bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of consciousness, collapse and associated driving restrictions: a retrospective case note review – an important reminder regarding driving restrictions
Authors: Williamson Adam , Muir Scott 
Published: May 2017

Background and aims National guidelines outlining medical standards for fitness to drive are provided by The Driver and Vehicle Licensing Agency. We aimed to establish whether patients presenting with collapse or loss of consciousness received documented advice regarding driving restrictions, if appropriate for their working diagnosis. Methods and results A retrospective case note review was undertaken over a four-month period for emergency patients clinically coded as seizure/convulsion (R568) and collapse/syncope (R55X); 163 patients had a primary or working diagnosis on discharge that suggested driving status and restrictions could have been reviewed. Six groupings of diagnoses were noted, and variation was seen amongst documentation for each. Current driving status was documented for 32 patients, and 34 had restriction advice documented; 73% (119 patients) had further investigations or clinic review planned. Conclusion Documentation of driving status and restrictions is poor. This audit serves to remind clinicians of the importance of considering driving status when discharging patients who have presented with collapse or loss of consciousness. Recent high-profile media coverage regarding medical driving restrictions, both locally and nationally, have emphasised the need for knowledge of The Driver and Vehicle Licensing Agency guidance.
Comparison of indoor air distribution and thermal environment for different combinations of radiant heating systems with mechanical ventilation systems
Authors: Wu Xiaozhou , Fang Lei , Olesen Bjarne W , Zhao Jianing , Wang Fenghao 
Published: May 2017

A hybrid system with a radiant heating system and a mechanical ventilation system, which is regarded as an advanced heating, ventilation and air-conditioning (HVAC) system, has been applied in many modern buildings worldwide. To date, almost no studies focused on comparative analysis of the indoor air distribution and the thermal environment for all combinations of radiant heating systems with mechanical ventilation systems. Therefore, in this article, the indoor air distribution and the thermal environment were comparatively analyzed in a room with floor heating (FH) or ceiling heating (CH) and mixing ventilation (MV) or displacement ventilation (DV) when the supply air temperature ranged from 15.0℃ to 19.0℃. The results showed that the temperature effectiveness values were 1.05–1.16 and 0.95–1.02 for MV + FH and MV + CH, respectively, and they were 0.78–0.91 and 0.51–0.67 for DV + FH and DV + CH, respectively. The Predicted Mean Vote values were from 0.24 to 0.45 and from 0.11 to 0.43 for MV + FH and MV + CH, respectively, and from 0.01 to 0.23 and from −0.41 to 0.10 for DV + FH and DV + CH, respectively. Hence, MV + FH had the largest temperature effectiveness and Predicted Mean Vote, and DV + CH had the smallest values. In addition, the vertical air temperature differences for MV + FH and MV + CH were all within the comfort zone according to ISO 7730, but exceeded the comfort zone for DV + FH and DV + CH when the supply air temperature was less than 17℃ and 19℃, respectively. The air distribution effectiveness values for MV + FH and MV + CH were close to the recommended value for MV in the ASHRAE Standard 62.1, and those for DV + FH and DV + CH were slightly less than the recommended value for displacement ventilation. The results in this article are relevant and useful in the process of selection and design of a hybrid system with a radiant heating system and a mechanical ventilation system in practice. Practical application: The supply air temperature is one of key parameters for the design and operation of a hybrid system with a radiant heating system and a mechanical ventilation system. The results in this article may contribute to the design and operation of a hybrid system when taking in account the indoor air quality and thermal comfort.
Partnerships for Active Children in Elementary Schools: Outcomes of a 2-Year Pilot Study to Increase Physical Activity During the School Day
Authors: Weaver R. Glenn , Webster Collin A. , Egan Cate , Campos Carolina M. C. , Michael Robert D. , Vazou Spyridoula 
Published: May 2017

