bluuebunny/crossref_metadata_2025_split huggingface dataset:
A medium-rise 1970s maternity hospital in the east of England: Resilience and adaptation to climate change
Authors: Short C Alan , Renganathan Giridharan , Lomas Kevin J 
Published: February 2015

The late 1970s design for the Rosie Maternity Hospital on the Addenbrookes campus in Cambridge is a recurring type across the UK National Health Service, a framed three-storey courtyard configuration in brick masonry. It was selected as a case study project for the ‘Design and Delivery of Robust Hospitals in a Changing Climate’ project, pursuing the methodology developed for that research. Temperature data were collected in representative spaces within the hospital, over a two-year period. These revealed overheating in mild conditions relative to an observed 24℃ threshold for sleep but concealed within the customary 28℃ threshold marking the upper limit of acceptable conditions. The building was modelled using current climate data to predict 2010 conditions. The model was then calibrated against the observed 2010 data and used to predict the likely internal temperatures in current and 2030s. The results indicated an increase in peak temperatures. Four adaptive intervention schemes were subsequently developed: an ‘enlightened’ industry standard ‘Passivhaus’-type option providing superinsulation, sealed glazing and heat recovery; a lower technology-based scheme promoting natural cross-ventilation by providing greater opening glazing area, opening up the plan, sunshading and additional insulation; an enhanced natural ventilation scheme glazing over the courtyards to provide supply air winter gardens, and an advanced natural ventilation option pursuing passive downdraught cooling. All four schemes were modelled using the projected current and 2030s weather data and their performance was compared. The schemes were fully costed to yield relative ‘value for money’ guidance to National Health Service Trusts. Practical application: The Heat wave Plan for England 2014 warns National Health Service (NHS) organisations of the risks to patients, particularly the very young, the elderly and the seriously ill, from extreme summer heat events.1 The Chief Medical Officer in her introduction challenges each NHS locality to plan well in advance of hot spells, as appropriate. This paper describes the likely extent of overheating risk and a series of potential adaptation plans for a recurring NHS hospital building type. As a consequence, estates and facilities decision makers in NHS organisations and Public Health England officers charged with the mitigation of risk resulting from overheating of wards and clinical spaces will benefit directly in their necessary decision making from the findings. Policy makers in the Department of Health and policy advisors in the NHS Sustainable Development Unit and the Climate Change Committee Adaptation Sub-Committee will benefit from the evidence presented in advising the NHS and Department of Health.
Diffusion-weighted imaging for evaluating lymph node eradication after neoadjuvant chemoradiation therapy in locally advanced rectal cancer
Authors: Ryu Kyeong Hwa , Kim Seung Ho , Yoon Jung-Hee , Lee Yedaun , Paik Jin Ho , Lim Yun-Jung , Lee Kwang Hwi 
Published: February 2015

Background As lymph node (LN) eradication is the prerequisite for clinical surveillance or local excision for patients who have achieved a complete response after preoperative chemoradiation therapy (CRT), the radiological evaluation of LN eradication is important. Purpose To evaluate the added value of diffusion-weighted imaging (DWI) in the evaluation of LN eradication after CRT in patients with locally advanced rectal cancer (LARC). Material and Methods Ninety-five consecutive patients (64 men, 31 women; mean age, 59 years; range, 32–82 years) who underwent pre- and post-CRT 1.5-T MRI with DWI (b = 0, 1000 s/mm2) were enrolled. To evaluate the added value of DWI in the evaluation of LN eradication after CRT, two radiologists first independently read the pre- and post-CRT T2-weighted (T2W) images and then read the combined T2W imaging set and the pre- and post-CRT DWIs with a 4-week interval. The radiologists recorded their confidence scores for LN eradication using a 5-point scale on a per-patient basis. The diagnostic performances were compared between the two reading sessions for each reader with pair-wise comparisons of receiver-operating characteristic curves. Histopathological reports served as the reference standards for LN eradication. Results The study population consisted of an LN-eradicated group ( n = 66) and a non-eradicated group ( n = 29). The diagnostic performances did not significantly differ between the two reading sessions for the two readers (AUCs for reader 1, 0.770 and 0.774, P = 0.8155; for reader 2, 0.794 and 0.798, P = 0.8588). Conclusion Adding DWI to T2W imaging provided no additional diagnostic benefit for the evaluation of LN eradication following CRT in patients with LARC.
Comparison of image quality and application values on different field-of-view diffusion-weighted imaging of breast cancer
Authors: Dong Haibo , Li Yadi , Yu Kang , Li Hui 
Published: February 2015

