bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol for Vitality: a proof-of-concept randomised controlled trial of exercise training or complex mental and social activities to promote cognition in adults with chronic stroke
Authors: Best John R , Eng Janice J , Davis Jennifer C , Hsiung Robin , Hall Peter A , Middleton Laura E , Graf Peter , Goldsmith Charles H , Liu-Ambrose Teresa 
Published: December 2018

IntroductionCerebrovascular disease—such as stroke—is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one’s risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke). Two potential intervention strategies are: (1) exercise training and (2) cognitive and social enrichment activities.Methods and analysisThe aim of this proof-of-concept randomised controlled trial is to determine whether a 6-month targeted exercise training programme or a 6-month cognitive and social enrichment programme can efficaciously and efficiently improve cognitive function in older adults with chronic stroke compared with a 6-month stretch and tone programme (ie, control). The primary measurement periods will be baseline, month 6 (postintervention) and month 12 (6-month follow-up). The primary outcome measure will be performance on the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus), a global measure of cognitive performance using multidimensional item response theory to summarise scores from the 13-item ADAS-Cog and other standard cognitive assessments. The primary analysis will compare changes in ADAS-Cog-Plus performance from baseline to month 6. Proof-of-concept outcomes relating to intervention feasibility will be analysed descriptively. The economic evaluation will examine the incremental costs and health outcome benefits generated by both interventions versus the control.Ethics and disseminationEthical approval has been obtained from the University of British Columbia’s Clinical Research Ethics Board (H13-00715, 26 July 2013). Any modifications to the protocol will require a formal amendment to the protocol and approval by the Research Ethics Board. Outcomes of this randomised controlled trial and the statistical code to generate those outcomes will be disseminated through publication in peer-reviewed journals as well as conference presentations.Trial registration numberNCT01916486.
Analysis of melting curves of MgO and LiF using the Lindemann law
Authors: Sunil K. , Sharma S. B. , Sharma B. S. 
Published: December 2018

We have determined the melting slopes as a function of pressure for MgO up to a pressure of 135 GPa, and for LiF up to a pressure of 100 GPa using the Lindemann law. Values of melting temperature have also been calculated from the melting slopes using Euler’s finite difference calculus method. It is found that the melting slope decreases continuously with the increase in pressure giving a nonlinear pressure dependence of the melting temperature. Values of bulk modulus and the Grüneisen parameter appearing in the Lindemann law of melting have been determined using the Stacey reciprocal K-primed equation of state and the Shanker reciprocal gamma relationship. The results for melting temperatures of MgO and LiF at different pressures are compared with the available experimental data. Values of melting temperatures at different pressures determined from the Al’tshuler relationship for the volume dependence of the Grüneisen parameter have also been included in the comparison presented.
Prognostic Value of Albuminuria and Influence of Spironolactone in Heart Failure With Preserved Ejection Fraction
Authors: Selvaraj Senthil , Claggett Brian , Shah Sanjiv J. , Anand Inder , Rouleau Jean L. , O’Meara Eileen , Desai Akshay S. , Lewis Eldrin F. , Pitt Bertram , Sweitzer Nancy K. , Fang James C. , Pfeffer Marc A. , Solomon Scott D. 
Published: December 2018

Background:
Albuminuria predicts adverse events in heart failure with preserved ejection fraction. No therapies to date have reduced albuminuria in heart failure with preserved ejection fraction.

Methods and Results:

We analyzed 1175 participants from the Americas from the TOPCAT study (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) with urinary albumin:creatinine ratio (UACR) measurements at baseline. We examined the association of UACR with the primary outcome (cardiovascular death, aborted cardiac arrest, or heart failure hospitalization) and its individual components, all-cause mortality, and several safety end points using multivariable-adjusted Cox regression. We evaluated whether spironolactone reduced albuminuria at the 1-year visit in a subpopulation (N=744). Thirty-five percent had microalbuminuria, 13% had macroalbuminuria, and 80% were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Increasing UACR was associated with male sex, higher systolic blood pressure, diabetes mellitus, and renal dysfunction. Macroalbuminuria (hazard ratio, 1.67; 95% CI, 1.22–2.28) and microalbuminuria (hazard ratio, 1.47; 95% CI, 1.15–1.86) were independently associated with the TOPCAT primary end point (compared with normoalbuminuria). Adjusting for placebo response, spironolactone reduced albuminuria by 39% in all participants at the 1-year visit compared with baseline (geometric mean ratio, 0.61; 95% CI, 0.49–0.77) and by 76% (geometric mean ratio, 0.24; 95% CI, 0.10–0.56) among those with macroalbuminuria. Reducing UACR by 50% was independently associated with a reduction in heart failure hospitalization (hazard ratio, 0.90;
P
=0.017) and all-cause mortality (hazard ratio, 0.91;
P
=0.019). The change in UACR was significantly associated with change in systolic blood pressure (
P
=0.001).

