bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficiency of a typical meteorological year and actual climatic data in the analysis of energy demand in buildings
Authors: Grudzińska Magdalena , Jakusik Ewa 
Published: February 2015

A typical meteorological year (TMY) for Poland was developed in 2004, on the basis of climatic data collected from 1971 to 2000. Due to the observed tendency of global warming, the buildings’ energy performance obtained with the use of TMY may differ from the actual heating and cooling demand. This research compares energy demand calculated using TMY and climatic data collected from 2001 to 2012. Calculations were made by means of a simulation computer program, designed for dynamic analyses of buildings and installation systems. The analyses concerned typical living quarters in a multifamily residential building located in Warsaw. According to the results, TMY is useful for estimating the heating demand of existing buildings. Cooling demand calculated with the use of TMY was, however, up to 37% lower in comparison with the mean cooling demand for subsequent years. This may distort the energy needs and indoor environment conditions in summer, and create discomfort while using existing and new buildings. Practical application: The paper presents comparison between energy demand calculated with the use of typical meteorological year (TMY) based on the climatic data from the period of 1971 to 2000, and real climatic data from subsequent 12 years, 2001–2012. There is substantial difference in the results presenting cooling demand in buildings evaluated with the use of both datasets. Unless national energy certification procedures are updated, this may cause serious faults in building design, due to incorrect assessment of internal conditions in new and existing buildings, and higher than expected energy use in summer.
Correlation between Sleep Disruption on Postoperative Pain
Authors: Miller Anya , Roth Thomas , Roehrs Timothy , Yaremchuk Kathleen 
Published: February 2015

ObjectivesTo identify the amount of sleep disruption that occurs in the postoperative inpatient hospital setting, determine the relationship between sleep disruption and the quantity of narcotics taken for postoperative pain, and determine if hospital length of stay is related to sleep disruption.Study DesignProspective cohort study.SettingSingle tertiary care academic institution.Subjects and MethodsFifty patients undergoing total hip or knee arthroplasty at Henry Ford Hospital in Detroit, Michigan, between January 2013 and November 2013 were asked to wear an actigraph during their postoperative hospital stay. Total sleep time, sleep efficiency, awake index, total narcotic use, visual analog pain scores, and postoperative complications were analyzed.ResultsOverall sleep efficiency was 61.2% and 66.5% with an awake index of 5.5 and 5.4 for each of the postoperative nights measured. A significant correlation was found between increased self‐reported pain scores and decreased total sleep time (r = −0.31; P =. 03). Spearman correlations between total sleep time, sleep efficiency, and awake index were made with narcotic use on postoperative day (POD) 0 and 1. Longer hospital length of stay was significantly correlated with decreased sleep efficiency (r = −0.35, P =. 01). Complication rates were not statistically different compared with sleep parameters.ConclusionBetter control of a patient’s pain is associated with greater sleep efficiency and total sleep time. Improvements in sleep efficiency in hospitalized patients may be associated with a decrease in length of stay.
Variation in duplex peak systolic velocity measurement in a multi-site vascular service
Authors: Normahani P , Aslam M , Martin G , Standfield NJ , Jaffer U 
Published: February 2015

Objective: Duplex US (DUS) is increasingly utilised as a first-line investigation for the assessment of carotid disease. For clinical decision-making, DUS assessment must be accurate and reproducible to ensure reliability. We aimed to investigate the variability in peak systolic velocity (PSV) measurement in a multi-site vascular network. Methods: DUS measurements of PSV were taken from continuous and pulsatile flow, generated by a high fidelity phantom, by 12 experienced vascular scientists across four hospitals. Participants were blinded to the actual PSV value (50 cm/s). Results: We observed an average error of 13.2% (± 8.3) and 11.6% (± 7.5) in PSV measurements taken from pulsatile and continuous waveforms, respectively. Measurements of PSV using the pulsatile waveform demonstrated statistically significant variation across all hospitals; ((hospital/mean) A 43.9 cm/s, B 61.7 cm/s, C 57.4 cm/s, D 47.7 cm/s, p=0.001). Further analysis demonstrated statistically significant variation in 4 instrumentation-related factors when measuring from a pulsatile waveform (Doppler angle, angle of insonation, velocity range, scale range). Conclusion: We observed a significant level of error and variation in PSV measurements across four sites within our vascular network. Variation in instrumentation-related factors may be accountable for this. In light of the centralisation of vascular services, it is increasingly important to unify and implement scanning protocols in order to reduce error and inter-site variability.
Pulmonary metastases from angiosarcoma: a spectrum of CT findings
Authors: Yogi Akira , Miyara Tetsuhiro , Ogawa Kazuhiko , Iraha Shiro , Matori Shigetaka , Haranaga Shusaku , Murayama Sadayuki 
Published: February 2015

