteady vibration signature for a Sirocco fan unit
Authors: González José , Delgado Laura , Velarde-Suárez Sandra , Fernández-Oro Jesús M , Díaz Katia Mª Argüelles , Rodríguez David , Méndez David 
Published: April 2019

The small forward-curved blades known as Sirocco fan units are very common and widespread solution for air conditioning used in public transportation applications, as buses or trains. The users quietness and comfort have become a main concerns in the automotive industry. For such kind of turbomachinery flow , the patterns becomes always highly 3D and unsteady, compromising the referred comfort, and setting the focus on the working flow variables. A mathematically exact solution for that flow, which would provide any required information on pressure or forces, is out of scope at the current engineering design processes. Nevertheless, some flow features and mechanical data are needed to progress in the frame of a modern industrial environment, involving maintenance protocols with important temporal and economic constraints for different design procedures. The correctness of a given maintenance protocol relies on its feasibility to handle a set of machine working parameters or variables, including a number of them as wide as possible. Doing so, a set of not-dangerous ranges for them can be established. Such ranges are often defined promoting a series of failures similar to real ones, when the machine is in its operative lifetime. In this paper and in order to establish proper working ranges for maintenance purposes, a series of failures have been experimentally tested for a Sirocco fan unit. Initially, real data from industry have been required and a list of main failures was made, including (1) impeller or rotor unbalance, (2) impeller channel obstruction and (3) blocked inlet. The failures are studied using a purified orbit diagram (POD) technique and a symmetrized dot pattern (SDP) technique. All four working conditions are studied for at least three different flow rates and, therefore, a deeper insight into the fan working parameters and options are made feasible. In the frame of the maintenance protocol, a full set of ranges for the considered failures has been obtained. Therefore, the present paper shows a novel possibility to enhance existing maintenance protocol using two advanced frequency-based techniques.
Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study
Authors: Bowling Mark R. , Folch Erik E. , Khandhar Sandeep J. , Kazakov Jordan , Krimsky William S. , LeMense Gregory P. , Linden Philip A. , Murillo Boris A. , Nead Michael A. , Pritchett Michael A. , Teba Catalina V. , Towe Christopher W. , Williams Terence , Anciano Carlos J. 
Published: April 2019

Background: Fiducial markers (FMs) help direct stereotactic body radiation therapy (SBRT) and localization for surgical resection in lung cancer management. We report the safety, accuracy, and practice patterns of FM placement utilizing electromagnetic navigation bronchoscopy (ENB). Methods: NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the superDimension™ navigation system. This prospectively collected subgroup analysis presents the patient demographics, procedural characteristics, and 1-month outcomes in patients undergoing ENB-guided FM placement. Follow up through 24 months is ongoing. Results: Two-hundred fifty-eight patients from 21 centers in the United States were included. General anesthesia was used in 68.2%. Lesion location was confirmed by radial endobronchial ultrasound in 34.5% of procedures. The median ENB procedure time was 31.0 min. Concurrent lung lesion biopsy was conducted in 82.6% (213/258) of patients. A mean of 2.2 ± 1.7 FMs (median 1.0 FMs) were placed per patient and 99.2% were accurately positioned based on subjective operator assessment. Follow-up imaging showed that 94.1% (239/254) of markers remained in place. The procedure-related pneumothorax rate was 5.4% (14/258) overall and 3.1% (8/258) grade ⩾ 2 based on the Common Terminology Criteria for Adverse Events scale. The procedure-related grade ⩾ 4 respiratory failure rate was 1.6% (4/258). There were no bronchopulmonary hemorrhages. Conclusion: ENB is an accurate and versatile tool to place FMs for SBRT and localization for surgical resection with low complication rates. The ability to perform a biopsy safely in the same procedure can also increase efficiency. The impact of practice pattern variations on therapeutic effectiveness requires further study. Trial registration: ClinicalTrials.gov identifier: NCT02410837.
Try to see it my way: exploring the co-design of visual presentations of wellbeing through a workshop process
Authors: Craven MP , Goodwin R , Rawsthorne M , Butler D , Waddingham P , Brown S , Jamieson M 
Published: April 2019