Background Single-shot echo planar imaging (SS-EPI) diffusion-weighted magnetic resonance imaging (DW-MRI) is the most-widely sequence in breast MRI. MRI artifacts and magnetic susceptibility are sometimes severe when this sequence is utilized at 3T. Purpose To compare the imaging quality, ADC values between SS-EPI DWI sequence and two reduced field-of-view (rFOV) DWI sequences of breast cancer. Material and Methods Twelve cases with breast cancer were scanned using SS-EPI DWI (FOV, 360 × 360 mm), rFOV DWI1 (FOV, 360 × 180 mm), and rFOV DWI2 (FOV, 280 × 140 mm), respectively. Image quality (scores 1 to 5) and ADC values of breast imaging were compared among three groups by different DWI sequences. SNR were compared between rFOV DWI1 and rFOV DWI2. Results The imaging quality score of 12 cases was 5.00 in rFOV DWI1, 3.60 in SS-EPI DWI, and 3.75 in rFOV DWI2. The mean ADC value of 12 cases was 1.211 × 10−3 mm2/s in SS-EPI DWI, 1.107 × 10–3 mm2/s in rFOV DWI1, and 1.038 × 10–3 mm2/s in rFOV DWI2. SNR of rFOV DWI1 images was much higher than that of rFOV DWI2. Conclusion rFOV DWI1 is the optimal DWI sequence in our study. Comparing with SS EPI DWI, suitable rFOV DWI has an obvious advantage, which can present higher image resolution and less distortion. It may be helpful in the diagnosis of breast cancer.
Overexpression of TGF-β via rAAV-Mediated Gene Transfer Promotes the Healing of Human Meniscal Lesions Ex Vivo on Explanted Menisci
Authors: Cucchiarini Magali , Schmidt Katharina , Frisch Janina , Kohn Dieter , Madry Henning 
Published: February 2015

Background: Direct application of therapeutic gene vectors derived from the adeno-associated virus (AAV) might be beneficial to improve the healing of meniscal tears. Purpose: To test the ability of recombinant AAV (rAAV) to overexpress the potent transforming growth factor–β (TGF-β) in primary cultures of human meniscal fibrochondrocytes, in human meniscal explants, and in experimental human meniscal lesions as a new tool to enhance meniscal repair. Study Design: Controlled laboratory study. Methods: The effects of the candidate treatment on the proliferative and metabolic activities of meniscal cells were monitored in vitro for up to 21 days and in situ in intact and injured human menisci for up to 15 days using biochemical, immunohistochemical, histological, and histomorphometric analyses. Results: Efficient production of TGF-β via rAAV was achieved in vitro and in situ, both in the intact and injured meniscus. Application of the rAAV TGF-β vector stimulated the levels of cell proliferation and matrix synthesis (type I collagen) compared with control gene transfer in all systems tested, especially in situ in regions of poor healing capacity and in sites of meniscal injury. No adverse effects of the candidate treatment were observed at the level of osseous differentiation, as tested by immunodetection of type X collagen. Most remarkably, a significant reduction of the amplitude of meniscal tears was noted after TGF-β treatment, an effect that was associated with increased expression levels of the α–smooth muscle actin contractile marker. Conclusion: Overexpression of TGF-β via rAAV gene transfer is capable of modulating the reparative activities of human meniscal cells, allowing for the healing of meniscal lesions by convenient injection in sites of injury. Clinical Relevance: Direct gene-based approaches using rAAV have strong potential to develop new therapeutic options that aim at treating human meniscal defects.
Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes
Authors: Jayanthi Neeru A. , LaBella Cynthia R. , Fischer Daniel , Pasulka Jacqueline , Dugas Lara R. 
Published: February 2015