Background Though a few reports have summarized the computed tomography (CT) findings of pulmonary metastases from angiosarcoma, the detailed CT findings of cysts are not well known, except for their characteristic thin walls. Purpose To retrospectively summarize the CT findings of pulmonary metastases from angiosarcoma, focusing mainly on the CT findings of cysts. Material and Methods Thirty-three patients with pulmonary metastases from angiosarcoma were selected retrospectively. Two radiologists reviewed and assessed patients’ chest CT images on a consensus basis for nodules, cysts, the CT halo sign, pneumothorax, pleural effusion, and enlarged lymph nodes. Cysts were also evaluated by wall thickness and smoothness, air-fluid levels, and vessels or bronchi penetrating the cysts. The relationship between cysts and pneumothorax was assessed using the Chi-square test. Results Nodules were found in 28 (85%) patients. Cysts were found in 19 (58%) patients; 17 had thin and smooth walls, 10 had thin and irregular walls, and four had thick and irregular walls. In addition, 12 patients showed vessels or bronchi penetrating the cysts, and six showed air-fluid levels. The CT halo sign, pneumothorax, pleural effusion, and mediastinal lymphadenopathy were seen in 19 (58%), 16 (48%), 26 (78.8%), and five (15.2%) patients, respectively. Pneumothorax occurred significantly more frequently in patients with cysts ( P = 0.002). Conclusion Cysts showed variability in their walls, and air-fluid levels and vessels or bronchi penetrating the cysts appeared to be characteristic findings, which may be useful for detection and accurate diagnosis in patients with pulmonary metastases from angiosarcoma.
Magnetic resonance elastography (MRE) for measurement of muscle stiffness of the shoulder: feasibility with a 3 T MRI system
Authors: Hong Sun Hwa , Hong Suk-Joo , Yoon Joon-Shik , Oh Chang-Hyun , Cha Jang Gyu , Kim Hee Kyung , Bolster Bradley 
Published: February 2015

Background Magnetic resonance elastography (MRE) at 3 T MR has the potential to improve the objective detection of skeletal muscle stiffness. Purpose To determine the feasibility of MRE using 3 T MR for measurement of the stiffness of shoulder muscles in subjects. Material and Methods This study prospectively evaluated 16 healthy subjects (mean age, 29.8 years; range, 25–51 years). MRE was acquired with 3 T MR through the use of a 2D-gradient-echo-based MRE sequence at two different excitation frequencies (90 and 120 Hz). The mean stiffness values (MSV) of the trapezius and infraspinatus muscles were measured by two radiologists. Differences between the MSV in the x, y, and z motion-sensitization directions were assessed. Inter-observer agreement was also measured. Results The MSV of the trapezius muscle were 2.72 kPa ± 0.6 (SD) at 90 Hz and 4.66 kPa ± 1.2 at 120 Hz, while the MSV for the infraspinatus muscle were 3.2 kPa ± 0.52 at 90 Hz and 4.38 kPa ± 0.92 at 120 Hz. The MSV for both muscles were significantly higher at 120 Hz than at 90 Hz ( P < 0.05). The MSV in the three different directions were significantly different from each other in the infraspinatus muscle ( P < 0.05). Levels of inter-observer agreement regarding MSV were good to excellent for both the trapezius (intraclass correlation coefficient [ICC] = 0.979–0.996) and infraspinatus muscles (ICC = 0.614–0.943). Conclusion MRE at 3 T is a feasible technique for the evaluation of shoulder muscle stiffness. Extended application of skeletal muscle MRE at 3 T will contribute to the evaluation and treatment of skeletal muscle disorders.
Eco-social occupational therapy
Authors: Simó Algado Salvador , Ann Townsend Elizabeth 
Published: February 2015

