bluuebunny/crossref_metadata_2025_split huggingface dataset:
Passive downdraught evaporative cooling wind-towers: A case study using simulation with field-corroborated results
Authors: Kassir Radwan M 
Published: September 2015

Passive downdraught evaporative cooling wind-towers (cool-towers) have received special interests for their energy saving potential. Improving their performance and broadening their use will therefore be environmentally and economically beneficial. This paper presents a case study where cool-towers are designed and constructed to provide cool air to the semi-open courtyards of the Princess Nora University campus located in the hot, arid region of Riyadh, KSA. Each courtyard is served by two cool-towers, each of 30 m2 cross-sectional area, 32.8 m height. A brief on the system design is provided. The cool-towers performance is investigated through computational fluid dynamics simulation. Temperature and velocity profiles indicate an induced, cooler air breeze in the courtyard; outside air is cooled from 46℃ to 34–38℃, while the induced space velocity ranges from 1.5 to 3.5 m/s. A 560 kW cooling capacity is attained per tower. A substantial energy saving of around 3.30E+05 kW-h per courtyard per season is achieved. The expended energy associated with the used water is only 1% of the saved cooling energy. The normalized water consumption is around 0.04 kg/s per 100 kW cooling. The effect of distance between the towers on their performance is examined. The predicted performance is corroborated through field measurements. Practical application: This article looks at a new breed of cooling wind-towers, which artfully blend the traditional principles behind a wind catcher with today’s technological advances. It tackles a study case where cool-towers are designed to cool outdoor courtyards across the Princess Nora Bint Abdul Rahman University (PNU) in Riyadh, Saudi Arabia. Using CFD, we find that the cool-towers are capable of generating a relatively comfortable zone in the courtyard. The result is an effective, power-efficient piece of technology that transforms the campus environment and the outdoor experience for students. The PNU cooling wind-towers are exceptional power savers, and demonstrate the power of tradition working in tandem with engineering ingenuity.
Visual health awareness, the Scottish community optometry service and Eyecare Integration Project: Breaking barriers in preventing visual impairment
Authors: Cheng Mei-Ling , Henderson Clair , Sinclair Anne , Sanders Roshini 
Published: September 2015

There are 34,492 registered with severe or partial sight impairment in Scotland, with 75% aged over 65. With the ageing population, the proportion of those who will develop sight impairing disease will only increase. Therefore, early presentation and treatment are important. Recently, new sight saving treatments and community screening programmes for sight impairing disease have been introduced with concomitant advance in ophthalmic digital imaging. In order to assess older patients’ attendance of free eye tests, awareness of different sight impairing disease and treatments. We describe the first electronic visual healthcare system within any global public healthcare service – ‘The Scottish Eyecare Integration Project’ – and potential improvements along with the General Ophthalmic Service (GOS) contract. A 14-point questionnaire was devised to assess 100 patients’ awareness of free annual eye tests, and the three most common causes and treatment for severe sight impairment: age-related macular degeneration (ARMD), glaucoma, and diabetic retinopathy (DR). In all, 82% of patients were aware of the free annual eye tests; however, 31% had not attended community optometrist for over 2 years. There was good awareness of glaucoma (77%), but poor understanding of glaucoma treatment (24%), ARMD (43%) and ARMD treatment (17%). Only 39% of patients had heard of free annual DR screening, but there was a significant difference between the two groups ( p = .0263), with increased awareness in the middle-aged group. More education is required to encourage the older population to use existing and new eye services. The Scottish Eyecare Integration Project along with the GOS contract is a significant step of change towards meeting the demand for a multidisciplinary approach, bringing ophthalmic care closer to home and into the community.
Progressive multi-component home-based physical therapy for deconditioned older adults following acute hospitalization: a pilot randomized controlled trial
Authors: Stevens-Lapsley Jennifer E , Loyd Brian J , Falvey Jason R , Figiel Greg J , Kittelson Andrew J , Cumbler Ethan U , Mangione Kathleen K 
Published: September 2015

