bluuebunny/crossref_metadata_2025_split huggingface dataset:
An assessment of, and response to, potential cross-contamination routes due to defective appliance water trap seals in building drainage systems
Authors: Gormley M , Swaffield JA , Sleigh PA , Noakes CJ 
Published: September 2011

The outbreak of severe acute respiratory syndrome (SARS), centred on Southeast Asia in 2002 and 2003, sparked fears of an uncontrollable pandemic. The outbreak at one housing complex in Hong Kong resulted in a disproportionately large number of cases with 321 people contracting the virus, resulting in 42 fatalities. This outbreak led to an investigation by World Health Organisation, which firmly laid the blame for the spread of the virus in the housing complex on defects in the building drainage and vent system. The mode of viral transmission was identified as due to airborne aerosolised particles from virus-laden excreta emanating from the drainage system. The aerosolised particles were allowed to enter the habitable space through empty water trap seals which are the main protection against such ingress in a building drainage and vent system. This research reports on the defective trap identification system developed to provide a means of testing the seal afforded by the water trap seal inbuildings. This innovative sonar-like technology incorporates a means of identifying compromised water trap seals anywhere in a building in a repeatable, non-destructive manner. While the technology has been effectively validated by a combination of laboratory investigation, site testing and numerical simulation, the rationale for the need to monitor water trap seals is less obvious to professionals operating in this field. This article addresses this issue and presents such a rationale, identifying some of the harmful pathogens which could lead to cross-contamination from person to person via the building drainage system. Practical applications: The research carried out in this area has highlighted the lack of any real monitoring of water trap seal status in buildings and has put the issue firmly on the agenda for consideration by building owners, operators and regulators, for whom the building drainage and vent system has long been categorised as ‘fit and forget’. The inspiration for this study was the response to the SARS outbreak which began in 2002. The case to monitor this important seal is clearly made and whilst the predicted pandemic of the SARS virus failed to materialise on an extended time frame and the outbreak has largely been consigned to history, it should serve as a constant reminder to professionals in the industry that we ‘fit and forget’ at our peril.
Using localised weather files to assess overheating in naturally ventilated offices within London's urban heat island
Authors: Demanuele C , Mavrogianni A , Davies M , Kolokotroni M , Rajapaksha I 
Published: September 2011

Urban environments typically experience increased average air temperatures compared to surrounding rural areas – a phenomenon referred to as the Urban Heat Island (UHI). The impact of the UHI on comfort in naturally ventilated buildings is the main focus of this article. The overheating risk in urban buildings is likely to be exacerbated in the future as a result of the combined effect of the UHI and climate change. In the design of such buildings in London, the usual current practice is to view the use of one generic weather file as being adequate to represent external temperatures. However, the work reported here demonstrates that there is a considerable difference between the overheating performance of a standard building at different sites within London. This implies, for example, that a building may wrongly pass or fail criteria used to demonstrate compliance with building regulations as a result of an inappropriate generic weather file being used. The work thus has important policy implications. Practical application: The Greater London Authority has recently developed, with the Chartered Institute of Building Services Engineers, guidance for developers to address the risk of overheating in buildings via the provision of weather files for London relating to three zones. While such an initiative is welcomed, it may be that a weather file tailored to the building location would be preferable. Of course, this would add further complexity to the process and a view would have to be taken as the viability of such an approach. The work presented in this article, however, suggests that serious consideration should be given to the use of tailored weather data for regulatory purposes.
An analysis of heat insulation efficiency of building outer skins used for green building
Authors: Hou W-S , Chuang T-F , Hsieh E-C , Chang Y-H 
Published: September 2011