Conclusions:
In TOPCAT, albuminuria was independently associated with worse cardiovascular outcomes. Spironolactone significantly reduced albuminuria compared with placebo. Reducing albuminuria was independently associated with improved outcomes.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00094302.
Description of the imagos of Cloeodes jaragua Salles &amp; Lugo-Ortiz, 2003 (Ephemeroptera, Baetidae)
Authors: GONÇALVES INÊS CORRÊA , DE-SOUZA MÁRCIA REGINA , NESSIMIAN JORGE LUIZ 
Published: December 2018

Cloeodes Traver, 1938 (Ephemeroptera, Baetidae) was established to include Baetidae specimens from Puerto Rico. Of the three species described by Traver (1938), only the type-species C. maculipes remains in this genus (Domínguez et al. 2006). A revision of Cloeodes by Waltz & McCafferty (1987) redefined its distinct characteristics and revealed the genus to be a widespread group of Neotropical origin with several species from South and Central America as well as from Southwestern North America and Southeast Asia.
Understanding Key-Informant Experiences and Perceptions of the 2016 Drought and Wildfires in Western North Carolina
Authors: Andersen Lauren M. , Bonevac Abie N. , Thompson Laura K. , Dempsey Kara E. , Shay Elizabeth D. , Sugg Margaret M. 
Published: December 2018

Abstract
In 2016, an exceptional drought and subsequent wildfires devastated the southeastern United States. Western North Carolina (WNC), a socioeconomically growing region that is dependent on revenue from tourism and agriculture, was particularly impacted by the events. The Southeast is not typically considered to be water vulnerable, and few studies have explored drought and wildfire in WNC. However, the region is projected to experience elevated water vulnerability as a result of rapid population growth and increased climatic variability. The recent events highlight the need for better understanding of water-related experiences and perceptions to inform proactive policies for risk mitigation in WNC. To evaluate stakeholder experiences and perceptions relating to the events in 2016, the authors conducted telephone interviews with key informants from a variety of sectors in two counties (Buncombe and Watauga) and then subjected their responses to content analysis. Informants frequently discussed themes relating to the “Natural Resources and Environment” code group, with responses revealing concerns about the health effects of smoke exposure, as well as water quantity. Other common topics of discussion for informants include water management, public awareness, and disaster severity. The prevalence of other themes varied by county, demonstrating the importance of local context. Surprisingly, informants rarely discussed risk in the context of increasing population and development, suggesting that current policies may inadequately address future risks. Stakeholders across all sectors placed substantial emphasis on information dissemination both within agencies and to the public. With a better understanding of key-informant experiences and perceptions, policymakers will be better equipped to address policy shortcomings as well as to prepare for future hazards.
Outcomes of Treating Early Glottic Neoplasms With a Potassium Titanyl Phosphate Laser
Authors: Nouraei S. A. Reza , Dorman Edwin B. , Macann Andrew , Vokes David E. 
Published: December 2018

Objectives: The aim of this study was to assess the outcome of treating glottic dysplasia and early squamous cell carcinoma (SCC) with potassium titanyl phosphate (KTP) photoangiolytic laser ablation. Methods: Patient demographics, comorbidities, and tumor characteristics were recorded. Perceptual, patient-reported, and objective voice outcomes were assessed. Use of treatment modalities in addition to the KTP laser, development of locoregional or metastatic SCC, and overall survival were recorded. Results: There were 23 patients with glottic dysplasia and 18 patients with glottic SCC. Mean age at treatment was 69 years. Most patients (95%) were male. Posttreatment fundamental frequency fell from 132 ± 35 to 116 ± 24 Hz ( P = .03). Overall, 61% of patients achieved a normal voice. There was a learning-curve, and most treatment failures occurred in the first half of the series. Five-year KTP-only disease-control rates were 87.1% and 53.5% for dysplasia and malignancy, respectively. Five-year overall survival was 56%, with no laryngectomies or deaths due to SCC. Conclusions: Ablating dysplasia and early glottic cancer using a KTP laser is a viable treatment option. It has a learning curve and a failure rate but, in this series, no ultimate loss of oncologic control. Its introduction into clinical practice should be managed carefully in the context of multidisciplinary cancer care. Level of Evidence: 4.
Identifying the Prevalence of Dysphagia among Patients Diagnosed with Unilateral Vocal Fold Immobility
Authors: Zhou Dimin , Jafri Mohsin , Husain Inna 
Published: December 2018

