bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Modifiable Risk Factors Are Associated With Declining Incidence of Hospitalized and Nonhospitalized Acute Coronary Heart Disease in a Population
Authors: Mannsverk Jan , Wilsgaard Tom , Mathiesen Ellisiv B. , Løchen Maja-Lisa , Rasmussen Knut , Thelle Dag S. , Njølstad Inger , Hopstock Laila Arnesdatter , Bønaa Kaare Harald 
Published: November 2015

Background—
Few studies have used individual person data to study whether contemporary trends in the incidence of coronary heart disease are associated with changes in modifiable coronary risk factors.

Methods and Results—

We identified 29 582 healthy men and women ≥25 years of age who participated in 3 population surveys conducted between 1994 and 2008 in Tromsø, Norway. Age- and sex-adjusted incidence rates were calculated for coronary heart disease overall, out-of-hospital sudden death, and hospitalized ST-segment–elevation and non–ST-segment–elevation myocardial infarction. We measured coronary risk factors at each survey and estimated the relationship between changes in risk factors and changes in incidence trends. A total of 1845 participants had an incident acute coronary heart disease event during 375 064 person-years of follow-up from 1994 to 2010. The age- and sex-adjusted incidence of total coronary heart disease decreased by 3% (95% confidence interval, 2.0–4.0;
P
<0.001) each year. This decline was driven by decreases in out-of-hospital sudden death and hospitalized ST-segment–elevation myocardial infarction. Changes in coronary risk factors accounted for 66% (95% confidence interval, 48–97;
P
<0.001) of the decline in total coronary heart disease. Favorable changes in cholesterol contributed 32% to the decline, whereas blood pressure, smoking, and physical activity each contributed 14%, 13%, and 9%, respectively.

Conclusions—
We observed a substantial decline in the incidence of coronary heart disease that was driven by reductions in out-of-hospital sudden death and hospitalized ST-segment–elevation myocardial infarction. Changes in modifiable coronary risk factors accounted for 66% of the decline in coronary heart disease events.
Positron Emission Tomographic Imaging in Stroke
Authors: Sahathevan Ramesh , Linden Thomas , Villemagne Victor L. , Churilov Leonid , Ly John V. , Rowe Christopher , Donnan Geoffrey , Brodtmann Amy 
Published: November 2015

Background and Purpose—
Cardiovascular risk factors significantly increase the risk of developing Alzheimer disease. A possible mechanism may be via ischemic infarction–driving amyloid deposition. We conducted a study to determine the presence of β-amyloid in infarct, peri-infarct, and hemispheric areas after stroke. We hypothesized that an infarct would trigger β-amyloid deposition, with deposition over time.

Methods—
Patients were recruited within 40 days of acute ischemic stroke and imaged with computed tomographic or magnetic resonance imaging and Pittsburgh compound B (11C-PiB) positron emission tomographic scans. Follow-up positron emission tomographic scanning was performed in a subgroup ≤18 months after the stroke event. Standardized uptake value ratios for regions of interest were analyzed after coregistration.

Results—

Forty-seven patients were imaged with
11
C-PiB positron emission tomography. There was an increase in
11
C-PiB accumulation in the stroke area compared with a reference region in the contralesional hemisphere, which was not statistically significant (median difference in standardized uptake value ratio, 0.07 [95% confidence interval, −0.06 to 0.123];
P
=0.452). There was no significant increase in the accumulation of
11
C-PiB in the peri-infarct region or in the ipsilesional hemisphere (median difference in standardized uptake value ratio, 0.04 [95% confidence interval, −0.02 to 0.10];
P
=0.095). We repeated
11
C-PiB positron emission tomography in 21 patients and found a significant reduction in accumulation of
11
C-PiB between regions of interest (median difference in standardized uptake value ratio, −0.08 [95% confidence interval, −0.23 to −0.03];
P
=0.04).