Aims: A 10-month project funded by the NewMind network sought to develop the specification of a visualisation toolbox that could be applied on digital platforms (web- or app-based) to support adults with lived experience of mental health difficulties to present and track their personal wellbeing in a multi-media format. Methods: A participant co-design methodology, Double Diamond from the Design Council (Great Britain), was used consisting of four phases: Discover – a set of literature and app searches of wellbeing and health visualisation material; Define – an initial workshop with participants with lived experience of mental health problems to discuss wellbeing and visualisation techniques and to share personal visualisations; Develop – a second workshop to add detail to personal visualisations, for example, forms of media to be employed, degree of control over sharing; and Deliver – to disseminate the learning from the exercise. Results: Two design workshops were held in December 2017 and April 2018 with 13 and 12 experts-by-experience involved, respectively, including two peer researchers (co-authors) and two individual-carer dyads in each workshop, with over 50% of those being present in both workshops. A total of 20 detailed visualisations were produced, the majority focusing on highly personal and detailed presentations of wellbeing. Discussion: While participants concurred on a range of typical dimensions of wellbeing, the individual visualisations generated were in contrast to the techniques currently employed by existing digital wellbeing apps and there was a great diversity in preference for different visualisation types. Participants considered personal visualisations to be useful as self-administered interventions or as a step towards seeking help, as well as being tools for self-appraisal. Conclusion: The results suggest that an authoring approach using existing apps may provide the high degree of flexibility required. Training on such tools, delivered via a module on a recovery college course, could be offered.
Culture Vitamins – an Arts on Prescription project in Denmark
Authors: Jensen A 
Published: April 2019

Aims: Four Arts on Prescription (AoP) projects are piloting in Denmark between 2016 and 2019. One of the local authorities delivering the project is Aalborg. The AoP project ‘Culture Vitamins’ runs for 10 weeks and offers a variety of cultural activities averaging 2.5 workshops per week for participants with mild to moderate depression, stress or anxiety. The study aims to evaluate and explore the potential mental health wellbeing benefits for the participants. Method: A qualitative approach with semi-structured interviews was used and included seven participants who were referred to the project by the local job centre. A thematic approach was applied to analyse the data and a theoretical lens of Salutogenesis was employed to explore the findings. Findings: The findings associated with mental health and the themes that emerged from the data described the participants’ subjective experiences and were (1) positive changes, (2) overcoming challenges and being in the ‘space’ and (3) moving from self-critical to self-caring. The reported mental health benefits were increased energy level, increased self-esteem, more joy in life, less panic attacks, increased motivation, a better understanding of own needs, an increased level of self-care and, in addition, some of the participants said that they felt more aligned to the labour market. Conclusions: The AoP project offered value and meaning for the participants and can be seen as a motivating tool that created access to new experiences and understandings by means of arts engagement. The ‘Culture Vitamins’ project can be regarded as a catalyst for connecting with inner resources and unlocking some of the barriers that mental ill health has created. The experience has shifted the participants’ experience of themselves in the world and initiated their motivation for the future. The ‘Culture Vitamins’ project offered a positive contribution to public health challenges associated with stress, anxiety and depression of individuals.
Does Hallux Valgus Correction Reduce the Width of the Forefoot?
Authors: Panchbhavi Vinod , Cordova Justin , Chen Jie , Janney Cory 
Published: April 2019

Background: Hallux valgus has been associated with a widened forefoot. Most surgical procedures for the correction of hallux valgus have the potential to reduce forefoot width. Success after hallux valgus surgery is correlated with relief of toe pain in conventional shoes and improvement in the appearance of the foot. Therefore, reduction in forefoot width, referred to as metatarsal span (MS), likely correlates with both criteria and may be a reliable radiographic indicator of success after hallux valgus surgery. Methods: Preoperative and postoperative radiographs of 52 patients who underwent correction of hallux valgus with a distal Chevron osteotomy and Akin osteotomy were evaluated by 4 observers. The observers measured the hallux valgus angle (HVA), the intermetatarsal first and second angle (IMA), and the MS. Results: Preoperative HVA ranged from 14° to 48°, IMA ranged from 6° to 25°, and MS ranged from 74.2 to 110.6 mm. The average HVA improvement was 19.4°, IMA improvement was 6.7°, and MS reduction was 8.7 mm. No correlation was identified with regard to correction of the HVA or IMA to MS. Conclusion: Digital radiographic linear measurements were easily and reliably made. Therefore, linear measurements as described in this article can be used as a tool to evaluate if clinical outcomes correlate with reduction of MS. A distal Chevron with an Akin osteotomy has the potential to reduce forefoot width. Levels of Evidence: Level IV: Case series
The role of observer’s fear of pain and health anxiety in empathy for pain: an experimental study
Authors: Serbic Danijela , Ferguson Lucy , Nichols Georgina , Smith Michaela , Thomas Georgina , Pincus Tamar 
Published: April 2019