Objective: To determine whether a progressive multicomponent physical therapy intervention in the home setting can improve functional mobility for deconditioned older adults following acute hospitalization. Design: Randomized controlled trial. Setting: Patient homes in the Denver, CO, metropolitan area. Participants: A total of 22 homebound older adults age 65 and older (mean ± SD; 85.4 ±7.83); 12 were randomized to intervention group and 10 to the control group. Intervention: The progressive multicomponent intervention consisted of home-based progressive strength, mobility and activities of daily living training. The control group consisted of usual care rehabilitation. Measurements: A 4-meter walking speed, modified Physical Performance Test, Short Physical Performance Battery, 6-minute walk test. Results: At the 60-day time point, the progressive multicomponent intervention group had significantly greater improvements in walking speed (mean change: 0.36 m/s vs. 0.14 m/s, p = 0.04), modified physical performance test (mean change: 6.18 vs. 0.98, p = 0.02) and Short Physical Performance Battery scores (mean change: 2.94 vs. 0.38, p = 0.02) compared with the usual care group. The progressive multicomponent intervention group also had a trend towards significant improvement in the 6-minute walk test at 60 days (mean change: 119.65 m vs. 19.28 m; p = 0.07). No adverse events associated with intervention were recorded. Conclusions: The progressive multicomponent intervention improved patient functional mobility following acute hospitalization more than usual care. Results from this study support the safety and feasibility of conducting a larger randomized controlled trial of progressive multicomponent intervention in this population. A more definitive study would require 150 patients to verify these conclusions given the effect sizes observed.
Combination of radiofrequency ablation with transarterial chemoembolization for treatment of hepatocellular carcinoma: experience from a Danish tertiary liver center
Authors: Bharadwaz Arindam , Bak-Fredslund Kirstine Petrea , Villadsen Gerda Elisabeth , Nielsen Jens Erik , Simonsen Kira , Sandahl Thomas Damgaard , Grønbæk Henning , Nielsen Dennis Tønner 
Published: September 2015

Background Recent studies have shown that the combination of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC) may offer a survival advantage compared to monotherapy. Purpose To study the effectiveness of combination therapy with RFA and TACE compared to that of TACE alone in a Scandinavian tertiary liver cancer center. Material and Methods A retrospective study of the patients treated with combination therapy vis-à-vis TACE alone from June 2007 to November 2012 was performed. Eighteen patients were treated with a combination of RFA and TACE with an interval of 1–4 days between the treatments. For comparison, a group of 18 patients treated with TACE as monotherapy in the same time period was matched with the combination group by demographic data, tumor characteristics, biochemical and clinical parameters, and performance status (PS). Results Each group consisted of 14 patients with cirrhosis and four without. There were no significant differences between the groups regarding age, gender, tumor characteristics, causes of cirrhosis, levels of bilirubin, creatinine, prothrombin time, Child Pugh score, or World Health Organization (WHO) performance status. The median survival of patients in the RFA + TACE combination group was 586 days compared to 296 days in the control group. The difference was not statistically significant ( P = 0.26). However, when we stratified the data for cirrhosis and WHO performance status, patients in the combination group had significantly better survival ( P = 0.024). Conclusion Combination therapy with RFA and TACE for unresectable HCC, compared to TACE alone, may offer a survival benefit for a selected group of patients with HCC.
Evaluation of rapid immunochromatographic tests for norovirus in neonatal and infant faecal specimens
Authors: Takahashi Nobumasa , Nojima Ikuko , Araki Tooru , Takasugi Mizue , Sakane Tomoko , Kodera Aya , Ikeda Masanori , Tsukahara Hirokazu 
Published: September 2015