Introduction Ecological crises associated with the global degradation of the natural environment call for dialogues and action to develop an economically and environmentally sustainable world. This paper proposes a new narrative for humanity by connecting ecology with broad ideas about occupation and occupational justice. Method The authors reflect on literature and action projects on ecology, occupation, and occupational justice. Results The authors propose that doing ecology is essentially occupational, and necessarily a matter of occupational justice given the strong link between poverty and the degradation of the natural environment. Conclusion Eco-social occupational therapy practices are illustrated in poverty reduction projects, funded through university–community partnerships in Spain. The potential to expand eco-social occupational therapy lies in publicly embracing ecological challenges, focusing practices on changing the environment, and attracting partners to find new funding for enabling people everywhere to participate in ecological sustainability through occupation. This paper calls on occupational therapists to spark dialogues and take action in doing ecology and justice through occupation.
Platelet-Rich Plasma Increases Anti-inflammatory Markers in a Human Coculture Model for Osteoarthritis
Authors: Osterman Chelsea , McCarthy Mary Beth R. , Cote Mark P. , Beitzel Knut , Bradley James , Polkowski Gregory , Mazzocca Augustus D. 
Published: February 2015

Background: Platelet-rich plasma (PRP) has anti-inflammatory effects with potential applications in the treatment of osteoarthritis (OA). Purpose: To use an in vitro coculture model of OA in human cartilage and synovium to investigate the anti-inflammatory effects of 2 different PRP preparations. Study Design: Controlled laboratory study. Methods: A coculture system was created using osteoarthritic cartilage and synovium from 9 patients undergoing total knee arthroplasty. Interleukin-1β (IL-1β) was added to each coculture to induce inflammation. Two PRP preparations were obtained—one yielding low white blood cell and platelet concentrations (PRPLP) and one yielding high platelet and white blood cell concentrations (PRPHP). Either PRPLP, PRPHP, or medium was added to the coculture wells. Control wells contained OA cartilage and synovium but neither IL-1β nor PRP. Normal, non-OA cartilage was obtained to establish baseline gene expression levels. Quantitative polymerase chain reaction was used to measure changes in markers of inflammation in the tissues (a disintegrin and metalloproteinase with thrombospondin motifs–5 [ADAMTS-5], tissue inhibitor of metalloproteinases–1 [TIMP-1], vascular endothelial growth factor [VEGF], aggrecan, and type I collagen) at 0, 24, 48, and 72 hours. Results: Treatment with PRPLP or PRPHP significantly decreased expression of TIMP-1 and ADAMTS-5 in cartilage, increased aggrecan expression in cartilage, and decreased ADAMTS-5, VEGF, and TIMP-1 expression in synovium compared with control cocultures ( P < .05). There was significantly less nitric oxide production in the PRPLP and PRPHP groups compared with controls ( P < .05). There were significant differences in gene expression in the normal cartilage compared with all 4 groups of OA cartilage at all 4 time points. Treatment with either PRPLP or PRPHP returned some gene expression to the same levels in normal cartilage but not for all markers of inflammation. Conclusion: This coculture model assessed 2 different PRP preparations and their anti-inflammatory effects over time on human OA cartilage and synovium. Both had a significant anti-inflammatory effect on gene expression; however, there was no difference in the anti-inflammatory effect between the 2 preparations. Clinical Relevance: Osteoarthritis is a leading cause of chronic disability, and less invasive treatment methods are needed. Study results suggest that PRP injections may be an effective alternative anti-inflammatory agent in the treatment of OA.
Multiemployer Pension Plans, the PBGC, and the MPRA
Authors: Kilgour John G. 
Published: February 2015

Multiemployer pension plans are negotiated between a union and two or more (usually many) employers in an industry. There are over 1,400 of them covering 10.4 million participants and they are insured by the Pension Benefit Guaranty Corporation (PBGC). In the aggregate, they are now woefully underfunded, as is the PBGC’s Multiemployer Program. Congress has enacted several laws in an effort to strengthen the financial position of multiemployer plans and to protect the PBGC. The most recent is the Multiemployer Pension Protection Act of (December) 2014 (MPRA). One of the tenets of pension law has been that retirement benefits once accrued and vested are inviolable. They cannot be curtailed or rescinded. The MPRA allows the trustees of certain distressed multiemployer plans to reduce the benefits of active and inactive participants including retirees in pay status. This paper examines the developments leading up to the MPRA and the underlying problems of multiemployer pension plans and the PBGC.
Childhood lupus nephritis in a developing country—24 years' single-center experience from North India
Authors: Singh S , Abujam B , Gupta A , Suri D , Rawat A , Saikia B , Minz R Walker , Joshi K , Nada R 
Published: February 2015

