bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrofit solutions for solid wall dwellings in England: The impact of uncertainty upon the energy performance gap
Authors: Loucari Constantinos , Taylor Jonathon , Raslan Rokia , Oikonomou Eleni , Mavrogianni Anna 
Published: May 2016

This study seeks to evaluate the impact of uncertainty in the pre-retrofit thermal performance of solid walls of English dwellings on post-retrofit energy use. Five dwelling archetypes, broadly representative of English solid wall properties, were modelled pre- and post-retrofit, under different wall insulation scenarios, using dynamic thermal simulation. Findings indicate that whilst solid wall insulation could result in a significant reduction of space heating demand, uncertainties in the pre-retrofit solid wall U-value could lead to a gap between the anticipated and actual energy performance. Specifically, results show that if the current U-value assumption of 2.1 W/m2K is indeed an overestimation of the in-situ U-value of solid walls, then the anticipated carbon savings could be significantly reduced by up to 65%. Practical application: The performance gap observed in this study revealed that the actual carbon savings arising from the retrofit of solid wall properties could be significantly lower than predicted. This will not only affect UK Government carbon reduction targets but it can also result in a lack of confidence amongst stakeholders who may consequently doubt the effectiveness of energy retrofit measures, thus reducing their uptake. Uncertainties regarding solid wall U-values may necessitate the re-examination of the carbon targets set for the retrofit of solid wall dwellings and the exploration of alternative ways to further reduce their carbon emissions, e.g. by specifying higher insulation thicknesses.
A design and assessment of solar chimney of bioclimatic house wall and roof for construction in the housing market of Thailand
Authors: Ratanachotinun Jaran , Kasayapanand Nat , Hirunlabh Jongjit , Visitsak Sopa , Teekasap Sombat , Khedari Joseph 
Published: May 2016

This research is a design and assessment of a bioclimatic house wall and roof to be constructed in Thailand’s housing market in order to provide information for potential builders as well as the peace of mind of the owner. The research found that a bioclimatic house with a double-layered solar chimney is appropriate for use in Thailand throughout the year. It lowers the average internal temperature of the house by approximately 1–2℃ when compared to the energy-saving material used in a normal building. Bioclimatic construction also creates natural ventilation, heat removal, and can reduce indoor temperature. It also comes with an easy-to-build design to facilitate construction and can save house energy consumption. Practical application: This research provides helpful information of solar chimney wall and roof for both the owners and developers in adopting an energy-efficient house for sustainable energy conservation. A solar chimney of a bioclimatic house is a highly interesting alternative for saving energy in the long term. When properly promoted, it will help save a huge amount of energy throughout Thailand and tropical area, and serve to promote the cause of global environmental conservation into the future.
Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media
Authors: da Costa Monsanto Rafael , Erdil Mehmet , Pauna Henrique F. , Kwon Geeyoun , Schachern Patricia A. , Tsuprun Vladimir , Paparella Michael M. , Cureoglu Sebahattin 
Published: May 2016

ObjectiveTo evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media.Study DesignComparative human temporal bone study.SettingOtopathology laboratory.Subjects and MethodsTo compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy.ResultsIn the chronic otitis media group (as compared with the age‐matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P <. 05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P =. 005), but that of type II cells was not (P =. 168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P =. 014) and in the posterior semicircular canal (P =. 002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P >. 1).ConclusionThe findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.
Endoscopic Resection of Sinonasal Malignancy
Authors: Rawal Rounak B. , Farzal Zainab , Federspiel Jerome J. , Sreenath Satyan B. , Thorp Brian D. , Zanation Adam M. 
Published: May 2016

