bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can the choice of building performance simulation tool significantly alter the level of predicted indoor overheating risk in London flats?
Authors: Petrou Giorgos , Mavrogianni Anna , Symonds Phil , Mylona Anastasia , Virk Dane , Raslan Rokia , Davies Mike 
Published: August 2018

The accurate prediction of building indoor overheating risk is critical in order to mitigate its possible consequences on occupant health and wellbeing. The Chartered Institution of Building Services Engineers issued Technical Memorandum 59 (TM59) with the aim of achieving consistency in the modelling processes followed for the prediction of overheating risk in new dwellings. However, as each tool’s prediction may depend on its inherent assumptions, an inter-model comparison procedure was used to assess whether the choice of building performance simulation tool influences the overheating assessment. The predictions of two popular tools, IES VE and EnergyPlus, were compared for nine variations of a naturally ventilated, purpose built, London flat archetype, modelled under the default algorithm options. EnergyPlus predicted a high overheating risk according to TM59 criteria in seven out of the nine model variants, contrary to the low risk of all the IES VE variants. Analysis of heat transfer processes revealed that wind-driven ventilation and surface convection algorithms were the main sources of the observed discrepancies. The choice of simulation tool could thus influence the overheating risk assessment in flats, while the observed discrepancies in the simulation of air and heat transfer could have implications on other modelling applications. Practical application:Technical Memorandum 59 issued by the Chartered Institution of Building Services Engineers may be widely adopted within the industry to assist the prediction of overheating risk in new dwellings. This work suggests that the choice of building performance simulation tool can greatly influence the predicted overheating risk. Furthermore, the differences identified in the modelling of heat transfer processes could also impact other modelling applications. Following these results, the need for detailed empirical validation studies of naturally ventilated homes has been highlighted.
Musculoskeletal Injury Risk After Sport-Related Concussion: A Systematic Review and Meta-analysis
Authors: McPherson April L. , Nagai Takashi , Webster Kate E. , Hewett Timothy E. 
Published: August 2018

Background: Clinical management of sport-related concussion typically involves a symptom checklist, clinical examination of mental status, and neurocognitive testing. However, recent studies have identified unresolved, impaired sensorimotor function after athletes return to sport. A review and meta-analysis of all current literature regarding risk of subsequent musculoskeletal (MSK) injury after concussion has yet to be published in the medical literature. Purpose/Hypothesis: To determine the odds that athletes will sustain MSK injury after concussion. It was hypothesized a priori that concussion would increase the risk for MSK injury. Study Design: Systematic review and meta-analysis. Methods: PubMed and Google Scholar were searched from January 2000 to November 2017. Reference lists of the included studies were manually searched. Two reviewers independently searched the literature for studies published in English that reported MSK injury after athletes returned to play following a concussion. Two independent reviewers completed data extraction using PRISMA guidelines and assessed study quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Institutes of Health. Random effects meta-analyses were used to calculate odds ratio (OR) and incidence rate ratio (IRR) of MSK injury after concussion. The primary study outcome of interest was the number of athletes who sustained MSK injury after concussion. Results: Eight studies met inclusion criteria for meta-analysis. Meta-analysis results indicated that athletes who had a concussion had 2 times greater odds of sustaining a MSK injury than athletes without concussion (OR, 2.11; 95% CI, 1.46-3.06). In addition, athletes with concussion demonstrated a higher incidence of MSK injury after return to sport compared with nonconcussed athletes (IRR, 1.67; 95% CI, 1.42-1.96). Further analysis showed that both male and female athletes with concussion were at an increased risk of MSK injury compared with their respective same-sex, nonconcussed controls (OR > 1.56, P < .01). Conclusion: Based on the evidence of higher risk of MSK injuries after concussion, standard clinical assessments for athletes with concussion should include not only physical symptoms and cognitive function before return to sport but also neuromuscular risk factors associated with increased risk for MSK injuries.
Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model
Authors: Su Wei , Qi Wenxiao , Li Xiaoxi , Zhao Song , Jiang Jia , Zhao Jinzhong 
Published: August 2018