Background: Data are lacking regarding the independent risk of injury related to intense single-sport training or growth rate in young athletes. Purpose: To determine whether sports specialization, weekly training volumes, and growth rates are associated with increased risk for injury and serious overuse injury in young athletes. Study Design: Case-control study; Level of evidence, 3. Methods: Injured athletes aged 7 to 18 years were recruited from 2 hospital-based sports medicine clinics and compared with healthy controls from affiliated primary care clinics undergoing sports physicals (2010-2013). Participants completed surveys reporting hours per week spent in organized sports, physical education class, and free play, as well as degree of sports specialization and Tanner stage. Heights and weights were measured. Injury details were obtained from athlete surveys and electronic medical records. Results: Of 1214 athletes enrolled, 1190 (50.7% male) had data satisfactory for analysis. There were 822 injured participants (49.5% male; unique injuries, n = 846) and 368 uninjured participants (55% male). Injured athletes were older than uninjured athletes (14.1 ± 2.1 vs 12.9 ± 2.6 years; P < .001) and reported more total hours of physical activity (19.6 ± 9.2 vs 17.6 ± 8.9 h/wk; P < .001) and organized sports activity (11.2 ± 2.6 vs 9.1 ± 6.3 h/wk; P < .01). After accounting for age and hours in sports activity spent per week, sports-specialized training was an independent risk for injury (odds ratio [OR], 1.27; 95% CI, 1.07-1.52; P < .01) and serious overuse injury (OR, 1.36; 95% CI, 1.08-1.72; P < .01). Young athletes participating in more hours of sports per week than number of age in years (OR, 2.07; 95% CI, 1.40-3.05; P < .001) or whose ratio of organized sports to free play time was >2:1 hours/week had increased odds of having a serious overuse injury (OR, 1.87; 95% CI, 1.26-2.76; P < .01). Growth rates were similar between injured and uninjured athletes (4.8 cm/y for both groups; P = .96). Conclusion: Injured young athletes were older and spent more hours per week in organized sports. There is an independent risk of injury and serious overuse injury in young athletes who specialize in a single sport. Growth rate was not related to injury risk. The study data provide guidance for clinicians counseling young athletes and their parents regarding injury risks associated with sports specialization.
Feasibility of Virtual Reality Environments for Adolescent Social Anxiety Disorder
Authors: Parrish Danielle E. , Oxhandler Holly K. , Duron Jacuelynn F. , Swank Paul , Bordnick Patrick 
Published: February 2015

Purpose: This study assessed the feasibility of virtual reality (VR) exposure as an assessment and treatment modality for youth with social anxiety disorder (SAD). Methods: Forty-one adolescents, 20 of which were identified as having SAD, were recruited from a community sample. Youth with and without SAD were exposed to two social virtual environments—party and public speaking—and two neutral virtual environments. Results: All youth reported significantly higher ratings on the Subjective Units of Distress Scale (SUDS) during the party and public speaking scenarios compared to the two neutral environments, while youth with SAD reported significantly higher SUDS in the public speaking and party environments than those without SAD. Youth also demonstrated acceptable levels of presence and immersion in the VR environments. Discussion: VR exposure treatment appears to be feasible for youth with SAD, highlighting the need for further research on its development.
The meaning of suffering in patients with advanced progressive cancer
Authors: Ellis Jackie , Cobb Mark , O’Connor Tina , Dunn Laurie , Irving Greg , Lloyd-Williams Mari 
Published: February 2015