ObjectivesThe use of endoscopic approaches for sinonasal malignancy resection has increased, but survival data are limited secondary to disease rarity and new surgical technique. Here we present a systematic review and meta‐analysis of endoscopic endonasal resection of sinonasal malignancy.Data SourcesMEDLINE, PubMed Central, NCBI Bookshelf, Cochrane Library, clinicaltrials.gov, National Guideline Clearinghouse.Review MethodsPRISMA/MOOSE guidelines were followed. MeSH terms were “endoscopic” AND (“esthesioneuroblastoma” OR “sinonasal adenocarcinoma” OR “squamous cell carcinoma” OR “sinonasal undifferentiated carcinoma”). For studies in which individual‐level data were available, results were obtained by direct pooling. For studies in which only summary Kaplan‐Meier curves were available, numerical data were extracted, traced, and aggregated by fitting a Weibull model.ResultsOf 320 studies identified, 35 case series were included (n = 952 patients), with 15 studies analyzed via aggregate modeling and 20 studies analyzed via direct pooling. Two‐ and 5‐year survival rates for patients in aggregate modeling were 87.5% and 72.3%, respectively (mean follow‐up: 32.9 months). Two‐ and 5‐year survival for patients in direct pooling were 85.8% and 83.5%, respectively (mean follow‐up: 43.0 ± 19.5 months). Significant overall survival difference was found between low‐ and high‐grade cancers (P =. 015) but not between low‐ and high‐stage cancers (P =. 79).ConclusionOverall 2‐ and 5‐year survival rates are comparable and sometimes greater than those from open craniofacial resection. Survival rates significantly differ by cancer grade but not stage. Journals and investigators should be encouraged to publish retrospective and prospective case series with staged survival updates based on established guidelines.
Surgical Timing of the Orbital “Blowout” Fracture
Authors: Damgaard Olaf Ehlers , Larsen Christian Grønhøj , Felding Ulrik Ascanius , Toft Peter Bjerre , von Buchwald Christian 
Published: May 2016

ObjectiveThe orbital blowout fracture is a common facial injury, carrying with it a risk of visual impairment and undesirable cosmetic results unless treated properly. Optimal timing of the surgical treatment is still a matter of debate. We set out to determine whether a meta‐analysis would bring us closer to an answer to this question.Data SourcesPubMed, EMBASE, Web of Science, and the Cochrane Library were searched from January 1980 to August 2014. We applied the following inclusion criteria: isolated blowout fractures, presenting early and late surgery groups (<14 and >14 days). Patients were evaluated for diplopia and enophthalmos.Review MethodsWe followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel‐Haenszel.ResultsWe identified 5 studies with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P =. 027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom.ConclusionWe found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma.
Pharmacological inhibition of mannose-binding lectin ameliorates neurobehavioral dysfunction following experimental traumatic brain injury
Authors: De Blasio Daiana , Fumagalli Stefano , Longhi Luca , Orsini Franca , Palmioli Alessandro , Stravalaci Matteo , Vegliante Gloria , Zanier Elisa R , Bernardi Anna , Gobbi Marco , De Simoni Maria-Grazia 
Published: May 2016

Mannose-binding lectin is present in the contusion area of traumatic brain-injured patients and in that of traumatic brain-injured mice, where mannose-binding lectin-C exceeds mannose-binding lectin-A. The reduced susceptibility to traumatic brain injury of mannose-binding lectin double knock-out mice (mannose-binding lectin−/−) when compared to wild type mice suggests that mannose-binding lectin may be a therapeutic target following traumatic brain injury. Here, we evaluated the effects of a multivalent glycomimetic mannose-binding lectin ligand, Polyman9, following traumatic brain injury in mice. In vitro surface plasmon resonance assay indicated that Polyman9 dose-dependently inhibits the binding to immobilized mannose residues of plasma mannose-binding lectin-C selectively over that of mannose-binding lectin-A. Male C57Bl/6 mice underwent sham/controlled cortical impact traumatic brain injury and intravenous treatment with Polyman9/saline. Ex-vivo surface plasmon resonance studies confirmed that Polyman9 effectively reduces the binding of plasma mannose-binding lectin-C to immobilized mannose residues. In vivo studies up to four weeks post injury, showed that Polyman9 induces significant improvement in sensorimotor deficits (by neuroscore and beam walk), promotes neurogenesis (73% increase in doublecortin immunoreactivity), and astrogliosis (28% increase in glial fibrillary acid protein). Polyman9 administration in brain-injured mannose-binding lectin−/− mice had no effect on post-traumatic brain-injured functional deficits, suggestive of the specificity of its neuroprotective effects. The neurobehavioral efficacy of Polyman9 implicates mannose-binding lectin-C as a novel therapeutic target for traumatic brain injury.
Accuracy of GFR estimating equations in a large Swedish cohort: implications for radiologists in daily routine and research
Authors: Nyman Ulf , Grubb Anders , Lindström Veronica , Björk Jonas 
Published: May 2016