Purpose: To evaluate the impact of the pilot study Partnerships for Active Children in Elementary Schools on the percentage of children achieving the Institute of Medicine guideline of 30 minutes of moderate-to-vigorous physical activity (MVPA) during the school day. Design: Pre/multiple post-quasi-experimental. Setting: Four elementary schools. Participants: Physical education (n = 3) and classroom teachers (n = 12) and students (n = 229). Intervention: Partnerships for Active Children in Elementary Schools was a multicomponent, theory-driven intervention facilitated through school–university partnerships. Intervention approaches included communities of practice, community-based participatory research, and service learning. Measures: Accelerometer-derived percentage of children accumulating 30 minutes of MVPA during the school day. Analysis: Multilevel mixed-effects regression estimated MVPA differences over time. Results: Compared to control, a 2.4% (95% confidence interval [CI]: −0.0% to 4.8%) and 8.8% (95% CI: −0.3% to 15.4%) increase in the percentage of time girls and boys engaged in MVPA during the school day was observed. The percentage of boys and girls in the intervention group achieving 30 minutes of MVPA/day increased from 57.5% to 70.7% and 35.4% to 56.9%, respectively. Boys and girls in the control group decreased from 61.5% to 56.4% and 52.6% to 41.9%, respectively. However, these changes did not reach statistical significance. Conclusion: Partnerships for Active Children in Elementary Schools demonstrated meaningful impact on children’s MVPA during the school day by increasing boys’ and girls’ MVPA. However, additional strategies may be required to help schools achieve the Institute of Medicine guideline.
Complications and Morbidity associated with Loop Ileostomies in Patients with Ulcerative Colitis
Authors: Park J. , Gessler B. , Block M. , Angenete E. 
Published: May 2017

Background and Aims: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. Material and Methods: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively. Results: In total, 71 patients were identified, and the median age was 39 years. A majority (94%) of the patients underwent proctectomy or proctocolectomy with primary construction of an ileal pouch–anal anastomosis. In total, 38 patients (54%) had one or more postoperative complications at index surgery. Stoma-related complications were seen in 49% where parastomal skin irritation was most common. In total, 18% of the patients were re-admitted due to morbidity related to the ileostomy, and the leading cause was high volume output. Complications related to closure were seen in 29% of the patients, and of these, 30% required surgical intervention. In total, five patients (7%) developed a symptomatic leakage in the ileo-ileal anastomosis. There was no mortality. Conclusion: Loop ileostomies in this young patient cohort resulted in considerable morbidity. Closure of the ileostomy was also associated with complications. Although the diverting loop ileostomy is constructed to decrease the clinical consequences of an anastomotic leakage, the inherent morbidity should be considered. Preventive measures for parastomal skin problems could improve results.
Adult student preferences: Instructor characteristics conducive to successful teaching
Authors: Phillips Lindsay A , Baltzer Carolyn , Filoon Lisa , Whitley Cynthia 
Published: May 2017

PurposeThis study examined adult students’ perspectives on what characteristics make for successful teaching and learning environments in the adult student classroom.MethodologyOne hundred and thirty-two adult students (ranging in age from 22 to 70) participated in a mixed methods (quantitative and qualitative) survey.FindingsAdult students seem to prefer instructors with knowledge and respect for adult learners, applied experience in the fields in which they teach, and those who have clear communication, and are fair and understanding. Participants viewed not understanding or respecting adult students and being arrogant or condescending as problematic characteristics for instructors to have.
Effect of atypical antipsychotics on body weight in geriatric psychiatric inpatients
Authors: Yeung Eugene YH , Chun Soojin , Douglass Alan , Lau Timothy E 
Published: May 2017