In general, the poor thermal insulation of building materials usually causes elevated room temperature, which not only reduces the comfort of the environment but also adds extra loading to the air conditioner. The objective of this study is to investigate the heat insulation efficiencies of building outer skins used for green building. A total of 25 types of multi-layer cladding materials and 9 types of single-layer skin materials made in Taiwan along with 4 types of overseas multi-layer skin materials were tested using the hot box method (HBM). The above data were then adopted to calculate the heat-insulation ability, vapor transmission volume and heat gain cooling load. Besides, the costs of the above materials were also collected to provide useful information for green building industry to select the most proper skin materials in considering both the material performance and costs. The analysis results suggest that the ‘k’ group (paint-baked metal plate + 2” 100 k rock wool + paint-baked metal plate) exhibits the best heat-insulating capacity, which is 67.0%. However, Item 15 (colour corrugated steel plate + conventional steel bearing plate + calcium silicate board) presents the smallest moisture-permeable amount at 0.001 g/h. Besides, Item ‘13’ exhibits the smallest cooling load, which is 1.8 W. From the above, it is shown that superior heat-insulating performance does not necessarily mean better moisture permeability resistance. The skin material which presents superior moisture permeability resistance does not always present a higher cooling load. For this reason, the appropriate skin materials should be selected by matching with the climatic environment where the building is located. Moreover, the decrement of CO2 emissions caused by transportation is also another key point which the green building industry should consider. Practical application: The objectives of this research are to investigate the heat insulation efficiencies of building outer skins used in the green buildings. The heat capacity, moisture-permeable resistance, solar heat gain cooling load and costs of the building outer skins frequently used in Taiwan have been calculated and collected in this study. Therefore, the engineers and building industry can choose the most suitable materials with the help of the above information.
Combination of Voice Therapy and Antireflux Therapy Rapidly Recovers Voice‐Related Symptoms in Laryngopharyngeal Reflux Patients
Authors: Park Jun‐Ook , Shim Mi‐Ran , Hwang Yeon‐Shin , Cho Kwang‐Jae , Joo Young‐Hoon , Cho Jung‐Hae , Nam Inn‐Chul , Kim Min‐Sik , Sun Dong‐Il 
Published: September 2011

ObjectivePatients with laryngopharyngeal reflux frequently experience voice‐related symptoms. This study was designed to investigate the effectiveness of combined voice and medical therapy in comparison with medical therapy alone in the improvement of voice‐related symptoms and parameters in patients with laryngopharyngeal reflux.Study DesignConcurrent nonrandomized comparative trial.SettingOtolaryngology department at a university hospital.Subjects and MethodsIn this prospective study, 100 patients diagnosed with laryngopharyngeal reflux with voice symptoms were divided into 2 groups: 50 patients were treated with medication alone, and 50 were treated with medication plus voice therapy. The following data were recorded before treatment and at 1, 2, and 3 months posttreatment: reflux symptom index (RSI), reflux finding score (RFS), voice handicap index (VHI), perceptual analysis, and acoustic analysis. The numbers of patients showing clinically significant reductions in these parameters were compared between groups using the following cutoff values: change in RSI ≥5, change in RFS ≥3, change in VHI ≥15, and change in grade, roughness, breathiness, asthenia, and strain scale (GRBAS) ≥1.ResultsSignificantly more patients in the study group showed a clinically significant change in RSI, VHI, and GRBAS score at the 1‐, 2‐, and 3‐month follow‐up evaluations. No clinically significant change in RFS was achieved in either group at 1 or 2 months, but a significantly greater change was achieved in the study group at 3 months.ConclusionsVoice therapy may help to restore reversible mucosal change secondary to acidic reflux, inducing rapid resolution of symptoms and shortening of the treatment period.
What are cancer patients’ experiences and preferences for the provision of written information in the palliative care setting? A focus group study
Authors: Tomlinson Kim , Barker Stephanie , Soden Katie 
Published: September 2011