Background Guidelines recommend estimation of glomerular filtration rate (eGFR) prior to iodine contrast media (CM) examinations. It is also recommended that absolute eGFR in mL/min, not commonly used relative GFR (adjusted to body surface area; mL/min/1.73 m2), should be preferred when dosing and evaluating toxicity of renally excreted drugs. Purpose To validate the absolute Lund–Malmö equation (LM-ABS) in comparison with the absolute Cockcroft–Gault (CG) equation and the relative equations, revised Lund–Malmö (LM-REV), MDRD, and CKD-EPI, after converting relative estimates to absolute values, and to analyze change in eGFR classification when absolute instead of relative eGFR was used. Material and Methods A total of 3495 plasma clearance of iohexol to measure GFR (mGFR) served as reference test. Bias, precision, and accuracy (percentage of estimates ±30% of mGFR; P30) were compared overall and after stratification for various mGFR, eGFR, age, and BMI subgroups. Results The overall P30 results of CG/LM-ABS/LM-REV/MDRD/CKD-EPI were 62.8%/84.9%/83.7%/75.3%/75.6%, respectively. LM-ABS was the most stable equations across subgroups and the only equation that did not exhibit marked overestimation in underweight patients. For patients with relative eGFR 30–44 and 45–59 mL/min/1.73 m2, 36% and 58% of men, respectively, and 24% and 32% of women, respectively, will have absolute eGFR values outside these relative eGFR intervals. Conclusion Choosing one equation to estimate GFR prior to contrast medium examinations, LM-ABS may be preferable. Unless absolute instead of relative eGFR are used, systematic inaccuracies in assessment of renal function may occur in daily routine and research on CM nephrotoxicity may be flawed.
Long-term effectiveness of sphenopalatine ganglion stimulation for cluster headache
Authors: Jürgens Tim P , Barloese Mads , May Arne , Láinez Jose Miguel , Schoenen Jean , Gaul Charly , Goodman Amy M , Caparso Anthony , Jensen Rigmor Højland 
Published: May 2016

Objectives The sphenopalatine ganglion (SPG) plays a pivotal role in cluster headache (CH) pathophysiology as the major efferent parasympathetic relay. We evaluated the long-term effectiveness of SPG stimulation in medically refractory, chronic CH patients. Methods Thirty-three patients were enrolled in an open-label follow-up study of the original Pathway CH-1 study, and participated through 24 months post-insertion of a microstimulator. Response to therapy was defined as acute effectiveness in ≥ 50% of attacks or a ≥ 50% reduction in attack frequency versus baseline. Results In total, 5956 attacks (180.5 ± 344.8, range 2–1581 per patient) were evaluated. At 24 months, 45% ( n = 15) of patients were acute responders. Among acute responders, a total of 4340 attacks had been treated, and in 78% of these, effective therapy was achieved using only SPG stimulation (relief from moderate or greater pain or freedom from mild pain or greater). A frequency response was observed in 33% ( n = 11) of patients with a mean reduction of attack frequency of 83% versus baseline. In total, 61% (20/33) of all patients were either acute or frequency responders or both. The majority maintained their therapeutic response through the 24-month evaluation. Conclusions In the population of disabled, medically refractory chronic CH patients treated in this study, SPG stimulation is an effective acute therapy in 45% of patients, offering sustained effectiveness over 24 months of observation. In addition, a maintained, clinically relevant reduction of attack frequency was observed in a third of patients. These long-term data provide support for the use of SPG stimulation for disabled patients and should be considered after medical treatments fail, are not tolerated or are inconvenient for the patients.
Drug Information — The Problems and Some Solutions
Authors: Conner Christopher S. , Watanabe Arthur S. , Rumack Barry H. 
Published: May 2016