Conclusions—

There was no significant increase in
11
C-PiB accumulation in or around the infarct. There was no increase in ipsilesional hemispheric
11
C-PiB accumulation over time. We found no evidence that infarction leads to sustained or increased β-amyloid deposition ≤18 months after stroke.
Commanding Angels
Authors: Leubner Ben 
Published: November 2015

This article investigates the conception of and attitude towards the ‘beyond’ in the work of the twentieth-century poets Rainer Maria Rilke and James Merrill, arguing for striking similarities in this regard despite the two poets being of different generations, nationalities, and languages. While the influence of poets such as W. B. Yeats and W. H. Auden on Merrill has been thoroughly illustrated by others, this essay aims to illustrate the no less paramount but less often discussed influence of Rilke, especially in matters regarding the spiritual.
Modelling the optimum thermal store and biomass boiler size for a small communal heating scheme
Authors: Faulkes Duncan M 
Published: November 2015

This paper presents a study of biomass boiler and thermal store optimisation for a small communal heating scheme. Poor system sizing has been identified by the Carbon Trust and CIBSE as affecting the performance of biomass heating systems, and a review of installations under the Renewable Heat Incentive has shown that typically systems have low utilisation and are less efficient than expected. Thermal store sizing affects the boiler efficiency and a literature review has highlighted that there is little research directly addressing the subject of optimisation of a thermal store for biomass heating systems. This paper studied the problem using a transient simulation of a heating system to establish the boiler and thermal store size that gave minimum energy consumption and the optimum life cycle cost for the range of options. The model demonstrated that for the systems assessed, the smallest boiler that met the design day average load used the least energy and larger thermal stores achieved greater seasonal efficiency. However the Renewable Heat Incentive tariff structure encourages oversized boilers with low utilisation and this gives rise to low seasonal efficiencies. Practical application: This paper looks into the role of thermal stores in improving biomass boiler efficiency. It also discusses the impact on efficiency that results from decisions to oversize biomass boilers in an attempt to maximise Renewable Heat Incentive income. The conclusions will be relevant to designers of biomass systems who are weighing up the implications of different boiler outputs and heat stores with regard to overall system performance. It may also interest operators who are investigating system performance and policy makers who are looking at how the tariff system could be affecting boiler size and performance.
Energy and exergy analysis of a two-stage cascade refrigeration system
Authors: Mohammadi SM Hojjat , Ameri Mehran 
Published: November 2015

A noble integration of a cascade refrigeration system with a two-stage compression chiller is proposed. The compression and the absorption systems have a cascade inter-cooler/evaporator, and the compression system has two compressors working in series. The compressors can be either reciprocating or screw type. This system runs by a driving unit which can be a micro-turbine or a solid oxide fuel cell. The system components are modeled and analyzed through the energy and exergy approaches. The performance parameters of the systems and the second law efficiency are calculated in different operating conditions. The results show that the maximum irreversibilities happen in the generator and the first-stage compressor, and the total destruction is higher when a micro-gas turbine is used as the prime mover. It appears that by using reciprocating compressors, energy and exergy are consumed up to 260% and 188% more efficiently in the proposed system compared to a traditional single-stage compression refrigeration system. The two latter parameters would be 53.7% and 29.2% in case of using screw compressors. Practical application: So much of our lives rely on refrigeration, from the food that we eat to the transportation and processing of vital resources. Industrial refrigeration systems such as gas compression, oil and gas processing, petrochemicals, power generation, carbon capture and food processing and storage are dependent on low-temperature refrigeration systems. Multi-stage refrigeration cycle is a conventional approach to provide low temperature for industrial processes. The proposed cascade system can reduce the energy consumption of a two-stage refrigeration system, using the waste heat from an industrial process. The first and second law analysis of the proposed system approves the upgrade in energy and exergy efficiencies of this system.
A new way of thinking about environmental building standards: Developing and demonstrating a client-led zero-energy standard
Authors: Parkin Anna , Mitchell Andrew , Coley David 
Published: November 2015

