bluuebunny/crossref_metadata_2025_split huggingface dataset:
Near-extreme summer meteorological data set for sub-tropical climates
Authors: Lau Kevin Ka-Lun , Ng Edward Yan-Yung , Chan Pak-Wai , Ho Justin Ching-Kwan 
Published: October 2016

Building performance simulation requires representative weather data of specific locations. Test Reference Year (TRY) and Typical Meteorological Year (TMY) are common hourly dataset for typical year conditions. In sub-tropical climates, overheating is very common in buildings due to high temperature and intense solar radiation. However, there are no universal approaches to develop a dataset for estimating summer discomfort in naturally ventilated and free-running buildings. This article employs the concept of Summer Reference Years (SRY) in order to represent the near-extreme summer conditions in Hong Kong. The derived SRY is able to capture the near-extreme conditions in the multi-year series. The SRY was found to represent the high Tdry values reasonably well during daytime when such near-extreme conditions occur. On the contrary, according to the number of HN-DHs, the SRY does not satisfactorily represent high night-time Tdry. It is possible to incorporate the sorting of Tdry-min in the SRY adjustment in order to better reflect night-time situations in sub-tropical climate. Further studies are therefore required to confirm whether such modifications give more accurate results in the assessment of building energy performance. Nonetheless, the SRY dataset can be applied in building performance simulation and the assessment of indoor thermal comfort. Practical application: The present study found that there are deficiencies for the SRY to represent the high night-time Tdry, which affects the building performance assessment in sub-tropical climates. It suggests potential improvement to the existing adjustment of SRY for representing the near-extreme summer conditions in order to obtain more accurate results of building assessment.
Design and Analysis Considerations for Cluster Randomized Controlled Trials That Have a Small Number of Clusters
Authors: Deke John 
Published: October 2016

Background: Cluster randomized controlled trials (CRCTs) often require a large number of clusters in order to detect small effects with high probability. However, there are contexts where it may be possible to design a CRCT with a much smaller number of clusters (10 or fewer) and still detect meaningful effects. Objectives: The objective is to offer recommendations for best practices in design and analysis for small CRCTs. Research design: I use simulations to examine alternative design and analysis approaches. Specifically, I examine (1) which analytic approaches control Type I errors at the desired rate, (2) which design and analytic approaches yield the most power, (3) what is the design effect of spurious correlations, and (4) examples of specific scenarios under which impacts of different sizes can be detected with high probability. Results/Conclusions: I find that (1) mixed effects modeling and using Ordinary Least Squares (OLS) on data aggregated to the cluster level both control the Type I error rate, (2) randomization within blocks is always recommended, but how best to account for blocking through covariate adjustment depends on whether the precision gains offset the degrees of freedom loss, (3) power calculations can be accurate when design effects from small sample, spurious correlations are taken into account, and (4) it is very difficult to detect small effects with just four clusters, but with six or more clusters, there are realistic circumstances under which small effects can be detected with high probability.
Quality of Life after Sequential Bilateral Cochlear Implantation: An Updated Comprehensive Cochlear Implant Questionnaire
Authors: Nahm Edmund A. , Liberatos Penny , Shi Qiuhu , Lai Erica , Kim Ana H. 
Published: October 2016

ObjectiveAssess psychometric properties of the Comprehensive Cochlear Implant Questionnaire (CCIQ) as a tool for assessing changes in health‐related quality of life (HRQoL) after receiving a second cochlear implant (CI2).Study DesignProspective study.SettingAcademic cochlear implant center.Subjects and MethodsThe CCIQ is a 29‐item questionnaire assessing the physical and psychosocial benefits of a CI2 based on a 5‐point Likert scale. The CCIQ was administered with the Nijmegen Cochlear Implant Questionnaire and the Short Form–12 Patient Questionnaire (SF‐12) to patients with a CI2. Speech perception was tested with the consonant‐nucleus‐consonant (CNC) word test and AzBio test.ResultsOf 56 patients, 32 (57.1%) completed the instruments sent by mail. Of the 32 patients, 22 (68.8%) completed retest CCIQs 6 weeks later. CCIQ scores demonstrated significantly increased HRQoL in all domains. Internal consistency was very good overall (Cronbach’s α = 0.90), with all subdomains exceeding an alpha value of 0.70. Test‐retest reliability was good, with an overall intraclass correlation of 0.62. The CCIQ showed a moderate correlation with the Nijmegen Cochlear Implant Questionnaire and a low correlation with the SF‐12. Average CNC and AZBio scores significantly improved by 31% ± 29% and 34% ± 33%, respectively. Audiometric data were not significantly correlated with the CCIQ.ConclusionThe CCIQ shows (1) good reliability and evidence of construct validity, (2) a significant increase in HRQoL and significantly improved speech perception after CI2, and (3) greater sensitivity at detecting CI2 improvements to HRQoL. This promising measure is quick and easy to administer and provides subjective assessments of HRQoL specifically for those with a CI2.
Laryngotracheal Stenosis: Risk Factors for Tracheostomy Dependence and Dilation Interval
Authors: Gadkaree Shekhar K. , Pandian Vinciya , Best Simon , Motz Kevin M. , Allen Clint , Kim Young , Akst Lee , Hillel Alexander T. 
Published: October 2016