Background: Whilst there is a wide range of literature pertaining to the need for excellent verbal communication within the palliative care setting, there is a paucity of research designed to identify the written informational needs of such patients. Aim: To identify the experiences and wishes of patients known to a specialist palliative care service in England with regards to written information. We considered both generalizable written information (such as leaflets, books and internet resources) as well as individualized information (for example, copies of letters given to patients). Design: Five focus group discussions were recorded and transcribed for analysis. Setting/participants: The focus groups took place at one specialist palliative care unit in England. Twenty-two patients with cancer over the age of 18 years were recruited. Results: Inductive, realist thematic analysis of the data set was performed. Themes have been broadly categorized into three main areas: (i) patients’ views on the role of written information, (ii) their experiences of written information in different formats, and (iii) their thoughts on what written information they would most value. Conclusions: Written information needs for this patient group vary greatly, sometimes in ways which can be predicted. Using a patient-centred approach to elicit information around an individual’s coping strategies, desire for knowledge and empowerment may be helpful. The data supports a proactive approach to making available (to those who want them) clear, concise and attractive leaflets.
A Simple Evaluation of Anterior Cruciate Ligament Femoral Tunnel Position
Authors: Illingworth Kenneth David , Hensler Daniel , Working Zachary Mark , Macalena Jeffrey Alexander , Tashman Scott , Fu Freddie H. 
Published: September 2011

Background: Postoperative determination of tunnel position after anterior cruciate ligament (ACL) reconstruction can be challenging. Hypothesis: The femoral tunnel angle and inclination angle are reliable methods for evaluating tunnel position after ACL reconstruction while aiding in determining whether an ACL reconstruction falls outside an anatomic range as defined on 3-dimensional (3D) computed tomography (CT). Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Fifty patients were included who received single-bundle ACL reconstructions with postoperative flexion weightbearing radiographs, magnetic resonance imaging (MRI), and CT scans. Femoral tunnel angles were determined from posterior-to-anterior postoperative radiographs, and inclination angles were determined from sagittal MRI. The ACL reconstructions were grouped by surgical technique, transtibial (TT) or tibial tunnel independent (TTI), and as either falling inside or outside an anatomic range on 3D CT. Results: Patients with tunnel positions within an anatomic range, as previously defined, had a larger femoral tunnel angle (39.3° ± 4.2°) and smaller inclination angle (49.5° ± 2.7°) than patients who fell outside an anatomic range (17.2° ± 12.5° and 62.3° ± 7.8°, respectively) ( P < .001). Patients in the TTI group had a larger femoral tunnel angle (37.6° ± 9.30°) and smaller inclination angle (51.8° ± 6.5°) than those in the TT group (14.2° ± 9.3° and 63.5° ± 7.2°, respectively) ( P < .001). Posterior-to-anterior femoral tunnel position was negatively correlated with femoral tunnel angle ( P < .001, r = .78) and positively correlated with inclination angle ( P < .001, r = .74). Based on a receiver operating characteristic (ROC) curve, a femoral tunnel angle of 32.7° (100% sensitivity and 85% specificity) and inclination angle of 55° (100% sensitivity and 87.5% specificity) were determined to distinguish ACL reconstructions that fell either within or outside an anatomic range on 3D CT. Conclusion: Femoral tunnel angle and inclination angle can be reliably determined from both posterior-to-anterior radiographs and sagittal MRI and provide a useful metric for characterizing femoral tunnel position.
In-Shoe Plantar Pressures Within Ankle-Foot Orthoses
Authors: Kearney Rebecca S. , Lamb Sarah E. , Achten Juul , Parsons Nicholas R. , Costa Matthew L. 
Published: September 2011