Background:Various suture materials can be clinically used for rotator cuff repair (RCR). RCR with high-strength nonabsorbable sutures may not be ideal, because it may cause stress shielding, which may hinder enthesis regeneration and maturation in the tendon-bone interface. RCR with strength-decreasing sutures (ie, absorbable sutures) may be a better choice. However, the effects of suture absorbability on enthesis regeneration and maturation have not been investigated.Hypothesis:The use of absorbable sutures in RCR would produce a better tendon-bone connection structure, which provides histological and biomechanical advantages over the use of nonabsorbable sutures.Study Design:Controlled laboratory study.Methods:A supraspinatus tear was created on the right shoulder in 108 of 120 skeletally mature male rabbits. The animals were randomly divided into 3 groups, with 36 rabbits in each group, to undergo RCR individually with total absorbable, partial absorbable, and nonabsorbable sutures (TAS, PAS, and NAS). Twelve animals in each group were sacrificed at 4, 8, and 12 weeks after surgery, with 6 operated shoulders used for histological evaluation to detect enthesis regeneration and maturation and the other 6 for biomechanical testing. The remaining 12 animals without supraspinatus tear were used as control.Results:At 12 weeks, in the tendon-bone interface, enthesis regeneration was detected in the TAS group but not in the NAS group. A mature enthesis appeared in the TAS group but not in the NAS group. In the PAS group, enthesis regeneration was also observed; however, the fibrocartilage was not abundant and the enthesis maturity not good as compared with the TAS group. Biomechanical testing showed that the rotator cuff–greater tuberosity connection structure in the TAS and PAS groups had greater values of ultimate load to failure, stiffness, and stress than the NAS group at all time points.Conclusion:In RCR in an acute rabbit rotator cuff tear model, the use of sutures with absorbability lead to enthesis regeneration, increased maturity of rotator cuff insertion, and enhanced rotator cuff–greater tuberosity connection.Clinical Relevance:Compared with the use of NAS, the use of TAS or PAS might be a better choice for RCR.
Bioactive Tape With BMP-2 Binding Peptides Captures Endogenous Growth Factors and Accelerates Healing After Anterior Cruciate Ligament Reconstruction
Authors: Crispim João F. , Fu Sai C. , Lee Yuk W. , Fernandes Hugo A.M. , Jonkheijm Pascal , Yung Patrick S.H. , Saris Daniël B.F. 
Published: August 2018

Background: The anterior cruciate ligament (ACL) has poor regenerative capacity, and an injury leads to loss of function, limiting quality of life and increasing the incidence of osteoarthritis. Surgical interventions can stabilize the joint and improve functional recovery. The delivery of growth factors (GFs) enhances the healing process; however, this is complex in its regulation, is high in costs, has side effects, and can only be accomplished with supraphysiological concentrations and thus is currently not clinically feasible. However, the immobilization of a patient’s endogenous GFs in biomaterials can overcome these problems. Purpose: To develop a method to capture endogenous bone morphogenetic protein–2 (BMP-2) and ultimately show enhanced ACL healing in vivo using this novel methodology. Study Design: Controlled laboratory study. Methods: BMP-2 binding peptides were synthetized, purified, and immobilized on polycaprolactone (PCL) films. The affinity between the peptide and human BMP-2 (hBMP-2) was confirmed with immunofluorescence and enzyme-linked immunosorbent assay. The C2C12 Luc reporter cell line was used to confirm the bioactivity of immobilized BMP-2. For in vivo experiments, the same functionalization technology was applied to the commercially available Polytape, and the functionalized tape was sutured together with the graft used for ACL reconstruction in rats. Each animal underwent reconstruction with either native Polytape (n = 3) or Polytape with BMP-2 binding peptides (n = 3). At 2 and 6 weeks after surgery, the graft was assessed by histology and micro–computed tomography. Results: The covalent immobilization of the peptide in PCL was successful, allowing the peptide to capture hBMP-2, which remained bioactive and led to the osteogenic differentiation of C2C12. In vivo experiments confirmed the potential of the Polytape functionalized with the BMP-2 binding peptide to capture endogenous BMP-2, leading to enhanced bone formation inside the femoral and tibial tunnels and ultimately improving the graft’s quality. Conclusion: The incorporation of BMP-2 binding peptides into materials used for ACL reconstruction can capture endogenous hBMP-2, which enhances the healing process inside the bone tunnels. Clinical Relevance: These results demonstrate the potential of using synthetic peptides to endow biomaterials with novel biological functions, namely to capture and immobilize endogenous GFs.
Advance Care Planning in a Geriatric Primary Care Clinic: A Retrospective Chart Review
Authors: Barkley Ariana , Liquori Mike , Cunningham Amy , Liantonio John , Worster Brooke , Parks Susan 
Published: August 2018