There are over 70 low energy and carbon standards in use around the world. None of these standards have been designed by the clients who pay for and occupy the buildings in question. In this work, the client was asked to define the building code for the construction of a new 2800 m2 building via a structured survey. The resulting zero-energy standard simply required the building to incur no energy utility bill. One year of monitoring of the completed building was used to see if the standard had been met. The result of this work is a new way of thinking about environmental building standards that solves many of the issues of obtaining and maintaining buy-in from the client. Practical application: This is the first time that the client has played a key role in the definition of a low-energy building standard. Measured energy consumption and renewable energy generation data are presented and demonstrate that the zero-energy criteria were successfully met. This work is important as it shows that the client can have a meaningful input into the design of an environmental standard. The paper should be of interest to architects, engineers, building energy researchers and those interested in methods that can be used to reduce the energy demand of buildings.
Thermoelectric cooling heating unit prototype
Authors: Martín-Gómez César , Ibáñez-Puy María , Bermejo-Busto Javier , Sacristán Fernández José Antonio , Ramos Juan Carlos , Rivas Alejandro 
Published: November 2015

The article describes from an architectonical point of view the design, assembly, and energy behavior of a prototype for air-conditioning in residential buildings using Peltier cells, which means the application in the field of construction of a technology used in very specific areas. The new system has been designed as an independent, prefabricated, modular construction element that must fit perfectly between the structural floors and is easily adapted to the demands of different buildings. The thermoelectric cooling heating unit is designed to offer a high level of comfort to those living in the building. The only mechanical elements are the dissipation heat fans placed on the outside of the prototype, and heat sinks to transfer the heat from the power elements, reducing the possibilities of failure. The result of all these ideas is the construction of a prefabricated module, consisting of a simplified inhabited housing unit with a thermoelectric installation serving the module, which has obtained a national patent. The results of the thermal and electric behavior demonstrate that the system does not work as well as had been expected; nevertheless, the system has a high potential for its use in buildings associated with photovoltaic. Practical application: The system opens new ways to the air-conditioning without using the traditional concepts of primary and secondary loop, because the system is highly independent. Their applications could be in building refurbishment where other systems involving the use of water or air are complicated to implement, in spaces where security and resilience are crucial factors (such as surgeries or computer server rooms), or those situations with extreme maximum and minimum temperatures or irregular electrical supply, as those could exist when the army must intervene or an humanitarian disaster occurs.
Diabetes Causation Beliefs Among Spanish-Speaking Patients
Authors: Concha Jeannie Belinda , Mayer Sallie D. , Mezuk Briana R. , Avula Danielle 
Published: November 2015

Purpose The purpose of this study was to explore how the inquiry of cultural diabetes causation beliefs can improve Hispanic/Latino patient self-management. Methods Two semistructured focus groups were conducted with 13 Hispanic/Latinos adults diagnosed with type 2 diabetes mellitus. Prior to taking part in the group discussion, participants completed a demographic survey and the Illness Perception Questionnaire–Revised. Results The top 5 diabetes causation items endorsed by participants per the questionnaire included stress or worry, behavior, hereditary, diet/eating habits, and family problems/worries. The qualitative analysis revealed stress as a recurring theme for a cause of diabetes. Work stress was specifically identified as a contributor to unhealthy eating and diabetes. Most participants were aware of and believed in susto and referred to it as coraje (anger). Participants believed that asking patients about their diabetes causation beliefs and emotional status can help health professionals (1) better understand the patient and (2) identify and prioritize diabetes treatments. Participants also indicated that the role of doctors is important and the encouragement that they give to patients is clinically and spiritually valued. Conclusions Stress was identified as a cause of diabetes in addition to unhealthy diets and heredity. Asking patients about diabetes causation beliefs and emotional status may help prioritize treatment and management goals.
Pulmonary valve replacement and quality-of-life assessment
Authors: Tsang Flora HF , Wong Sophia J , Cheung Yiu-fai 
Published: November 2015