Several problems evident in the drug information delivery process and some solutions are presented. Major problems with current sources of drug information are accessibility of data, completeness of data, validity of information, appropriateness in the clinical setting, and currency. Better drug information sources are needed to provide rapid answers to patient-related questions routinely occurring in the clinical setting. Currently available mechanisms described to solve existing drug information problems are clinical pharmacologists and specialists, clinical pharmacists, drug information centers, and a computer-output microfiche drug information system (DRUGDEX®).
Antibiotic Sensitivity of Penicillin - Resistant Staphylococcus aureus in three midwestern family practice populations
Authors: Helling Dennis K. , Jones Mark E. , Majhanovich John J. , Massad Susan 
Published: May 2016

Penicillin-resistant Staphylococcus aureus is commonly seen in hospital settings. Recent evidence suggests similar trends in community settings. This study was conducted to determine the incidence of nasal carriage and antibiotic sensitivity patterns of S. aureus in non-hospitalized patients from three midwestern family practice offices. The effect of geographic location of the clinics on nasal carriage and antimicrobial sensitivities was investigated. The following participant variables were analyzed to determine their correlation with nasal carriage and penicillin sensitivity patterns: age, sex, last hospitalization, previous antimicrobial usage, patient or family member employment in a health care facility, and the number of household members. Swabs of the anterior nares were collected from 462 ambulatory patients seen at the three family practice offices. Of these patients, 155 (33.5 percent) were shown to be carriers of S. aureus; 89 percent of the S. aureus isolates were resistant to penicillin. Significant numbers of organisms were also found resistant to tetracycline (22 percent) and sulfadiazine (78 percent). No significant correlations were found between the participant variables and the sensitivity of S. aureus to penicillin or carriage of the organism, nor were there any significant differences between clinics. Penicillinase-resistant penicillins and erythromycin are recommended for use in suspected staphylococcal skin infections.
Serum Digoxin Concentrations in Atrial Fibrillation: A Review
Authors: Masuhara Joy E. , Lalonde Richard L. 
Published: May 2016

Studies evaluating the relationship of serum digoxin concentrations (SDCs) with pharmacodynamic effects in atrial fibrillation have important limitations. In general, a poor correlation is found between SDC and ventricular rate, but this is understandable, considering the many other factors that affect conduction through the atrioventricular node. The ventricular rate, although a clinically important and easily monitored parameter, may not always be a good measure of digoxin effect. In certain patients, signs and symptoms of toxicity may develop before the desired decrease in heart rate. The SDC may provide, in many cases, information that cannot be obtained solely from the clinical response, but is of great relevance to therapeutic decision making.
An Education Program That Improves the Psychomotor Skills Needed for Metaproterenol Inhaler Use
Authors: O'Bey Kimberly A. , Jim Lucia K. , Gee Joseph P. , Cowen Mark E. , Quigley Anne E. 
Published: May 2016

This is the first report assessing an education program's impact on teaching patients the psychomotor skills needed for proper use of the metaproterenol inhaler. Most patients do not use pressurized inhalers correctly. This inability could lead to suboptimal or ineffective therapy. Pharmacists provided a standardized education program to asthma patients and to those with chronic obstructive pulmonary disease for three clinic visits. Proper use of the inhaler was assessed by evaluating the patient's psychomotor performance for each visit before and after instruction. Of 19 patients, 18 demonstrated a mean improvement of 33.5 percent from preinstruction to postinstruction evaluation at the first visit (Student's t-test, p < 0.0005). Both preinstruction and postinstruction scores demonstrated an upward trend for all three visits, the postinstruction scores always being higher than the preinstruction scores. These results indicate that our standardized education program helped improve psychomotor performance. Certain instructional aspects that need emphasis in future education programs have been identified.
Theophylline Toxicity—A Consequence of Congestive Heart Failure
Authors: LeGatt Donald F. 
Published: May 2016