Objective Data on outcome of childhood lupus nephritis from developing countries are sparse. This study looks at outcome in children with lupus nephritis from a federal government-funded teaching hospital in North India. Methods This study included children less than 14 years of age with lupus nephritis who presented to a single center during a period of 24 years (1991 to 2013). Data on clinical characteristics and outcome were extracted from medical records. The primary outcome was actuarial survival (time-to-death) and secondary outcome was actuarial renal survival using Kaplan-Meier analysis. A worst-case scenario that assumed children who were lost to follow-up as having either died or gone into end-stage renal disease was also calculated. Log-rank test and Cox-regression were used to assess difference in survival by histological class and predictors of poor outcome, respectively. Results This study included 72 children, with a female:male ratio of 3:1, mean (±SD) age at onset of lupus 9.3 (±2.4) years and mean (±SD) time from onset-to-nephritis being 9.4 (±12.6) months. Renal biopsy was conducted in 53 children. The most common histological class was class IV (35 children). Mortality occurred in 22 children (30%), with half of these occurring at presentation. The two important causes of death were infection and end-stage renal disease. Actuarial survival was 81%, 67% and 59% at one, five and 10 years, respectively. In the worst-case scenario, actuarial survival was 72%, 53% and 38%, respectively. Renal survival was 96%, 89% and 78% (worst-case scenario 86%, 73% and 52%) at one, five and 10 years, respectively. There was no difference in survival by histological class. On univariate analysis, serum creatinine at presentation (hazard ratio = 2.2 (95% CI 1.3–3.9)) and serious infection (hazard ratio 7.9 (95% CI 2.6–23.5)) were statistically significant predictors of time-to-death. Conclusion Outcome of children with lupus nephritis from India is worse than developed countries. Nearly one-third of the children died, half at presentation, with common causes being infection and end-stage renal disease.
Differences between clinical and laboratory findings in patients with recent diagnosis of SLE according to the positivity of anti-dsDNA by the Crithidia luciliae method
Authors: Sarbu M I , Salman-Monte T C , Rubio Muñoz P , Lisbona M P , Bernabé M Almirall , Carbonell J 
Published: February 2015

Background Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIF) is considered to have the highest specificity for systemic lupus erythematosus (SLE). Objective The objective of this report is to evaluate whether the presence of anti-dsDNA antibodies detected by the CLIF method is associated with a specific clinical phenotype in recently diagnosed SLE. Methods This retrospective cross-sectional study included all patients with newly diagnosed SLE between 1990 and 2011 and followed up in our institution. Demographic, clinical and laboratory findings were assessed. Correlations between positivity of anti-dsDNA by the CLIF method, clinical and laboratory data were analyzed. Results A total of 104 patients were included in the analysis. Patients who were positive for anti-dsDNA by the CLIF method at the time of diagnosis had (statistically) significantly higher titers of anti-dsDNA by the ELISA method, antinuclear (ANA) and anticardiolipin antibodies, lymphopenia and complement consumption compared with the other two groups. Also they presented significantly more musculoskeletal symptoms at baseline. Conclusion The presence of anti-dsDNA by the CLIF method in newly diagnosed SLE was associated with certain markers of increased disease activity. Its use could be a useful biomarker for a specific clinical phenotype suggestive of a more severe involvement at the time of the diagnosis.
Proximal Supination Osteotomy of the First Metatarsal for Hallux Valgus
Authors: Yasuda Toshito , Okuda Ryuzo , Jotoku Tsuyoshi , Shima Hiroaki , Hida Takashi , Neo Masashi 
Published: February 2015