Background There is a lack of research into suffering and what it means to the individual patient with advanced cancer and its importance in end of life care. Aims To explore the concept of suffering and distress by eliciting what individual patients with advanced cancer perceived as suffering and how they utilised their own resources to manage suffering. Method A qualitative study design of focused narrative interviews analysed by thematic analysis was conducted with a heterogeneous sample of 49 palliative day care patients. Results For those patients who perceived they were suffering, this study revealed a wide spectrum of definitions which could be described within the following areas; the unavoidable and avoidable suffering, physical and emotional suffering, suffering as loss and finally transformation through suffering. Conclusions These findings provide important insight that broadens and enriches our understanding into the concept of suffering and how patients utilise their resources, which may have important implications for end of life care.
Current UK practices in the management of subacromial impingement
Authors: Bryceland James K , Drury Colin , Tait Gavin R 
Published: February 2015

Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.
Prospective validation of pediatric disease severity scores to predict mortality in Ugandan children presenting with malaria and non-malaria febrile illness
Authors: Conroy Andrea L , Hawkes Michael , Hayford Kyla , Namasopo Sophie , Opoka Robert O , John Chandy C , Liles W Conrad , Kain Kevin C 
Published: February 2015

Abstract
Introduction
The development of simple clinical tools to identify children at risk of death would enable rapid and rational implementation of lifesaving measures to reduce childhood mortality globally.

Methods
We evaluated the ability of three clinical scoring systems to predict in-hospital mortality in a prospective observational study of Ugandan children with fever. We computed the Lambaréné Organ Dysfunction Score (LODS), Signs of Inflammation in Children that Kill (SICK), and the Pediatric Early Death Index for Africa (PEDIA). Model discrimination was evaluated by comparing areas under receiver operating characteristic curves (AUCs) and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. Sub-analyses were performed in malaria versus non-malaria febrile illness (NMFI), and in early (≤48 hours) versus late (>48 hours) deaths.

Results
In total, 2089 children with known outcomes were included in the study (99 deaths, 4.7% mortality). All three scoring systems yielded good discrimination (AUCs, 95% confidence interval (CI): LODS, 0.90, 0.88 to 0.91; SICK, 0.85, 0.83 to 0.86; PEDIA, 0.90, 0.88 to 0.91). Using the Youden index to identify the best cut-offs, LODS had the highest positive likelihood ratio (+LR, 95% CI: LODS, 6.5, 5.6 to 7.6; SICK, 4.4, 3.9 to 5.0; PEDIA, 4.4, 3.9 to 5.0), whereas PEDIA had the lowest negative likelihood ratio (−LR, 95% CI: LODS, 0.21, 0.1 to 0.3; SICK, 0.22, 0.1 to 0.3; PEDIA, 0.16, 0.1 to 0.3), LODS and PEDIA were well calibrated (P = 0.79 and P = 0.21 respectively), and had higher AUCs than SICK in discriminating between survivors and non-survivors in malaria (AUCs, 95% CI: LODS, 0.92, 0.90 to 0.93; SICK, 0.86, 0.84 to 0.87; PEDIA, 0.92, 0.90 to 0.93), but comparable AUCs in NMFI (AUCs, 95% CI: LODS, 0.86, 0.83 to 0.89; SICK, 0.82, 0.79 to 0.86; PEDIA, 0.87, 0.83 to 0.893). The majority of deaths in the study occurred early (n = 85, 85.9%) where LODS and PEDIA had good discrimination.

Conclusions
All three scoring systems predicted outcome, but LODS holds the most promise as a clinical prognostic score based on its simplicity to compute, requirement for no equipment, and good discrimination.
Spontaneous Formation of Gold Nanoparticles with Octa(3-aminopropyl) Polyhedral Oligomeric Silsesquioxane
Authors: Imoto Hiroaki , Ishida Katsuya , Sasaki Ai , Irie Yasuyuki , Ito Hideaki , Naka Kensuke , Chujo Yoshiki 
Published: February 2015