ObjectiveLaryngotracheal stenosis (LTS) is a fibrotic process that narrows the upper airway and has a significant impact on breathing and phonation. Iatrogenic injury from endotracheal and/or tracheostomy tubes is the most common etiology. This study investigates differences in LTS etiologies as they relate to tracheostomy dependence and dilation interval.Study DesignCase series with chart review.SettingSingle‐center tertiary care facility.Subjects and MethodsReview of adult patients with LTS was performed between 2004 and 2015. The association of patient demographics, comorbidities, disease etiology, and treatment modalities with patient outcomes was assessed. Multiple logistic regression analysis and Kaplan‐Meier analysis were performed to determine factors associated with tracheostomy dependence and time to second procedure, respectively.ResultsA total of 262 patients met inclusion criteria. Iatrogenic patients presented with greater stenosis (P =. 023), greater length of stenosis (P =. 004), and stenosis farther from the vocal folds (P <. 001) as compared with other etiologies. Iatrogenic patients were more likely to be African American, use tobacco, and have obstructive sleep apnea, type II diabetes, hypertension, chronic obstructive pulmonary disease, or a history of stroke. Iatrogenic LTS (odds ratio [OR] = 3.1, 95% confidence interval [95% CI] = 1.2‐8.2), Cotton‐Myer grade 3‐4 (OR = 2.6, 95% CI = 1.1‐6.4), and lack of intraoperative steroids (OR = 2.9, 95% CI = 1.2‐6.9) were associated with tracheostomy dependence. Nonsmokers, patients without tracheostomy, and idiopathic LTS patients had a significantly longer time to second dilation procedure.ConclusionIatrogenic LTS presents with a greater disease burden and higher risk of tracheostomy dependence when compared with other etiologies of LTS. Comorbid conditions promoting microvascular injury—including smoking, COPD, and diabetes—were prevalent in the iatrogenic cohort. Changes in hospital practice patterns to promote earlier tracheostomy in high‐risk patients could reduce the incidence of LTS.
Ultrasonographic Evaluation of Cervical Lymph Nodes in Thyroid Cancer
Authors: Machado Maria Regina Marrocos , Tavares Marcos Roberto , Buchpiguel Carlos Alberto , Chammas Maria Cristina 
Published: October 2016

ObjectiveTo determine what ultrasonographic features can identify metastatic cervical lymph nodes, both preoperatively and in recurrences after complete thyroidectomy.Study DesignProspective.SettingOutpatient clinic, Department of Head and Neck Surgery, School of Medicine, University of São Paulo, Brazil.Subjects and MethodsA total of 1976 lymph nodes were evaluated in 118 patients submitted to total thyroidectomy with or without cervical lymph node dissection. All the patients were examined by cervical ultrasonography, preoperatively and/or postoperatively. The following factors were assessed: number, size, shape, margins, presence of fatty hilum, cortex, echotexture, echogenicity, presence of microcalcification, presence of necrosis, and type of vascularity. The specificity, sensitivity, positive predictive value, and negative predictive value of each variable were calculated. Univariate and multivariate logistic regression analyses were conducted. A receiver operator characteristic (ROC) curve was plotted to determine the best cutoff value for the number of variables to discriminate malignant lymph nodes.ResultsSignificant differences were found between metastatic and benign lymph nodes with regard to all of the variables evaluated (P <. 05). Logistic regression analysis revealed that size and echogenicity were the best combination of altered variables (odds ratio, 40.080 and 7.288, respectively) in discriminating malignancy. The ROC curve analysis showed that 4 was the best cutoff value for the number of altered variables to discriminate malignant lymph nodes, with a combined specificity of 85.7%, sensitivity of 96.4%, and efficiency of 91.0%.ConclusionGreater diagnostic accuracy was achieved by associating the ultrasonographic variables assessed rather than by considering them individually.
Perspectives on advance care planning among patients recently requiring non-invasive ventilation for acute respiratory failure: A qualitative study using thematic analysis
Authors: Smith Tracy A , Disler Rebecca T , Jenkins Christine R , Ingham Jane M , Davidson Patricia M 
Published: October 2016