Objectives To compare the diagnostic performance of two norovirus rapid immunochromatographic kits (QuickNavi®-Norovirus [QN] and QuickNavi®-Norovirus 2 [QN2]; Denka Seiken, Niigata, Japan) for neonatal and infant faecal specimens. Methods Monthly faecal samples were collected from infants from birth to 12 months of age, and tested for norovirus using QN and QN2. Real-time reverse transcription polymerase chain reaction (RT–PCR) was used as the gold standard for norovirus detection. The diagnostic performance of the kits was calculated. Results A total of 343 specimens from 81 infants were analysed. In all samples, the specificity of QN and QN2 was 80% (275/343) and 99% (339/343), respectively. In infants aged <1 month, the specificity of QN was 33% (23/70), increasing to 93% at 4 months of age. Specificity of QN2 was ≥94% in infants between 0 and 12 months of age. Conclusions QN2 offers improved performance and is more useful than QN for the diagnosis of norovirus infection in the neonatal and infant period.
Deepening Trochleoplasty With a Thick Osteochondral Flap for Patellar Instability
Authors: McNamara Iain , Bua Nelson , Smith Toby O. , Ali Khameinei , Donell Simon T. 
Published: September 2015

Background: In patients with patellar instability and severe trochlear dysplasia, trochleoplasty has become increasingly used as part of its surgical management. Hypothesis: Deepening trochleoplasty for severe dysplasia in patellofemoral instability improves function and increases sports participation. Study Design: Case series; Level of evidence, 4. Methods: Between 1995 and 2010, deepening trochleoplasty with a thick flap was performed in 90 patients (107 knees) with severe trochlear dysplasia. Data were collected prospectively preoperatively, at 6 weeks, and at 1-year follow-up. The patients were surveyed retrospectively to determine the clinical and functional outcomes including sports and exercise participation at a minimum of 2 years, with complete data available in 92%. Results: The average follow-up was 6 years (range, 2-19 years). The median Kujala score was 63 (interquartile range [IQR], 47-75) preoperatively, rising to 79 (IQR, 68-91) at 1-year follow-up and 84 (IQR, 73-92) at final follow-up ( P < .05). Seventy-two percent were satisfied with their knee function at 1-year follow-up, rising to 83% at final follow-up ( P < .0001). Sports and exercise participation increased from 36 patients (40%) preoperatively to 60 (67%) at final follow-up. The number of patients involved in competitions increased slightly from 10 (11%) to 11 (12%). Of those sports that involved twisting (eg, soccer, cricket, badminton), the number of patients participating increased from 16 (18%) to 22 (24%), whereas in nontwisting sports (eg, running, swimming, cycling), it increased from 24 (27%) to 47 (52%), of whom 12 (16%) used walking as exercise. Two patients who had undergone medial patellofemoral ligament (MPFL) reconstruction as the index operation needed the MPFL revised, and a further 8 patients needed MPFL reconstruction subsequently for instability symptoms and a mediolateral glide in extension of more than 2 quadrants’ displacement. At final follow-up, no patient had mechanical patellofemoral instability. Conclusion: Deepening trochleoplasty with a thick flap improves clinical and functional outcomes for patients with symptomatic patellar instability with severe trochlear dysplasia. These results improve over time and beyond 1-year clinical follow-up. However, trochleoplasty does not lead to a significant improvement in sports participation at a competitive level. It does improve patient participation in sports and exercise, principally in nontwisting sports activities.
Moving It Along: A study of healthcare professionals’ experience with ethics consultations
Authors: Crigger Nancy , Fox Maria , Rosell Tarris , Rojjanasrirat Wilaiporn 
Published: September 2015

Background: Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them. Objectives: The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals. Design and Method: The researchers in this study used a constructivist grounded theory approach that represents how one group of professionals experienced ethics consultations in their hospital in the United States. Results: The results were sufficient to develop an initial theory that has been named after the core concept: Moving It Along. Three process stages emerged from data interpretation: moral questioning, seeing the big picture, and coming together. It is hoped that this initial work stimulates additional research in describing and understanding the complex social process that occurs for healthcare professionals as they address the difficult moral issues that arise in clinical practice.
Dying With Dyspnea in the Hospital
Authors: Morris Deborah , Galicia-Castillo Marissa 
Published: September 2015