Background: Studies suggest that antipsychotic-induced weight gain is not a great concern in the elderly population. This study investigated the weight change in elderly patients with various treatment duration and antipsychotics. Part 1 of the study was to determine whether atypical antipsychotics induced weight change in elderly patients. Part 2 was to determine whether certain atypical antipsychotics induced more weight change in elderly patients. Methods: In Part 1, a retrospective chart review was done on 115 geriatric inpatients. After exclusion, patients were divided into four groups: control ( n = 17), new treatment ( n = 18), long-term treatment ( n = 13), and medication switch groups ( n = 8). In Part 2, a retrospective medication review was performed on 169 geriatric inpatients. After exclusion, patients were divided into three groups: aripiprazole ( n = 18), olanzapine ( n = 49), and risperidone ( n = 57). Body weights were obtained at two different time points. Results: No significant difference in weight change was observed among the control (1.5 kg), new treatment (0.8 kg), long-term treatment (−0.3 kg), and medication switch (1.9 kg) groups. No significant difference in weight change was observed between patients with and without dementia (0.8 and 1.1 kg, respectively). The weight change in the aripiprazole group (−2.0 kg; −2.30% from baseline) was significantly different from the weight change in the olanzapine group (0.7 kg; 1.87% from baseline; p < 0.05), but not from the risperidone group (−0.4 kg; −0.45% from baseline). Clinically significant weight gain (>7% increase in body weight) occurred in 14.3% of the olanzapine patients, a percentage significantly higher than the 3.5% in the risperidone group. Conclusion: Although atypical antipsychotics were generally weight neutral in the geriatric population, aripiprazole and olanzapine were associated with significant weight loss and weight gain, respectively.
Prevalence of Rotator Cuff Atrophy and Fatty Infiltration in Patients Undergoing Total Shoulder Arthroplasty
Authors: Naimark Micah , Berliner Jonathan , Zhang Alan L , Davies Michael , Ma C Benjamin , Feeley Brian T 
Published: May 2017

Background Rotator cuff fatty infiltration and atrophy are risk factors for worse outcomes after total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the prevalence of preoperative fatty infiltration and atrophy in TSA patients compared to control patients without glenohumeral osteoarthritis. Methods We retrospectively identified 30 patients undergoing TSA for primary glenohumeral arthritis who had preoperative magnetic resonance imaging. TSA patients were matched by age and sex with control patients without arthritis or full-thickness rotator cuff tears. Blinded observers graded fatty infiltration of the 4 rotator cuff muscles and measured supraspinatus atrophy by the occupation ratio. A multivariate analysis was used to correlate arthritis, age, sex, and body mass index with rotator cuff atrophy and fatty infiltration. Results Goutallier grade ≥ 2 fatty infiltration was seen in at least one muscle for 13/30 (43%) TSA patients and 1/30 (3%) control patients ( P < .01). The average supraspinatus fossa occupation ratio was 0.72 ± 0.24 in the TSA group compared to 0.92 ± 0.23 for controls ( P < .01). Moderate to severe supraspinatus muscle atrophy (occupation ration < 0.6) was observed in 10/30 (33%) TSA patients and 0/30 (0%) controls. Glenohumeral arthritis was an independent predictor of atrophy and fatty infiltration ( P < .01). Age, sex, and body mass index were not significantly correlated with atrophy or fatty infiltration. Conclusion Glenohumeral arthritis is associated with rotator cuff atrophy and fatty infiltration. In the absence of rotator cuff tendon tearing, glenohumeral arthritis may contribute to the pathophysiology of rotator cuff muscle degeneration.
Clonal hematopoiesis, with and without candidate driver mutations, is common in the elderly
Authors: Zink Florian , Stacey Simon N. , Norddahl Gudmundur L. , Frigge Michael L. , Magnusson Olafur T. , Jonsdottir Ingileif , Thorgeirsson Thorgeir E. , Sigurdsson Asgeir , Gudjonsson Sigurjon A. , Gudmundsson Julius , Jonasson Jon G. , Tryggvadottir Laufey , Jonsson Thorvaldur , Helgason Agnar , Gylfason Arnaldur , Sulem Patrick , Rafnar Thorunn , Thorsteinsdottir Unnur , Gudbjartsson Daniel F. , Masson Gisli , Kong Augustine , Stefansson Kari 
Published: May 2017

Key Points
Whole-genome sequencing of 11 262 Icelanders reveals that clonal hematopoiesis is very common in the elderly. Somatic mutation of some genes is strongly associated with clonal hematopoiesis, but in most cases, no driver mutations were evident.
Oophoropexy for ovarian torsion: a new easier technique
Authors: Hosny Tamer A. 
Published: May 2017

Abstract
Background
Oophoropexy for ovarian torsion is easy to be done by many tools either suturing to the lateral pelvic wall, plication of the ovarian ligament or even fixation to the back of the uterus, but it is little bit difficult to do it for pregnant women with less manipulation.