Purpose: Advance care planning (ACP) is theorized to benefit both the patient and their family when end of life is near as well as earlier in the course of serious illness. However, ACP remains underutilized, and little is known about the nature of ACP documentation in geriatrics practices. The study investigated the prevalence and nature of ACP documentation within a geriatric primary care clinic. Methods: A retrospective chart review was conducted on a randomly selected sample of electronic medical record (EMR) charts. The sample consisted of patients aged 65 and older who were seen in the clinic from January 1, 2015, to December 31, 2016. Charts were reviewed for ACP documentation and data regarding age, gender, race, religion, comorbidities (end-stage renal disease, congestive heart failure, cancer, and dementia), recent hospitalizations, and visit type. Results: Ninety-eight charts were reviewed (n = 98). Nine patients (9.18%) had an advance directive (AD) or power of attorney (POA) available within their EMR. Twenty-five patients (25.5%) had provider notes documenting that they have an AD, POA, or preferred health-care decision maker; however, no documents were available. The remaining 64 (65.3%) patients had no evidence of ACP documentation within their EMR. Age was the only demographic variable associated with completion of an AD ( P = .038). Discussion: The rate of ACP documentation (34.6%) was lower than the average among US adults aged 65 and over (45.6%); further, most patients with ACP documentation did not have an AD or POA on file. The authors plan to reevaluate ACP statistics in the same office following a future intervention.
The transposed femoral vein arteriovenous fistula for hemodialysis
Authors: Söderman Martin , Lindholt Jes S , Clausen Lene L 
Published: August 2018

Introduction: The prevalence and incidence of patients in need of hemodialysis worldwide are increasing. The population in need of hemodialysis is becoming older and vascular comorbidities are more frequent than decades ago. Consequently, the prevalence of patients with exhausted possibilities of upper limb vascular accesses increases. In contrast to other lower limb vascular accesses, a fistula by transposing the femoral vein to the superficial femoral artery promises better patency rates in preliminary series. Methods: The first seven cases performed between October 2015 and March 2017 at the only center in Denmark performing this procedure were reviewed regarding demographics, comorbidities, complications, and patency. Results: The study population consisted of five males and two females, with a mean age of 61.6 ± 9.9 years, mean body mass index 24.9 ± 2.6, with various causes of uremia. Five patients (71.4%) experienced at least one complication, such as wound dehiscence, lymphocele, infection, hematoma, or steal. First cannulation of the transposing the femoral vein to the superficial femoral artery was conducted after 12.2 ± 4.3 weeks. Postoperatively, the patients have been followed 16.4 ± 9.6 months in the dialysis center. All but one is still using their transposing the femoral vein to the superficial femoral artery for dialysis, but three of these needed revision to maintain patency giving a primary and primary-assisted patency of 42.9 (95% confidence interval: 15.8–75.0) and 85.7 (95% confidence interval: 48.7–97.4), respectively. Conclusion: Although postoperative complications and need for revision to maintain patency persists, our experience suggests that this is a feasible method when it is no longer possible to create an upper extremity vascular access. A learning curve for the entire vascular access team must be expected.
The Effect of Perioperative Bevacizumab on Disease-Free and Overall Survival in Locally Advanced HER-2 Negative Breast Cancer: A Meta-Analysis
Authors: Alnimer Yanal , Hindi Zakaria , Katato Khalil 
Published: August 2018