ObjectiveTo identify dysphagia prevalence and characteristics among patients with unilateral vocal fold immobility (UVFI) through a systematic review of current literature.Data SourcesEmbase, PubMed, ScienceDirect, Wiley Online Library.Review MethodsFour electronic databases were reviewed according to the PRISMA criteria. Original English‐language studies examining dysphagia among adult patients with UVFI met eligibility. Two researchers independently analyzed qualified articles.ResultsOf 227 studies discovered through the literature search, 17 satisfied eligibility criteria. The prevalence of symptomatic dysphagia ranged from 55.6% to 69.0%, and the aspiration rate was 20.0% to 50.0%. Self‐reporting and clinical evaluation were used to identify symptomatic dysphagia, while videofluoroscopic swallowing study and functional endoscopic evaluation of swallowing evaluated aspiration. Left‐sided UVFI predominated. The most common causes of UVFI were iatrogenic and idiopathic. Central lesions and acute‐onset UVFI were each associated with more severe dysphagia. Patients were more likely to aspirate on liquids versus purées and pastes. Benefits of medialization thyroplasty and vocal cord injection were equivocal.ConclusionA significant portion of patients with UVFI present with dysphagia due to anatomic and physiologic disruptions during the swallow. Study population heterogeneity and small sample sizes in the reviewed studies may have compromised reliability, calling for large‐scale studies with rigorous methodology. Future studies should not only strive to identify the mechanics of the disordered swallow but also explore patients’ quality of life and the effectiveness of current treatments for dysphagia with underlying UVFI.
Multi‐institutional Evaluation of Medialization Laryngoplasty in the Elderly
Authors: Philips Ramez , Chorath Kevin , DeSilva Brad , Forrest L. Arick , Simpson C. Blake , Matrka Laura 
Published: December 2018

ObjectiveTo evaluate voice outcomes of medialization laryngoplasty in the elderly population (65 years and older) and to identify swallow outcomes, complication rates, and predictors of voice outcomes.Study DesignCase series with chart review.SettingTwo tertiary academic medical centers.Subjects and MethodsWe retrospectively reviewed charts of 136 patients age 65 years and older undergoing medialization laryngoplasty between January 2008 and May 2016 at 2 tertiary academic institutions. Primary outcome was assessed using Voice Handicap Index 10 (VHI‐10) score and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) score. Secondary outcomes were assessed using the Eating Assessment Tool 10 (EAT‐10) when dysphagia was present, stroboscopic analysis of glottic closure, and complication rates. A logistic regression analysis assessed predictors of voice improvement after medialization laryngoplasty.ResultsTotal GRBAS and VHI‐10 scores showed a significant improvement postoperatively (P <.05). A ≥20% improvement was seen in 81.6% of patients, and a ≥50% improvement was seen in 53.7%. No patient had major complications. Minor complications occurred in 5.9% of patients. Multivariable logistic regression identified preoperative injection augmentation as an independent predictor of less improvement in VHI‐10 score (P =. 015). Voice therapy prior to medialization did not affect voice outcomes (P =. 640).ConclusionPatient‐ and provider‐perceived voice quality are significantly improved after medialization laryngoplasty in the elderly, and the procedure is associated with a low complication rate even in an elderly cohort. Improvement in patient‐perceived voice outcomes after medialization laryngoplasty was diminished in patients with preoperative injection augmentation.
Prognostic Impact of High‐Risk Pathologic Features in HPV‐Related Oropharyngeal Squamous Cell Carcinoma and Tobacco Use
Authors: Kompelli Anvesh R. , Morgan Patrick , Li Hong , Harris William , Day Terry A. , Neskey David M. 
Published: December 2018

ObjectivesTo assess the impact of pathologic features and chronic tobacco use on human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC).Study DesignCase series with chart review.SettingSingle tertiary care referral center.Subject and MethodsA total of 301 patients were treated for OPSCC from 2008 to 2016. Clinical and pathologic T and N stage, American Joint Committee on Cancer (AJCC) stage (seventh and eighth edition staging manuals), cigarette pack years, alcohol use, and presence of extranodal extension (ENE), perineural invasion (PNI), or lymphovascular invasion (LVI) were assessed. Patients were stratified into HPV negative, HPV‐positive heavy smokers (≥20 pack years), and HPV‐positive nonsmokers. Five‐year survival by Kaplan‐Meier method was assessed.ResultsOf the HPV‐positive patients, 97 were nonsmokers and 73 were heavy smokers. HPV‐positive heavy smokers had significantly decreased survival compared to their nonsmoking counterparts (P =. 02). The presence of ENE was associated with a significantly decreased 5‐year survival (P =. 02) in heavy smokers relative to nonsmokers in HPV‐positive patients. Furthermore, for the AJCC eighth edition, clinically stage 1 HPV‐positive heavy smokers had significantly decreased survival relative to nonsmokers (P =. 01).ConclusionsThis series highlights the potential need for more aggressive therapy for HPV‐positive patients with extensive tobacco use under the new staging system.
Attachment style and perceived discrimination: Associations with depression among young lesbian, gay, and bisexual Romanian adults
Authors: Popa-Velea Ovidiu , Diaconescu Liliana Veronica , Ion Florentina Alexandra , Ştefancu Denisa , Truţescu Carmen 
Published: December 2018