Background: Advances in the management of Achilles tendon rupture have led to the development of immediate weightbearing protocols. These vary regarding which ankle-foot orthoses (AFOs) are used and the number of inserted heel wedges used within them. Purpose: This study was conducted to evaluate plantar pressure measurements and temporal gait parameters within different AFOs, using different numbers of heel wedges. Study Design: Controlled laboratory study. Methods: Fifteen healthy participants were evaluated using 3 different AFOs, with 4 different levels of inserted heel wedges. Therefore, a total of 12 conditions were evaluated, in a sequence that was randomly allocated to each participant. Pressure and temporal gait parameters were measured using an in-shoe F-Scan pressure system, and range of movement was measured using an electrogoniometer. Results: Ankle-foot orthoses that were restrictive in design, combined with a higher number of inserted heel wedges, reduced forefoot pressures, increased heel pressures, and decreased the amount of time spent in the terminal stance and preswing phase of the gait cycle ( P = .029, .002, and .001). Conclusion: The choice of AFO design and the number of inserted heel wedges have a significant effect on plantar pressure measurements and temporal gait parameters. The implications of these changes need to be applied to the clinical management of acute Achilles tendon ruptures. This clinical management requires a balance between protected weightbearing and functional loading, requiring further research within a clinical context. Clinical Relevance: The biomechanical data from this research imply that a carbon-fiber AFO, with 1 heel raise, protects against excessive dorsiflexion while facilitating the restoration of near-normal gait parameters. This could lead to an accelerated return to function, avoiding the effects of disuse atrophy. This is in contrast to the rigid rocker-bottom AFO design with a greater number of heel-wedge inserts. However, research within a clinical context would be required to ascertain if these biomechanical advantages translate into a functional benefit for patients. The results should also be considered in relation to the amount of force a healing Achilles tendon can withstand.
Biomechanical Evaluation of Knee Joint Laxities and Graft Forces After Anterior Cruciate Ligament Reconstruction by Anteromedial Portal, Outside-In, and Transtibial Techniques
Authors: Sim Jae Ang , Gadikota Hemanth R. , Li Jing-Sheng , Li Guoan , Gill Thomas J. 
Published: September 2011

Background: Recently, anatomic anterior cruciate ligament (ACL) reconstruction is emphasized to improve joint laxity and to potentially avert initiation of cartilage degeneration. There is a paucity of information on the efficacy of ACL reconstructions by currently practiced tunnel creation techniques in restoring normal joint laxity. Study Design: Controlled laboratory study. Hypothesis: Anterior cruciate ligament reconstruction by the anteromedial (AM) portal technique, outside-in (OI) technique, and modified transtibial (TT) technique can equally restore the normal knee joint laxity and ACL forces. Methods: Eight fresh-frozen human cadaveric knee specimens were tested using a robotic testing system under an anterior tibial load (134 N) at 0°, 30°, 60°, and 90° of flexion and combined torques (10-N·m valgus and 5-N·m internal tibial torques) at 0° and 30° of flexion. Knee joint kinematics, ACL, and ACL graft forces were measured in each knee specimen under 5 different conditions (ACL-intact knee, ACL-deficient knee, ACL-reconstructed knee by AM portal technique, ACL-reconstructed knee by OI technique, and ACL-reconstructed knee by TT technique). Results: Under anterior tibial load, no significant difference was observed between the 3 reconstructions in terms of restoring anterior tibial translation ( P > .05). However, none of the 3 ACL reconstruction techniques could completely restore the normal anterior tibial translations ( P < .05). Under combined tibial torques, both AM portal and OI techniques closely restored the normal knee anterior tibial translation ( P > .05) at 0° of flexion but could not do so at 30° of flexion ( P < .05). The ACL reconstruction by the TT technique was unable to restore normal anterior tibial translations at both 0° and 30° of flexion under combined tibial torques ( P < .05). Forces experienced by the ACL grafts in the 3 reconstruction techniques were lower than those experienced by normal ACL under both the loading conditions. Conclusion: Anterior cruciate ligament reconstructions by AM portal, OI, and modified TT techniques are biomechanically comparable with each other in restoring normal knee joint laxity and in situ ACL forces. Clinical Relevance: Anterior cruciate ligament reconstructions by AM portal, OI, and modified TT techniques result in similar knee joint laxities. Technical perils and pearls should be carefully considered before choosing a tunnel creating technique.
Surface morphology, mechanical and tribological properties of blended deproteinized natural and polyisoprene rubbers
Authors: Nasir RM , El-Tayeb NSM 
Published: September 2011