Abstract
Mixture of octa(3-aminopropyl) polyhedral oligomeric silsesquioxane (POSS-NH2) and tetrachloroauric(III) acid under basic condition spontaneously produced gold nanoparticles (AuNPs). The amino groups reduced Au(III) cation to Au(0) and interacted with the surface of AuNPs; POSS-NH2 worked as a reductant and a stabilizer at once. Sodium hydroxide partially hydrolyzed Si–O bonds of polyhedoral oligomeric silsesquioxane (POSS) to generate SiO− species, which stabilized AuNPs via electrostatic interparticle repulsion to avoid aggregation. Addition of hydrochloric acid neutralized the amino groups of POSS-NH2, and generated NH3+ interacted with SiO− to form aggregates. That is, pH-responsive AuNPs were prepared through the facile method.
Barriers preventing Australian midwives from providing antenatal asthma management
Authors: McLaughlin Karen , Kable Ashley , Ebert Lyn , Murphy Vanessa E 
Published: February 2015

International guidelines indicate that management of asthma during pregnancy should be multidisciplinary; however, the role of midwives has not been researched. Method: A qualitative descriptive study exploring Australian midwives' current knowledge about asthma in pregnancy and their perceived role in antenatal asthma management was conducted, involving individual semi-structured in-depth interviews with 13 midwives in a tertiary referral hospital. Data were analysed using Morse and Field's four-stage process. Findings: Midwives identified barriers preventing them from providing antenatal asthma management, including: lack of knowledge about asthma in pregnancy; time constraints; women's knowledge about asthma in pregnancy; lack of a clear referral pathway; and lack of accessible asthma management equipment. Barriers were influenced by the institutional context in which the midwives worked. Conclusion: While participants identified barriers preventing them from providing recommended antenatal asthma management, they also suggested that improving their knowledge about asthma in pregnancy and developing a clear referral pathway may be beneficial.
The effect of pelvic compression on deep abdominal muscle thickness during the active straight leg raise test
Authors: Brizzolara Kelli , Wang-Price Sharon , Roddey Toni , Wilson Iseult 
Published: February 2015

Background/Aims: The estimated prevalence of sacroiliac joint (SIJ) pain is 13–30% in patients with non-specific low back pain. One common presentation is pain at or near the SIJ, and common physical therapy interventions include lumbopelvic stabilisation programmes and pelvic compression belts. The aim of this study was to: i) assess how compression of the SIJ affects the thickness of the deep abdominal muscles during the active straight leg raise (ASLR); ii) determine between-day intra-tester reliability of ultrasound imaging to assess percentage change in thickness of the deep abdominal muscles. Methods: Participants (n=15) with unilateral symptoms near the SIJ and age-matched and sex-matched controls (n=15) were recruited for this study. Ultrasound imaging was used to obtain the thickness of the transverse abdominis (TrA) and internal oblique (IO) muscles. Measurements were taken at rest and during the ASLR, with and without pelvic compression. Results: Two separate two-way (group × pelvic compression) analysis of variance (ANOVA) designs with repeated measures were used to analyse the thickness of the TrA and IO muscles; interactions were not significant for percentage change in the TrA (p=0.57) or IO (p=0.10) muscles. Intra-tester reliability was higher when testing with pelvic compression and in the control group (ICC: 0.85–0.89 vs 0.70–0.76). Conclusions: Pelvic compression did not immediately affect the muscular response of the TrA or IO muscles during the ASLR. Pelvic compression belts may be used to address the passive systems of the pelvis by increasing stability; however, specific localised exercises may be needed to improve the percentage change in thickness of the deep abdominal muscles during the ASLR.
Multi-product Bertrand Oligopoly with Exogenous and Endogenous Consumer Heterogeneity
Authors: Bernhardt Dan , Graham Brett 
Published: February 2015

AbstractWe develop a spatial model in which consumers receive firm-specific location shocks and firms endogenously determine both franchise/product locations and prices. Remarkably, firms fail to profit from endogenous product-specific heterogeneity alone: while ex-post consumer heterogeneity ensures positive gross profits, competition for market share results in socially excessive product lines and zero net profits. With added exogenous taste heterogeneity, endogenous spatial heterogeneity drives profits below their levels with only taste heterogeneity. Finally, we introduce multiple product lines and show that when product costs differ across lines, firms earn positive profits as long as consumer preferences over lines are imperfectly correlated.