Background Chronic pulmonary regurgitation is common after repair of tetralogy of Fallot. Despite the deleterious effects of chronic pulmonary regurgitation on right ventricular function, many patients with repaired tetralogy of Fallot remain asymptomatic. Health is defined not only by the absence of disease but also by physical, mental, and social wellbeing. We sought to examine the impact of pulmonary valve replacement on quality of life in asymptomatic patients with repaired tetralogy of Fallot and chronic pulmonary regurgitation. Methods From January 2009 to December 2012, 25 (18 male) asymptomatic patients (mean age 23.4 ± 7.4 years) who underwent pulmonary valve replacement for significant pulmonary regurgitation were recruited. Cardiac magnetic resonance was performed pre- and postoperatively. Quality of life was assessed using the Chinese version of the SF-36v2 evaluation tool. Demographics, clinical data, magnetic resonance findings, and quality-of-life scores were collected and calculated for comparison. Results After surgery, the indexed right ventricular end-diastolic volume (193 ± 47.3 vs. 105.6 ± 29.6 mL m−2, p < 0.001) and indexed right ventricular end-systolic volume (108.5 ± 32.9 vs. 61.1 ± 23 mL m−2, p < 0.001) decreased significantly. The response rates for pre- and postoperative quality-of-life assessments were 100%. Patients demonstrated improvements in all 8 domains of the SF-36v2 assessment. The physical (46.5 ± 6.6 vs. 49.9 ± 6.4, p = 0.012) and mental (43.7 ± 7.8 vs. 51.9 ± 7.6, p < 0.001) component summary scores increased after surgery. Conclusion Pulmonary valve replacement can improve the quality of life in patients with chronic asymptomatic pulmonary regurgitation.
Impact of comorbidity index on morbidity and survival in non-small cell lung cancer
Authors: Otake Sotaro , Ohtsuka Takashi , Asakura Keisuke , Kamiyama Ikuo , Kohno Mitsutomo 
Published: November 2015

Background The number of surgeries in older patients with comorbidities is constantly growing. The present study examined the impact of comorbidity on postoperative complications and long-term survival in patients with completely resected non-small cell cancer. Methods Between 2004 and 2008, 423 patients with non-small cell lung cancer underwent complete resection. A retrospective comparison of perioperative mortality, morbidity, Charlson comorbidity index (CCI), and postoperative length of hospital stay was performed. Results The number of patients with CCI 0, 1–2, and ≥3 was 226, 170 and 27, respectively. The 5-year overall survival was 88% among patients with CCI 0, and 84% in those with CCI ≥1 ( p = 0.05) in all pathological stages. The CCI 0 group had significantly better overall survival than CCI 0 group and 30 (15%) in the CCI ≥1 group ( p = 0.024). Length of stay was shorter in the CCI 0 group (11 ± 5 days) than in the CCI ≥1 group (15 ± 19 days, p = 0.015). Conclusions A high CCI correlated with higher postoperative morbidity and longer length of stay. We identified better a prognosis in patients with CCI 0 compared to those with CCI 1–2.
The effect of arm positioning on timing and enhancement of intravenous contrast media at coronary computed tomography angiography
Authors: Svensson Anders , Cederlund Kerstin , Aspelin Peter , Nyman Ulf , Brismar Torkel B 
Published: November 2015

Background Adequate intravenous contrast media (CM) enhancement is crucial for evaluation of the coronary arteries. Purpose To compare the timing and enhancement of intravenous CM at coronary computed tomography angiography (CCTA) when positioning the arms in the traditional superior direction with that of positioning them in the ventral direction during the CM injection. Material and Methods One hundred patients were randomized into two groups. Group A ( n = 50) had their arms positioned in the superior direction, resting on a head and arm support. Group B ( n = 50) held their arms resting on the front panel of the computer tomography (CT) scanner. Scanning delay time was defined by test bolus technique. A total of 60 mL iodixanol, 320 mg/mL, was followed by a 50 mL saline flush at 6 mL/s. Cardiac output (CO) and heart rate (HR) were obtained before scanning. The attenuation was calculated by placing regions of interest (ROI) in ascending aorta, left atrium, and inferior vena cava. Results More patients in group A compared with group B (26 versus 14) showed a higher attenuation of the left atrium in comparison to the ascending aorta ( P < 0.05). Body weight (BW) and CO were significantly related to the attenuation of ascending aorta ( P < 0.01). Conclusion By placing the arms in a ventral, instead of superior position the frequency of too early imaging at CCTA can be reduced.
Incorporating the hepatobiliary phase of gadobenate dimeglumine-enhanced MRI in the diagnosis of hepatocellular carcinoma: increasing the sensitivity without compromising specificity
Authors: Cortis Kelvin , Liotta Rosa , Miraglia Roberto , Caruso Settimo , Tuzzolino Fabio , Luca Angelo 
Published: November 2015