The morphology, and mechanical and tribological properties of deproteinized natural rubber with constant viscosity (DPNR) and synthetic cis-1, 4 polyisoprene vulcanizates (IR2200) using ISAF220 carbon black (CB) blends were studied in various ratios: 100/0, 75/25, 50/50, 25/75 and 0/100. Results for different operating test conditions under applied normal load, sliding speed and sliding distance were analyzed. The experimental results showed that the addition of CB (30 phr.) has significantly affected the wear and frictional performance of both DPNR-CV and IR2200 by decreasing the abrasion weight loss by more than 80% compared with the unfilled DPNR and IR2200. Adding 30 phr CB decreases the abrasion weight loss to more than 70%. The surface topography of micro-scales abrasion was characterized by scanning electron microscopy (SEM). Using SEM micrographics, the influence of blend ratios on wear mechanisms and spacing imprinted abrasion patterns was highlighted.
Shape design of the deep-drawing preform for manufacturing of automobile drum clutch hubs
Authors: Park J H , Kim S G , Park Y C , Song X G 
Published: September 2011

A large variety of metal forming processes is required in manufacturing for automotive applications. Traditionally, the design process for metal forming tools is based on trial-and-error and on the skill of experienced die-makers. This approach results in high development cost and long lead-times. Especially, the drum clutch requires tight dimensional accuracy in inside diameter and gear shape because it is used as the main component for the automatic transmission. The drum clutch investigated in this study is formed in five forming steps, which are first deep drawing, second deep drawing, restriking, embossing, and Grob processes. Dimensional accuracy of the final products greatly depends upon how much more accurate pre-form is manufactured in the previous forming processes before the Grob process. The deep drawing, restriking, and embossing processes in which the pre-form is formed are very important and decisive steps. Thus in some cases, excessive strain by these operations causes dimensional inaccuracy and cracks initiated from the base and wall of the product. Based on the above background, the objective of this study is to optimize the pre-form shape and tooling so that excessive thinning and crack formation are avoided while a sharp corner radius and flatness are obtained. Process variables such as the punch shapes both of first and second deep drawing, and punch angle were selected to evaluate the deformation characteristics. The optimum parameters were determined from forming simulations using commercial finite element method codes, DEFORM-2D, specifically developed for metal forming simulation. Finally, experiments for the whole drum clutch forming processes were carried out to verify the optimized forming parameters and the analytical results.
HLA, PTPN22 and PD-1 associations as markers of autoimmunity in neuromyelitis optica
Authors: Asgari N , Nielsen C , Stenager E , Kyvik KO , Lillevang ST 
Published: September 2011

Background: Neuromyelitis optica (NMO) is a disease with autoimmune characteristics. A genetic autoimmune dependency for NMO has not been clarified in detail. Objective: To investigate immunogenetic aspects of NMO. Methods: Forty-one patients with NMO and 42 patients with multiple sclerosis (MS) were diagnosed in a population-based Caucasian cohort. HLA DQA1, DQB1, and DRB1 alleles were determined. Polymorphisms in programmed death 1 (PD-1) PD-1.3 G/A and protein tyrosine phosphatase non-receptor 22 (PTPN22) 1858 C/T were genotyped. Results: In the NMO group 15% had other autoimmune disorders and 39% had family occurrence of autoimmunity, comparable to MS. A higher frequency of a family history (17%) of NMO and MS was found in the NMO group ( p < 0.026). The frequency of HLA-DQB1*0402 allele was increased in NMO ( p after Bonferroni correction, cp < 0.035) and the HLA-DRB1*15 and DQB1*06 alleles were increased in MS ( cp < 0.0027, cp < 0.01), compared to controls. No associations of the PTPN22 1858 T were detected. The PD-1.3A allele was increased both in NMO ( p < 0.0023) and in MS patients ( p < 0.028) compared to controls. Conclusion: Patients with NMO had frequent co-existence of autoimmunity and family occurrence of NMO and MS. The PD-1.3A allele was associated with NMO. The data suggest genetic autoimmune dependency of NMO.