Objective
We propose that using trocar site closure needle can be easier and faster technique to do this. To assess the feasibility of using the trocar site closure needle to do oophoropexy in ovarian torsion and its possible applicability.

Patients
Seven patients presented with ovarian torsion; four of them were pregnant at 7, 15, 19 and 20 weeks of gestation, two patients with ovarian hyperstimulation in IVF cycles and one adolescent patient with hemorrhagic cyst. They were diagnosed by clinical presentation and ultrasound with Doppler analysis, and confirmed by laparoscopy where they underwent detorsion and fixation of the ovary using the trocar site closure needle.

Results
Follow up of all the cases after one week showed improvement of the symptoms and normal Doppler flow of the target ovary then after three weeks by ultrasonography which revealed normal Doppler flow in the previously torsioned ovary. Two pregnant women underwent cesarean delivery where the operated ovary was observed during the delivery and was normal in shape and freely mobile with no adhesions.

Conclusion
We propose that this technique is easier, faster and more comfortable especially in ovarian torsion in pregnant women and torsion in hyperstimulated ovaries.
Cochlear implant electrode sealing techniques and related intracochlear pressure changes
Authors: Todt Ingo , Utca Julica , Karimi Dania , Ernst Arne , Mittmann Philipp 
Published: May 2017

Background The inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage. In a surgically hearing preservational concept, low intracochlear pressure changes are of high importance. The aim of this study was to observe intracochlear pressure changes due to different sealing techniques in a cochlear model. Methods Cochlear implant electrode insertions were performed in an artifical cochlear model and the intracochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude of intracochlear pressure. Four different sealing conditions were compared: 1) overlay, 2) overlay with fascia pushed in, 3) donut-like fascia ring, 4) donut-like fascia ring pushed in. Results We found statistically significant differences in the occurrence of maximum amplitude of intracochlear pressure peak changes related to sealing procedure comparing the different techniques. While the lowest amplitude changes could be observed for the overlay technique (0.14 mmHg ± 0.06) the highest values could be observed for the donut-like pushed in technique (1.79 mmHg ± 0.69). Conclusion Sealing the electrode inserted cochlea can lead to significant intracochlear pressure changes. Pushing in of the sealing tissue cannot be recommended.
A phase III randomized clinical trial (RCT) of tandem myeloablative autologous stem cell transplant (ASCT) using peripheral blood stem cell (PBSC) as consolidation therapy for high-risk neuroblastoma (HR-NB): A Children's Oncology Group (COG) study.
Authors: Park Julie R. , Kreissman Susan G. , London Wendy B. , Naranjo Arlene , Cohn Susan Lerner , Hogarty Michael D. , Tenney Sheena Cretella , Haas-Kogan Daphne , Shaw Peter John , Geiger James Duncan , Doski John J , Gorges Sandra Wooton , Khanna Geetika , Voss Stephan D. , Maris John M. , Grupp Stephan A. , Diller Lisa 
Published: May 2017

LBA3 Background: ASCT improves event-free survival (EFS) for HR-NB. Pilot studies suggest that intensification of myeloablative therapy using tandem ASCT further improves outcome for HR-NB. We conducted a multicenter RCT comparing tandem vs. single consolidation in patients with HR-NB. Methods: Between 11/2007 and 2/2012, 652 eligible patients (pts) with newly diagnosed HR-NB received induction therapy: 6 cycles of chemotherapy including initial 2 cycles of dose-intensive cyclophosphamide/topotecan followed by PBSC collection. Randomization occurred at end induction to single ASCT with carboplatin-etoposide-melphalan (CEM) or tandem ASCT with thiotepa–cyclophosphamide ASCT followed by a modified CEM (TC:CEM). HR pts with non-MYCN amplified Stage 3 (age>18mos) or Stage 4 (age 12-18 mos) tumors were non-randomly assigned to single ASCT (CEM). EFS and overall survival (OS) were analyzed as intent-to-treat. Results: Median age at study entry was 3.1 yrs, 88% (n=574 pts) had Stage 4 disease and 38.2% (n=249 tumors) had MYCN amplification. A total of 355 pts were randomized (CEM n=179 pts; TC:CEM n=176 pts) and 27 patients were non-randomly assigned to CEM. Of randomized pts, 249 patients received post-consolidation immunotherapy on COG trials. Treatment-related mortality was 2.6% (Induction n=7 [1%]; Consolidation n=10 [2.8%; n=8 CEM, n=2 TC:CEM]). Rates of severe mucosal, infectious or liver toxicities were similar between arms. 3-year EFS and OS from diagnosis were 51.1±2.0% and 68.2±1.9%, respectively. EFS and OS for randomized cohort are shown in the Table. Conclusions: Tandem myeloablative consolidation therapy improves survival probability in patients with high-risk neuroblastoma, especially in the setting in post-consolidative immunotherapy. Clinical trial information: NCT00567567. [Table: see text]
Phylogeny of the tribes Juanulloeae and Solandreae (Solanaceae)
Authors: Orejuela Andrés , Wahlert Gregory A. , Orozco Clara Inés , Barboza Gloria , Bohs Lynn 
Published: May 2017