Introduction: Empathy for pain is influenced by several factors, including observer beliefs. This study aimed to test the associations between empathy for pain, fear of pain and health anxiety. Methods: A total of 182 participants rated their levels of empathy towards 16 images (8 female and 8 male) of individuals in pain and provided measures of fear of pain, health anxiety as well as age, sex and the presence of current pain. Findings: Both fear of pain and health anxiety were positively associated with empathy for pain, but in the regression model, only fear of pain was a significant positive predictor of overall empathy for pain and its three subscales: affective distress, vicarious pain and empathic concern. The presence of pain also predicted overall empathy for pain, affective distress and vicarious pain. Observer’s sex and age were not significant. The pattern of results remained the same when we repeated the analysis separately for images with males and females. Conclusion: The results suggest that more fearful observers, and those in current pain themselves, have higher levels of empathy for pain. Future research should examine the mechanisms underlying this relationship and how fear of pain may influence empathic behaviours towards people in pain.
Reviving the lost art of scleral buckling surgery for rhegmatogenous retinal detachment: evaluation of risk factors of detachments, poor physiological outcomes, and perspective from a developing country
Authors: Singh Sweta , Khatri Anadi , Byanju Raghunandan , Kharel Muna , Joshi Kriti , Khadka Thapa Saru 
Published: April 2019

Purpose: To evaluate the primary anatomic and physiological success of scleral buckling surgery for rhegmatogenous retinal detachment and factors influencing its outcomes. Methods: This is a prospective analytical study of 92 eyes that underwent scleral buckling at the Lumbini Eye Institute and Research Center, in Lumbini, Nepal. Parameters evaluated which could influence the outcome of the surgery included the lens status, duration of symptoms, locations of breaks, the extent of retinal detachment, and preoperative proliferative vitreoretinopathy. Results: A total of 92 eyes from 88 patients with rhegmatogenous retinal detachment were evaluated; 68 (74%) eyes were of male and 24 (26%) were of female. The mean time of presentation was 4.71 ± 8.45 months. The overall primary anatomical and physiological success was achieved in 79 (84.9%) and 68 (73.9%) of the cases at 6 months. Sixteen cases developed re-detachment (mean duration of 2.8 ± 1.8 months). Eleven of the cases had a successful anatomical outcome and five of the patients had persistent detachment despite second surgery. In phakic patients, the primary success rate was 92.7% whereas in pseudophakic it was 71.4%. Proliferative vitreoretinopathy 10 (63%) was the most common cause of surgical failure. Bilateral buckling at the same setting was done to two patients—both achieving primary success. Conclusion: Scleral buckling is a very good surgical option for rhegmatogenous retinal detachment and represents a surgical technique worth being trained, performed, practiced, and continued despite advancements in modern vitreoretinal surgical devices and preference for vitrectomy and tamponade agents. It may also be successfully tried in cases of bilateral rhegmatogenous retinal detachment if a doubt regarding compliance for follow-up and surgery for the fellow eye exists.
Chronic CD30 signaling in B cells results in lymphomagenesis by driving the expansion of plasmablasts and B1 cells
Authors: Sperling Stefanie , Fiedler Petra , Lechner Markus , Pollithy Anna , Ehrenberg Stefanie , Schiefer Ana-Iris , Kenner Lukas , Feuchtinger Annette , Kühn Ralf , Swinerd Gene , Schmidt-Supprian Marc , Strobl Lothar J. , Zimber-Strobl Ursula 
Published: April 2019