Background Diagnosis of hepatocellular carcinoma (HCC) is centered on wash-in of contrast during the arterial phase followed by washout during the portal or delayed venous phase. Nodules showing hypointensity on the hepatobiliary phase are also likely to represent HCC, however, the role of this phase is not yet established. Purpose To investigate the role of the hepatobiliary phase on Gadobenate dimeglumine (Gd-BOPTA) magnetic resonance imaging (MRI) in characterizing HCCs lacking the typical arterial enhancement and venous washout. Material and Methods Ninety-seven cirrhotic patients (78 men, 19 women; mean age, 58.5 years) who underwent liver transplantation (2004–2012) and Gd-BOPTA enhanced MRI within 3 months of surgery were retrospectively reviewed. A nodule-by-nodule analysis was performed, followed by liver explant correlation. Statistical analysis was then performed by a biostatistician using commercially available software. Results A total of 193 HCCs were found in 97 liver explants, of which 24.9% (48/193) were not detectable on imaging. The 145 HCCs seen on imaging showed the typical wash-in/washout pattern (Pattern A) in 46.9% (68/145), arterial enhancement without washout (Pattern B) in 37.9% (55/145), and hypovascularity on arterial and venous sequences (Pattern C) in 15.2% (22/145). Pattern A was exclusive to HCC. Twenty-three of the 55 HCCs showing Pattern B were also hypointense on the hepatobiliary phase (Pattern B1). Combining Pattern B1 with Pattern A raises the sensitivity of HCC characterization from 46.9% to 62.8% ( P = 0.007), with no significant compromise on specificity. Conclusion When coupled with Pattern A, Pattern B1 augments sensitivity of HCC characterization with no significant compromise on the specificity.
To assess the association between vertebral marrow fat content and colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy
Authors: Xu Haidong , Zhang Yuqin , Dong Haibo , Pei Feng , Li Guanwu , Wu Dongmei 
Published: November 2015

BackgroundAlthough lower bone mineral density (BMD) is considered to have an increased risk for colorectal adenoma, no association between marrow fat content and colorectal adenoma has been elucidated yet.PurposeTo evaluate the relationship between marrow fat fraction (MFF) and the presence of colorectal adenoma in postmenopausal women using magnetic resonance spectroscopy (MRS).Material and MethodsWe performed a cross-sectional observational study on 152 postmenopausal patients with colorectal adenoma and 100 matched control subjects who underwent screening colonoscopy, biochemical measurements, dual-energy X-ray absorptiometry, and MRS. Logistic regression models were performed to assess the relationships among BMD, MFF, and colorectal adenoma.ResultsWith univariate analysis, marrow fat accumulation was higher and BMD values were lower in patients with colorectal adenoma compared with those in controls. After adjustment for potential confounders including demographics, health history, blood lipid levels, indexes of glucose metabolism, and validated measures of diet and physical activity, MFF was significantly positively associated with colorectal adenoma (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.10–2.46; P = 0.008). Vertebral BMD, but not total hip and femoral neck BMD, was inversely related with colorectal adenoma (OR, 0.62; 95% CI, 0.14–0.89; P = 0.027). Additionally, MFF was associated with adenoma number, size, and high-risk adenoma (all P < 0.01). MFF was found to be an independent risk factor of a high-risk colorectal adenoma (OR, 2.08; 95% CI, 1.24–3.60; P = 0.019).ConclusionMarrow fat accumulation is highly associated with colorectal adenoma, particularly high-risk adenoma, in postmenopausal women.