AbstractThe tribe Juanulloeae is composed of seven to nine Neotropical genera of lianas and epiphytic or terrestrial shrubs that exhibit a wide variety of floral morphologies and pollination syndromes. Their commonly epiphytic habit in the forest canopy and relatively infrequent flowering has resulted in few and fragmentary specimens and has complicated taxonomic study of the tribe so that many of its genera remain poorly understood. Solandra, currently included in the monotypic tribe Solandreae, is morphologically very similar to the Juanulloeae but its phylogenetic affinities are unclear. In this study, a phylogeny of the Juanulloeae and Solandra was inferred from maximum parsimony and Bayesian analyses of nuclear and plastid DNA sequences (ITS, waxy, trnT‐trnF, rps16‐trnK). Solandra was strongly supported as sister to the Juanulloeae and the two tribes are combined here under the older name Solandreae. Many genera within the group, notably Juanulloa, Markea, and Trianaea, are not monophyletic as currently circumscribed. We review the morphological characteristics of the genera and clades in light of the phylogenetic evidence presented here and highlight the need to re‐evaluate the morphological characters used to delimit genera of the tribe. On the basis of our results, we propose to (1) broaden the circumscription of tribe Solandreae to include tribe Juanulloeae, (2) recognize nine genera in the Solandreae, including the reinstatement of Poortmannia and Hawkesiophyton, and (3) make two new species‐level combinations, propose one new species‐level synonym, and designate a lectotype for Trianaea neovisae.
Incentives in Contests with Heterogeneous Solvers
Authors: Körpeoğlu Ersin , Cho Soo-Haeng 
Published: May 2017

In a contest in which solvers with heterogeneous expertise exert effort to develop solutions, a recent paper [Terwiesch C, Xu Y (2008) Innovation contests, open innovation, and multiagent problem solving. Management Sci. 54(9):1529–1543] argues that as more solvers enter the contest, every solver will reduce effort due to a lower probability of winning the contest. This paper corrects mistakes in this theory, and shows that there exist high-expertise solvers who may raise their effort in response to increased competition. This is because more entrants raise the expected best performance among other solvers, creating positive incentives for solvers to exert higher effort to win the contest. Because of this positive effect, we find that a free-entry open contest is more likely to be optimal to a contest organizer than what Terwiesch and Xu (2008) and other prior literature asserted. The e-companion is available at https://doi.org/10.1287/mnsc.2017.2738 . This paper was accepted by Gad Allon, operations management.
Tests, scans and investigations, 10. Hydrogen breath test
Authors: Peate Ian 
Published: May 2017

There are several procedures that are undertaken in order to help make a diagnosis or to assess a patient's response to treatment, or their disease progression. Hydrogen breath testing is one of these procedures. This test is used widely; it is a non-invasive way to assist with the diagnosis of a number of conditions. The test investigates the pathophysiology of functional gastrointestinal disorders. This article provides the reader with an overview of the hydrogen breath, with a focus on the procedure and a discussion of the role and function the healthcare assistant and the assistant practitioner (HCA and AP) play in relation to this procedure.