AbstractCD30 is expressed on a variety of B-cell lymphomas, such as Hodgkin lymphoma, primary effusion lymphoma, and a diffuse large B-cell lymphoma subgroup. In normal tissues, CD30 is expressed on some activated B and T lymphocytes. However, the physiological function of CD30 signaling and its contribution to the generation of CD30+ lymphomas are still poorly understood. To gain a better understanding of CD30 signaling in B cells, we studied the expression of CD30 in different murine B-cell populations. We show that B1 cells expressed higher levels of CD30 than B2 cells and that CD30 was upregulated in IRF4+ plasmablasts (PBs). Furthermore, we generated and analyzed mice expressing a constitutively active CD30 receptor in B lymphocytes. These mice displayed an increase in B1 cells in the peritoneal cavity (PerC) and secondary lymphoid organs as well as increased numbers of plasma cells (PCs). TI-2 immunization resulted in a further expansion of B1 cells and PCs. We provide evidence that the expanded B1 population in the spleen included a fraction of PBs. CD30 signals seemed to enhance PC differentiation by increasing activation of NF-κB and promoting higher levels of phosphorylated STAT3 and STAT6 and nuclear IRF4. In addition, chronic CD30 signaling led to B-cell lymphomagenesis in aged mice. These lymphomas were localized in the spleen and PerC and had a B1-like/plasmablastic phenotype. We conclude that our mouse model mirrors chronic B-cell activation with increased numbers of CD30+ lymphocytes and provides experimental proof that chronic CD30 signaling increases the risk of B-cell lymphomagenesis.
Laboratory animal allergy is preventable in modern research facilities
Authors: Feary Johanna R. , Schofield Susan J. , Canizales Jennifer , Fitzgerald Bernadette , Potts James , Jones Meinir , Cullinan Paul 
Published: April 2019

BackgroundHistorical data suggest 15% of laboratory animal workers develop IgE sensitisation and 10% symptoms of laboratory animal allergy (LAA), including occupational asthma. Individually ventilated cages (IVCs) are replacing conventional open cages; we sought to evaluate their impact on the development of LAA.MethodsWe surveyed 750 laboratory animal workers and measured airborne Mus m 1 (mouse allergen) levels in seven UK institutions. We compared the prevalence of sensitisation to mouse proteins (by specific IgE assay or skin prick test) and of work-related allergic symptoms in IVC-only and open cage units.ResultsFull-shift Mus m 1 levels were lower in IVC than open cage units (geometric mean 1.00 (95% CI 0.73–1.36)versus8.35 (95% CI 6.97–9.95) ng·m−3; p<0.001), but varied eight-fold across the IVC units (geometric mean range 0.33–4.12 ng·m−3). Primary analyses on data from 216 participants with ≤3 years exposure to mice revealed a lower prevalence of sensitisation in those working in IVC units compared with conventional cage units (2.4% (n=2)versus9.8% (n=13); p=0.052). Sensitisation in IVC units varied from 0% to 12.5%; the use of fitted respiratory protection was less common in IVC units where prevalence of sensitisation was higher. Work-related allergy symptoms were more frequently reported by mouse-sensitised individuals (46.7%versus10.9%; p<0.001) and only by those working in open cage units.ConclusionIn contemporary practice, LAA is now largely preventable with the use of IVC systems and the judicious use of appropriate respiratory protection.
Riociguat for treatment of pulmonary hypertension in COPD: a translational study
Authors: Pichl Alexandra , Sommer Natascha , Bednorz Mariola , Seimetz Michael , Hadzic Stefan , Kuhnert Stefan , Kraut Simone , Roxlau Elsa T. , Kojonazarov Baktybek , Wilhelm Jochen , Gredic Marija , Gall Henning , Tello Khodr , Richter Manuel J. , Pak Oleg , Petrovic Aleksandar , Hecker Matthias , Schermuly Ralph T. , Grimminger Friedrich , Seeger Werner , Ghofrani Hossein A. , Weissmann Norbert 
Published: April 2019

Chronic obstructive pulmonary disease (COPD), which comprises the phenotypes of chronic bronchitis and emphysema, is often associated with pulmonary hypertension (PH). However, currently, no approved therapy exists for PH-COPD. Signalling of the nitric oxide (NO)–cyclic guanosine monophosphate (cGMP) axis plays an important role in PH and COPD.We investigated the treatment effect of riociguat, which promotes the NO–cGMP pathway, in the mouse model of smoke-induced PH and emphysema in a curative approach, and retrospectively analysed the effect of riociguat treatment on PH in single patients with PH-COPD.In mice with established PH and emphysema (after 8 months of cigarette smoke exposure), riociguat treatment for another 3 months fully reversed PH. Moreover, histological hallmarks of emphysema were decreased. Microarray analysis revealed involvement of different signalling pathways,e.g.related to matrix metalloproteinases (MMPs). MMP activity was decreasedin vivoby riociguat. In PH-COPD patients treated with riociguat (n=7), the pulmonary vascular resistance, airway resistance and circulating MMP levels decreased, while oxygenation at rest was not significantly changed.Riociguat may be beneficial for treatment of PH-COPD. Further long-term prospective studies are necessary to investigate the tolerability, efficacy on functional parameters and effect specifically on pulmonary emphysema in COPD patients.
Long-term evaluation of home-based pulmonary rehabilitation in patients with fibrotic idiopathic interstitial pneumonias
Authors: Wallaert Benoit , Duthoit Louise , Drumez Elodie , Behal Hélène , Wemeau Lidwine , Chenivesse Cécile , Grosbois Jean-Marie 
Published: April 2019