Background: While many patients hope to die at home, many die in hospitals. Patients die with unrecognized and untreated symptoms including dyspnea. Objective: We sought to determine prevalence of dyspnea at end of life in patients dying in acute hospital care and examine treatment patterns. Design/Participants: A retrospective chart review of deaths at tertiary care hospital over a 3-month period evaluated dyspnea in last 24 hours of life, opioid orders and administration as well as presence of palliative care consultation. Results: Of 106 decedents, 88 experienced dyspnea or tachypnea in last 24 hours of life. Health care providers noted only 50% as dyspneic, even those undergoing terminal comfort extubation. Almost all patients with dyspnea documented by staff had orders and received opioids; however, few orders described treatment specifically for dyspnea. Patients with palliative care consultations more often received opioids ( P = .0007), and opioid orders more often specified treatment of dyspnea ( P = .013). Conclusion: These findings support that previous work noting many patients experience dyspnea at end of life. Despite national guidelines, health care providers may still be underrecognizing and likely not optimally treating dyspnea at the end of life in the hospital. Collaboration with palliative medicine providers may improve assessments and treatments for quality end-of-life care for hospitalized patients.
Cross-Sectional Contrast Between Individuals With Foot/Ankle vs Knee Osteoarthritis for Obesity and Low Education on Health-Related Quality of Life
Authors: Perruccio Anthony V. , Gandhi Rajiv , Lau Johnny T. C. , Syed Khalid A. , Mahomed Nizar N. , Rampersaud Y. Raja 
Published: September 2015

Background: Improving health-related quality of life (HRQoL) necessitates an understanding of the influence of patient characteristics on, and interrelationship among, HRQoL domains. In osteoarthritis (OA), these associations have predominantly been examined in hip/knee populations. We investigated whether there were differences in these associations between foot/ankle and knee OA samples. Methods: Individuals seeking orthopedic care for foot/ankle or knee OA completed a questionnaire pre-consultation, including HRQoL domains (bodily pain [BP], physical [PF] and social functioning [SF], and mental [MH] and general health [GH]), obesity, comorbidity, and sociodemographic characteristics. Associations were examined via stratified path analysis (foot/ankle vs knee). Foot/ankle: n = 180, mean age = 55 (range: 25 to 82), 52% female. Knee: n = 253, mean age = 62 (range: 26 to 92), 51% female. Results: The interrelationship among HRQoL domains was generally similar between groups. However, the influence of patient characteristics differed. Low educational status was associated with worse scores for GH, MH, and SF in the foot/ankle group, whereas no significant effects were found in the knee group. Obesity was associated with worse scores for SF, BP, and GH in the foot/ankle compared to the knee group. Patient characteristics explained considerably more of the variation in domain scores in the foot/ankle group. Conclusion: There are significant differences in the impact of patient characteristics on HRQoL domains in foot/ankle versus knee OA patients. Therefore, a universal approach to patient education/intervention to improve HRQoL in lower-extremity OA is not likely to achieve optimal results. Based on these findings, we recommend joint-specific patient education, with a particular emphasis on patient characteristics among the foot/ankle OA population. Level of Evidence: Level III, retrospective comparative study.
Upper limb joint position sense during shoulder flexion in healthy individuals: a pilot study to develop a new assessment method
Authors: Glendon Kerry , Hood Victoria 
Published: September 2015

Background Altered shoulder joint position sense (JPS) following shoulder injury has been demonstrated in the literature and may increase the risk of injury. A JPS assessment targeting the shoulder will provide the clinician with an objective marker. The present study aimed to develop an assessment method of JPS using an active relocation test (ART). Methods In total, 40 healthy participants were recruited. A laser-pointer attached to the index finger during an ART allowed measurement (mm) of JPS by measuring the distance between the target and relocated position. Participants were blindfolded and stood an arm’s length (approximately 1 m) away from the wall. Whilst keeping the wrist in neutral and elbow extended, the participant actively moved to the target position (90° glenohumeral flexion), held for 5 seconds, returned their arm to their side and actively returned to the target position. A mean was calculated from three trials to provide an ART score. Results The mean (SD) dominant and nondominant ART score was 89.2 (SD 35.5) mm (95% confidence interval = 77.87 mm to 100.5 mm) and 94.1 (34.5) mm (95% confidence interval = 83.1 mm to 105.2 mm), respectively. Arm dominance did not significantly affect ART scores. Conclusions No significant difference was demonstrated between the dominant and nondominant arm using an ART assessing JPS acuity. Further studies are needed to establish inter-rater and intra-rater reliability.
Pre-Occupancy Evaluation of Patient Satisfaction in Hospitals
Authors: van der Zwart Johan , van der Voordt Theo J. M. 
Published: September 2015