Purpose: This study aims to evaluate the importance of individual determinants (gender, age), attachment style, and perceived discrimination on depression among young lesbian, gay, and bisexual (LGB) Romanians. Method: Participants comprised 374 young adults (172 men and 202 women; mean age = 25.75, SD = 7.78; 216 LGB and 158 heterosexuals). They completed the Adult Attachment Scale, the Beck Depression Inventory, and underwent a structured interview, designed to classify clinical depression, and measure the perceived discrimination in relation to their sexuality. Differences between groups were evaluated using the χ2 test (for the distribution of depressed individuals), the Mann–Whitney test (to compare the depression scores), a hierarchical linear regression analysis (to identify the predictors of depression), the F-test (to compare perceived discrimination in the LGB subgroups), and a moderation analysis (to test the interaction effects of attachment and sexual identity). Results: In the LGB group, the depression scores were higher ( U = 12.99, Z = −4.14, p < .0001) and the insecure attachment was more prevalent, χ2(2) = 25.66, p < .0001, than in heterosexuals. Perceived discrimination inside this group was skewed toward higher scores (mean = 5.68, SD = 2.58). Attachment style played the highest predictive role for depression (β = .352, p < .0001), followed by age (β = −.120, p < .012). The predictive effect of attachment on depression was not mediated by sexual orientation. Conclusion: Our study points out insecure attachment style and age as being important in the onset of depression in LGB individuals. This result can have implications for how depression is handled in these patients and the development of efficient care standards.
The effect of dose expectancies on caffeine withdrawal symptoms during tapered dose reduction
Authors: Mills Llewellyn , Boakes Robert A , Colagiuri Ben 
Published: December 2018

Background: Negative expectancies can exacerbate withdrawal symptoms via the nocebo effect. As such, information provided about dose reductions during attempts to taper a drug could contribute to withdrawal symptoms and increase the likelihood of relapse. The current study tested whether blinding participants to dose reductions during a supervised caffeine dose taper reduced these nocebo-induced withdrawal symptoms. Methods: Three groups of moderate to heavy coffee drinkers had their dose of caffeine reduced (tapered) from 300 mg per day to 0 mg over the course of five days and reported withdrawal symptoms twice daily. Groups were given differing information about how much caffeine they were receiving. An Open Reduction group was given accurate information about dose reductions. A Blind Reduction group was given no dose information whatsoever. A Deceptive Reduction group was misinformed about dose, with instructions suggesting that the dose remained on 300 mg for three days then dropped to 0 mg. Results: The Open Reduction group reported more pronounced caffeine withdrawal symptoms than the Deceptive Reduction group on the days with the greatest discrepancy between actual dose and informed dose, indicating a nocebo effect of open versus deceptive reductions. In addition, the rate of increase in reported withdrawal symptoms in the Blind Reduction and Deceptive Reduction groups was less than that of the Open Reduction group. Conclusion: These results suggest that awareness of dose reductions during a dose taper can result in a nocebo withdrawal effect, and that removing this awareness can reduce withdrawal. This has important implications for standard supervised dose-tapering practice, where patients are aware of the timing and magnitude of dose reductions.
Excision of tumors in the parapharyngeal space using an endoscopically assisted transoral approach: a case series and literature review
Authors: Chen Zhe , Chen Ya-Lian , Yu Qi , Zhou Shui-Hong , Bao Yang-Yang , Shang De-sheng , Ruan Ling-Xiang 
Published: December 2018

Objective Magnetic resonance imaging (MRI) provides important information regarding tumors in the parapharyngeal space (PPS), revealing their origin, whether they are benign or malignant, and their relationships with surrounding structures. Methods Twelve tumors in the PPS were completely excised using an endoscopically assisted transoral approach (EATA). The MRI features were analyzed. Results Ten pleomorphic adenomas confirmed on postoperative pathological examination had the parotid pedicle sign. A fat space between the tumor and parotid gland may distinguish such a tumor from a tumor arising from a minor salivary gland in the prestyloid space and a tumor arising from the deep lobe of the parotid gland. Both the jugular vein and carotid artery were displaced posteriorly in all 10 cases of pleomorphic adenomas. The principal features of the two schwannomas confirmed on postoperative pathological examination were separation of the internal carotid artery and internal jugular vein and anteromedial displacement of the internal carotid artery, suggesting that the tumors originated in the poststyloid space. In this review, 95 tumors were excised by the EATA in the English-language literature. Conclusions MRI renders differential diagnosis possible. PPS tumors may be completely excised via an EATA guided by tumor features evident on preoperative MRI.