Introduction: Multiple trials demonstrated that adding Bevacizumab to the standard neoadjuvant chemotherapy in HER-2 negative breast cancer increases pathological complete response. We conducted this meta-analysis to evaluate that effect on survival. Methods: We performed a systematic search for randomized trials measuring the effect of adding either neoadjuvant or adjuvant Bevacizumab to the standard chemotherapy on disease-free and overall survival in breast cancer surgical candidates. The Mantel-Haenszel method and random effect model were used to analyze the data. A total of 7 randomized controlled trials were included in the analysis with a mean follow-up of 45 months. Results: No statistically significant difference in overall survival was found after adding Bevacizumab to the standard chemotherapy in the overall study population, HR=0.9, 95% CI (90.72–1.13), estrogen/ progesterone positive subgroup, HR=0.99, 95% CI (0.72–1.35), or in triple negative breast cancer, HR=0.88, 95% CI (0.77–1.01). However, there was a small but significant improvement in disease-free survival in triple negative breast cancer with a HR of 0.88, 95% CI (0.78–0.98), but not in estrogen/ progesterone receptor positive tumors, HR=1.01, 95% CI (0.81–1.26). Conclusions: The addition of Bevacizumab along with the standard chemotherapy would not improve overall survival in breast cancer surgical candidates, however, due to a small but significant improvement on disease-free survival in triple negative breast cancer, that would not eliminate the possibility of a certain subgroup of the latter who might benefit from adding Bevacizumab.
Air-Mobile Stroke Unit for access to stroke treatment in rural regions
Authors: Walter Silke , Zhao Henry , Easton Damien , Bil Cees , Sauer Jonas , Liu Yang , Lesmeister Martin , Grunwald Iris Q , Donnan Geoffrey A , Davis Stephen M , Fassbender Klaus 
Published: August 2018

Background In recent years, important progress has been made in effective stroke treatment, however, patients living in rural and remote areas have nil or very limited access to timely reperfusion therapies. Aims Novel systems of care to overcome the detrimental treatment gap for stroke patients living in rural and remote regions need to be developed. Summary of review A possible solution to the treatment disparity between stroke patients living in metropolitan and rural areas may involve the use of specially designed aircrafts equipped with the ability to diagnose and treat acute stroke at remote emergency sites. We describe technical solutions for an Air-Mobile Stroke Unit (Air-MSU) concept, where an aircraft is customized with the ability to perform multimodal computed tomography, in addition to onboard laboratory equipment and telemedicine connection. The Air-MSU is envisioned not only to allow intravenous thrombolysis in the field but also to allow prehospital triage to a comprehensive stroke center through use of contrast intracerebral vascular imaging. Several options for the Air-MSU approach are described, and issues regarding the potential medical benefit, optimal operating environment, technical realization, and integration in pre-existing solutions (e.g., flying doctor service) are addressed. Conclusion The Air-MSU may represent a novel tool to reduce treatment disparity for stroke patients in rural and remote areas. However, this approach requires further implementation research to determine the overall benefit to these communities.
Five-year results after collagenase treatment of Dupuytren disease
Authors: Werlinrud Jens C. , Hansen Karina L. , Larsen Søren , Lauritsen Jens 
Published: August 2018

This study assesses the joint-specific sustained effect of collagenase clostridium histolyticum treatment of Dupuytren disease over a 5-year follow-up period. The study includes 107 consecutive treatments in patients with extension deficits greater than 20° affecting the metacarpophalangeal or proximal interphalangeal joints. Success was defined as no follow-up treatment due to relapse or maintained extension deficit less than 20°. The 5-year estimate of no follow-up treatment was 79% (95% CI: 64–88) for metacarpophalangeal and 49% (95% CI: 26–69) for proximal interphalangeal joints, which was a significant difference (log-rank test, p = 0.0044). For those who did not undergo re-treatment, a non-significant relapse was found for metacarpophalangeal joints and a 65% (34°, 95% CI: 24–46) relapse for proximal interphalangeal joints. We conclude that treating metacarpophalangeal joints with collagenase clostridium histolyticum is effective with acceptable recurrence rates. However, when treating proximal interphalangeal joints with collagenase clostridium histolyticum, patients should be informed of the high risk of recurrence and the greater chance of need for further treatment. Level of evidence: II
Predictors of Pain and Functional Outcomes After the Nonoperative Treatment of Rotator Cuff Tears
Authors: Jain Nitin B. , Ayers Gregory D. , Fan Run , Kuhn John E. , Baumgarten Keith , Matzkin Elizabeth , Higgins Laurence D. 
Published: August 2018