A case is reported of an elderly patient with congestive heart failure (CHF), who was treated with juvenile oral doses of theophylline (Theo-Dur). The patient experienced toxic symptoms, and plasma concentrations were determined. A value of 60.6 μg/ml was reported and the theophylline administration was subsequently discontinued. Plasma concentrations and toxicity of theophylline are unpredictable in patients with CHF because of the great variability in clearance. This case demonstrates the necessity for careful monitoring of theophylline plasma levels in CHF patients.
Effect on Physician Prescribing Practices of Changing from a Qualitative to a Quantitative Antimicrobial Susceptibility Test Reporting System
Authors: Ward Thomas T. , Regner Michael J. , Collell Karen L. , Brown Ronald R. , Sewell David L. 
Published: May 2016

The use of disc diffusion susceptibility testing has been criticized because it often fails to take into consideration achievable levels of antimicrobial agents at the actual sites of infection. An increasing number of hospitals are converting from disc diffusion antimicrobial susceptibility testing to more quantitative susceptibility testing techniques. Advocates of these latter techniques have suggested that providing information beyond sensitive, intermediate, and resistant reporting will emphasize, more effectively, the importance of considering achievable antibiotic concentrations at the site of infection, when choosing an antimicrobial agent. This study examined whether providing more quantitative susceptibility test reports would affect physicians' antimicrobial prescribing practices. Results obtained on the preeducation and posteducation questionnaires indicate success in improving the collective knowledge of physicians. In retrospective audits of the appropriateness of antimicrobial use, both before and after the educational program, physician usage of antimicrobial agents was categorized as inappropriate in more than ⅔ of the cases. The major reason for the negative outcome in this study is probably due to physicians' indifference to the results of urine culture and susceptibility test data. A change was made in antimicrobial therapy after return of the susceptibility report less than 20 percent of the time. As more laboratories convert to quantitative antimicrobial susceptibility testing, there will be a need for a closer liaison among physicians, clinical pharmacists, microbiologists, and infectious disease specialists, to ensure optimum utilization of the additional susceptibility data provided.
Science: Part of the Problem, Most of the Answer
Authors: Goyan Jere E. 
Published: May 2016

The history of the drug approval process in the United States includes three phases. First, the Food and Drug Act of 1906 essentially required that the labeling of drugs be truthful. The 1938 Food, Drug, and Cosmetic Act added a requirement that drugs be proven safe, and the 1962 act added the requirement that drugs be efficacious. Each of these steps required more and more sophisticated science. Subsequent to the Kefauver-Harris Amendments of 1962, the number of innovative molecular entities each year has declined, the reasons for which have been subject to great debate. This decline has paralleled decreases in innovation across almost all American industry, leading to questions about the future of our country as an industrialized society. Both the Carter and Reagan administrations attempted to address this problem in a number of ways, including cutting back on those regulations that are perceived as unnecessary. Other innovative approaches have been used, such as the establishment of an Office of Small Manufacturers Assistance in the FDA Bureau of Medical Devices, mandated by the 1976 Medical Device Amendments. The latter came about in recognition of the fact that small businesses tend to be more creative and efficient than larger industries and more adversely affected by regulation. However, the problems raised in the regulation of technology transfer almost inevitably arise because of perceived scientific questions. Such questions, in turn, can only be answered by good science performed by the sponsor and understood by the regulator. Thus, it is essential that the FDA be staffed with knowledgeable scientists who can interact easily with their peers in academia and industry. Although science is often the cause of our troubles, it is also our only hope for minimizing the costs of new drugs and other technology. In turn, minimizing such costs will maximize the opportunities for innovation.