Aim: To explore analytical drawing techniques as a means to assess the attainment of preset objectives in the design phase of hospital buildings and to test ex ante if the building fits with these objectives, with a focus on view on nature, wayfinding, daylight, visibility of patient areas from reception desks, privacy, and communication between medical staff and patients, and noise reduction. Background: The impact of the build environment on user value is at the core of evidence-based design, but these values are normally only experienced by users after the building is constructed. Therefore, assessment of these values during the design phase could improve the outcome for patients. Topical Headings: An analysis of available assessment tools showed that research by drawing and the use of space syntax methods is an adequate means to visualize the strengths and weaknesses of floor plans in relation to spatial user experience. This approach is illustrated by an assessment of a nursing ward of the Deventer hospital in the Netherlands. Conclusions/Recommendations: Floor plan analysis by using space syntax techniques makes it possible to visualize various aspects of user value and supports the incorporation of usability issues in the discussion between the designer, the client, and the users during the design process. It is recommended to test the findings of the design assessment by a post-occupancy evaluation of the building-in-use and to conduct similar studies in other hospitals, as a means to build a body of knowledge for user-oriented design and management of hospital buildings.
Chronic urinary bladder torsion causing urinary incontinence in a cat
Authors: James Daniel R , Collins David , Johnson Philippa J , Marchevsky Andrew M 
Published: September 2015

Case summary A 10-month-old female spayed domestic shorthair cat was presented for urinary incontinence. The cat was azotaemic, and ultrasound examination identified hydroureter and hydronephrosis. Subsequent computed tomography (CT) contrast pyelography allowed a diagnosis of urinary bladder torsion. Surgical findings and treatment are described. Postoperatively, incontinence and azotaemia resolved, and marked improvements were documented with ultrasound and CT in urinary tract structural abnormalities. Relevance and novel information To our knowledge, urinary bladder torsion has not been previously reported in the cat. This case most probably occurred as a complication of ovariohysterectomy, as has been reported in the dog; however, the presenting sign of chronic urinary incontinence is unique. Response to surgical correction was favourable.
Proliferative, necrotizing and crescentic immune complex-mediated glomerulonephritis in a cat
Authors: Gross Carolyn , Cianciolo Rachel E , Lees George E , Brown Cathy A , Foster Jonathan D 
Published: September 2015

Case Summary A 5-year-old cat was examined for vomiting and anorexia of 2 days’ duration. Azotemia, hyperphosphatemia and hypoalbuminemia were the main biochemical findings. Serial analyses of the urine revealed isosthenuria, proteinuria and eventual glucosuria. Hyperechoic perirenal fat was detected surrounding the right kidney by ultrasonography. Histopathologic evaluation of ante-mortem ultrasound-guided needle biopsies of the right kidney was consistent with proliferative, necrotizing and crescentic glomerulonephritis with fibrin thrombi, proteinaceous and red blood cell casts, and moderate multifocal chronic-active interstitial nephritis. Owing to a lack of clinical improvement, the cat was eventually euthanized. Post-mortem renal biopsies were processed for light microscopy, transmission electron microscopy and immunofluorescence. This revealed severe focal proliferative and necrotizing glomerulonephritis with cellular crescent formation, podocyte injury and secondary segmental sclerosis. Ultrastructural analysis revealed scattered electron-dense deposits in the mesangium, and immunofluorescence demonstrated positive granular staining for λ light chains, consistent with immune complex-mediated glomerulonephritis. Severe diffuse acute tubular epithelial injury and numerous red blood cell casts were also seen. Relevance and novel information To our knowledge, this is the first report of naturally occurring proliferative, necrotizing and crescentic immune complex glomerulonephritis in a cat.