Background: Optimal patient selection is key to the success of nonoperative treatment for rotator cuff tears. Purpose: To assess the predictors of pain and functional outcomes in a longitudinal cohort of patients undergoing nonoperative treatment. Study Design: Cohort study; Level of evidence, 2. Methods: A multicenter cohort of patients with rotator cuff tears undergoing nonoperative treatment was recruited from March 2011 to February 2015. Patients completed a detailed health questionnaire, completed standardized shoulder questionnaires including the Shoulder Pain and Disability Index (SPADI), and underwent magnetic resonance imaging. In addition to baseline assessments, patients received follow-up questionnaires at 3, 6, 12, and 18 months. Longitudinal mixed models were used to test predictors of the SPADI score, and interactions with time were assessed. Results: In our cohort of 70 patients, being married as compared with being single/divorced/widowed ( P = .02), a shorter duration of symptoms ( P = .02), daily shoulder use at work that included light or no manual labor versus moderate or heavy manual labor ( P = .04), alcohol use of 1 to 2 times per week or more as compared with 2 to 3 times per month or less ( P = .007), and absence of fatty infiltration ( P = .0009) were significantly associated with decreased SPADI scores (improved shoulder pain and disability) over time. When interactions with time were assessed, having a college level of education or higher compared with less than a college education showed a differential effect over time, with those with a college level of education or more having lower SPADI scores ( P = .004). Partial-thickness tear versus full-thickness tear also had an interaction with follow-up duration, such that those with a partial-thickness tear had lower SPADI scores ( P = .0002). Conclusion: Longitudinal predictors of better outcomes of the nonoperative treatment of rotator cuff tears included being married, having at least a college education, shorter duration of symptoms, light or manual labor in daily work, alcohol use of 1 to 2 times per week or more, partial-thickness tear, and absence of fatty infiltration of the rotator cuff. Our results suggest that nonoperative treatment should be performed early for optimal outcomes. These data can be used to select optimal candidates for the nonoperative treatment of rotator cuff tears and to assist with patient education and expectations before treatment.
Characteristics of ventilator-associated pneumonia due to hypervirulent Klebsiella pneumoniae genotype in genetic background for the elderly in two tertiary hospitals in China
Authors: Liu Chao , Guo Jun 
Published: August 2018

Abstract
Background
Aerobactin is a critical factor for the hypervirulent Klebsiella pneumoniae (hvKp), but data for the aerobactin-positive genotype of hvKp in elderly persons with ventilator-associated pneumonia (VAP) is limited. The purpose of this study is to understand the risk factors and characteristics of the hvKp genotype for elderly patients with VAP.

Methods
A retrospective study of 73 elderly patients with Kp was conducted from November 2008 to December 2017 in two tertiary hospitals. The clinical and microbiological data, including inflammatory reaction, nutritional status, antimicrobial susceptibility testing, string test, extended-spectrum-β-lactamase (ESBL) production, virulence-associated gene (capsular serotype-specific gene and rmpA/A2,magA,aerobaction) and multilocus sequence typing, of the hvKp group defined as aerobactin positive were compared with those of classic Kp strains.

Results
Of 73 Kp isolates, 46.6% were hvKp. ST23 is highly prevalent in two hospitals but is not highly associated with hvKp in different hospitals. Additionally, ST23, ST37 and ST2906 are more likely to induce lethal VAP. Most hvKp strains are sensitive to common antibiotics, but the number of multidrug-resistant (MDR) hvKp is increasing. Importantly, 38.2% of hvKp isolates produced ESBLs. Hypermucoviscosity and virulence-associated genes (K1,magA and rmpA/A2) were highly clustered in the hvKp group (P < 0.001). Cancer (P = 0.004), digestive disease (P = 0.038) and surgery (P = 0.023) within 1 month are strongly associated with the VAP-hvKp group. The incidence of septic shock (P = 0.016) and Sequential Organ Failure Assessment (SOFA) scores (P < 0.001) are significantly higher in the hvKp group. Multivariate analysis indicated that cancer (odds ratio [OR] = 5.365) is an independent risk factor for VAP-hvKp infection.

Conclusions
The morbidity for elderly patients with VAP due to hvKp is high. MDR-HvKp is emerging, which is a great challenge for clinical practice.