Background: Risk factors for hallux valgus recurrence include postoperative round-shaped lateral edge of the first metatarsal head and postoperative incomplete reduction of the sesamoids. To prevent the occurrence of such conditions, we developed a proximal supination osteotomy of the first metatarsal. Our aim was to describe this novel technique and report the outcomes in this report. Methods: Sixty-six patients (83 feet) underwent a distal soft tissue procedure combined with a proximal supination osteotomy. After the proximal crescentic osteotomy, the proximal fragment was pushed medially, and the distal fragment was abducted, and then the distal fragment of the first metatarsal was manually supinated. Outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographic examinations. The average follow-up duration was 34 (range, 25 to 52) months. Results: The mean AOFAS score improved significantly from 58.0 points preoperatively to 93.8 points postoperatively ( P < .0001). The mean hallux valgus and intermetatarsal angle decreased significantly from 38.6 and 18.0 degrees preoperatively to 11.0 and 7.9 degrees postoperatively, respectively (both, P < .0001). Sixty-nine feet (69/83, 83%) had a positive round sign preoperatively, and 66 feet (66/83, 80%) had a negative round sign postoperatively. According to the Hardy’s classification of position of the sesamoids, all feet were classified as grade V or greater preoperatively, and 49 feet (49/83, 59%) were classified as grade IV or less postoperatively. Three feet (3/83, 4%) had recurrence of hallux valgus, defined as a hallux valgus angle ≥ 25 degrees. Conclusion: The rates of occurrence of a positive round sign and incomplete reduction of the sesamoids significantly decreased postoperatively, which may have contributed to the low hallux valgus recurrence rates. We conclude that a proximal supination osteotomy was an effective procedure for correction of hallux valgus and can achieve a low rate of hallux valgus recurrence. Level of Evidence: Level IV, retrospective case series.
Why Do Lesser Toes Deviate Laterally in Hallux Valgus? A Radiographic Study
Authors: Roan Li-Yi , Tanaka Yasuhito , Taniguchi Akira , Tomiwa Kiyonori , Kumai Tsukasa , Cheng Yuh-Min 
Published: February 2015

Background: Hallux valgus foot with laterally deviated lesser toes is a complex condition to treat. Ignoring the laterally deviated lesser toes in hallux valgus might result in unsatisfactory foot shape. Without lateral support of the lesser toes, it might increase the risk of recurrence of hallux valgus. We sought to identify associated radiographic findings in patients where lesser toes follow the great toe in hallux valgus and deviate laterally. Methods: The weight-bearing, anteroposterior foot radiographs of 24 female hallux valgus feet with laterally deviated lesser toes (group L), 34 female hallux valgus feet with normal lesser toes (group H), and 43 normal female feet (group N) were selected for the study. A 2-dimensional coordinated system was used to analyze the shapes and angles of these feet by converting each dot made on the radiographs onto X and Y coordinates. Diagrams of the feet in each group were drawn for comparison. The hallux valgus angle, lateral deviation angle of the second toe, intermetatarsal angles, toe length, metatarsal length, and metatarsus adductus were calculated according to the coordinates of the corresponding points. Results: The mapping showed the bases of the second, third, and fourth toe in group L shifted laterally away from their corresponding metatarsal head ( P < .001). The mean 2-3 intermetatarsal angles were: group L, H, N = 7.7 ± 2.6, 4.3 ± 1.9, 4.3 ± 1.3 degrees, respectively (P < .001); mean 3-4 intermetatarsal angles were, for groups L, H, N = 7.3 ± 2.3, 6.1 ± 2.1, 6.3 ± 1.4 degrees, respectively ( P < .05). Larger hallux valgus angles ( P < .001), more adducted first metatarsal ( P < .05), and divergent lateral splaying of the lesser metatarsals ( P < .001) were found in group L. Conclusion: Larger 2-3 and 3-4 intermetatarsal angles, larger hallux valgus angle, more adducted first metatarsal, and divergent lateral splaying of the lesser metatarsals were associated with lateral deviation of the lesser toes in hallux valgus. Level of Evidence: Level III, comparative study.
Neuromyelitis optica spectrum disorder as a paraneoplastic manifestation of lung adenocarcinoma expressing aquaporin-4
Authors: Iorio Raffaele , Rindi Guido , Erra Carmen , Damato Valentina , Ferilli Michela , Sabatelli Mario 
Published: February 2015

Background: The observations of neuromyelitis optica spectrum disorders (NMOSD) occurring in the setting of cancer suggest that aquaporin-4 (AQP4) autoimmunity may in some cases be paraneoplastic. Results: We describe a 72-year-old patient who developed a longitudinally extensive transverse myelitis associated with AQP4 autoantibodies in the setting of a lung adenocarcinoma recurrence. AQP4 expression was demonstrated in tumor cells. IgG in patient’s cerebrospinal fluid bound to tumor cells co-localizing with AQP4 immunoreactivity. Conclusions and relevance: This case expands the spectrum of paraneoplastic AQP4 autoimmunity highlighting the importance of considering an oncological screening in patients with late-onset NMOSD.