BackgroundFew studies have examined the benefits of pulmonary rehabilitation in patients with fibrotic idiopathic pulmonary pneumonia (f-IIP). Here, we report the results of an observational study in routine clinical practice of home-based pulmonary rehabilitation for f-IIP patients.MethodsA total of 112 consecutive patients (61 with idiopathic pulmonary fibrosis and 51 with fibrotic nonspecific interstitial pneumonitis) were enrolled, of whom 65 had mild-to-moderate disease (forced vital capacity (FVC) ≥50% predicted and diffusing capacity of the lung for carbon monoxide (DLCO) ≥30% predicted) and 47 had severe disease (FVC <50% predicted and/orDLCO<30% predicted). The 2-month pulmonary rehabilitation programme consisted of a once-weekly visit with retraining, therapeutic education and psychosocial support. Patients were provided with an individualised action plan and were followed-up bimonthly for 12 months. Exercise tolerance (6-min stepper test (6MST)), mood (Hospital Anxiety and Depression Scale (HADS)) and quality of life (QoL) (Visual Simplified Respiratory Questionnaire (VSRQ)) were assessed before (T0), immediately after (T2), 6 months after (T8) and 12 months after (T14) the end of the pulmonary rehabilitation programme.Results6MST strokes, HADS Anxiety score and VSRQ score were each significantly improved at T2(n=101), T8(n=76) and T14(n=62) compared with T0values. The improvements in outcomes were not influenced by disease severity or subtype. Patients who completed the study had significantly better baseline FVC andDLCOvalues than those who did not.ConclusionsHome-based pulmonary rehabilitation provides long-term benefits in exercise tolerance, anxiety and QoL for patients with f-IIP. Pulmonary rehabilitation should be prescribed systematically as part of the therapeutic arsenal for these patients.
Effect of the GLP-1 Receptor Agonist Exenatide on Impaired Awareness of Hypoglycemia in Type 1 Diabetes: A Randomized Controlled Trial
Authors: van Meijel Lian A , Rooijackers Hanne M , Tack Cees J , de Galan Bastiaan E 
Published: April 2019

Abstract

Context
Impaired awareness of hypoglycemia (IAH), resulting from habituation to recurrent hypoglycemia, can be reversed by strict avoidance of hypoglycemia. Adjunctive treatment with glucagon-like peptide-1 receptor agonists may reduce glucose variability, hence lower the risk of hypoglycemia and improve awareness. The aim of our study was to investigate the effect of exenatide on awareness of hypoglycemia in patients with type 1 diabetes and IAH.

Methods
This was a randomized double-blind, placebo-controlled crossover trial. Ten patients with type 1 diabetes and IAH were included [age, 38.5 ± 4.4 years; 40% males; glycated hemoglobin 7.2% ± 0.4% (55.2 ± 4.8 mmol/mol)]. Patients were treated with exenatide 5 µg twice daily (first two weeks), followed by 10 µg twice daily (remaining four weeks) or matching placebo, with a four-week washout period. Patients wore blinded glucose sensors in the final weeks and modified hyperinsulinemic normoglycemic-hypoglycemic glucose clamps (nadir 2.5 mmol/L) were performed at the end of each treatment period.

Results
Treatment with exenatide caused body weight to decrease compared with placebo (−3.9 ± 0.9 vs 0.6 ± 1.2 kg, P = 0.047). Exenatide did not change mean 24-hour glucose levels (8.3 ± 0.4 vs 8.5 ± 0.3 mmol/L, exenatide vs placebo, P = 0.64), median (interquartile range) percentage of time spent in hypoglycemia [15.5 (4.5, 25.5) vs 7.8 (4.4, 17.1)%, P = 0.11] and frequency of hypoglycemia (15.8 ± 3.7 vs 12.1 ± 3.5, P = 0.19). Symptom scores in response to clamped hypoglycemia were similar between exenatide [median change 1.0 (−1.5, 7.0)] and placebo [4.5 (1.5, 5.8), P = 0.08].

Conclusions
Six weeks of treatment with exenatide did not improve awareness of hypoglycemia in patients with type 1 diabetes and IAH.