Background: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. Aim: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. Design: Qualitative research using thematic analysis. Settings and participants: Tertiary teaching hospital. Patients with acute hypercapnic respiratory failure requiring non-invasive ventilation. Results: Individuals recently treated with non-invasive ventilation describe feeling the future is beyond their control and instead controlled by their illness. Participants often recognised their poor prognosis but avoided discussing some difficult topics. The majority preferred not to undergo cardiopulmonary resuscitation but most had not discussed this with healthcare professionals. When participants voiced concerns about their future health to family members, they were met with polarised responses. Some encountered willingness for further discussion, while others met deflection, deterring further conversation. An overarching narrative of ‘Looking through my illness to an uncertain but concerning future’ unites these themes. Conclusion: This study suggests opportunities and barriers for advance care planning in individuals with chronic disease. Patients’ understanding of their prognosis and their attitudes to cardiopulmonary resuscitation suggests an opportunity for advance care planning. Structuring discussions around patients’ preferences for care during future exacerbations may foster a sense of control over the future despite illness. The diversity of familial responses to patients’ concerns about their future health has implications for advance care planning. These findings have the potential to improve care for patients with respiratory failure and suggest an important ongoing research agenda.
A metasynthesis study of family caregivers’ transition experiences caring for community-dwelling persons with advanced cancer at the end of life
Authors: Duggleby Wendy , Tycholiz Jamie , Holtslander Lorraine , Hudson Peter , Nekolaichuk Cheryl , Mirhosseini Mehrnoush , Parmar Jasneet , Chambers Thane , Alook Angele , Swindle Jennifer 
Published: October 2016

Background: Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. Aims: To (a) explore the transition experience of family caregivers caring for persons with advanced cancer living in the community, (b) describe potential triggers for transitions, (c) identify what influences this experience, and (d) develop a conceptual framework of their transition experience. Design: Sandelowski and Barroso’s methodology for synthesizing qualitative research included (a) a comprehensive search of empirical literature, (b) quality appraisal of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Data sources: Literature was sourced from six electronic data bases. Inclusion criteria were as follows: (a) published qualitative studies (and mixed-method designs) of the caregiving experience of family caregivers of community-living persons with advanced cancer at the end of life, (b) participants (caregivers and care recipients) of 18 years of age and above, (c) studies published in English in any country, and (d) studies published between 2004 and 2014. Results: A total of 72 studies were included in the metasynthesis. Family caregivers experience a “life transition” whereby their lives are permanently altered. The participants described the process of redefining normal which consisted of coming to terms with their situation and connecting with others. Outcomes of these processes were as follows: (a) maintaining a sense of personhood, (b) reframing hope, (c) maintaining self-efficacy, (d) finding meaning, and (e) preparing for the death of their care recipient. Conclusion: The findings provide a framework to guide the development of supportive programs and future research.
‘There’s a Catch-22’ – The complexities of pain management for people with advanced dementia nearing the end of life: A qualitative exploration of physicians’ perspectives
Authors: De Witt Jansen Bannin , Brazil Kevin , Passmore Peter , Buchanan Hilary , Maxwell Doreen , McIlfatrick Sonja J , Morgan Sharon M , Watson Max , Parsons Carole 
Published: October 2016

Background: Pain management is a cornerstone of palliative care. The clinical issues encountered by physicians when managing pain in patients dying with advanced dementia, and how these may impact on prescribing and treatment, are unknown. Aim: To explore physicians’ experiences of pain management for patients nearing the end of life, the impact of these on prescribing and treatment approaches, and the methods employed to overcome these challenges. Design: Qualitative, semi-structured interview study exploring barriers to and facilitators of pain management, prescribing and treatment decisions, and training needs. Thematic analysis was used to elicit key themes. Setting/participants: A total of 23 physicians, responsible for treating patients with advanced dementia approaching the end of life, were recruited from primary care ( n = 9), psychiatry ( n = 7) and hospice care ( n = 7). Results: Six themes emerged: diagnosing pain, complex prescribing and treatment approaches, side effects and adverse events, route of administration, importance of sharing knowledge and training needs. Knowledge exchange was often practised through liaison with physicians from other specialities. Cross-speciality mentoring and the creation of knowledge networks were believed to improve pain management in this patient population. Conclusion: Pain management in end-stage dementia is complex, requiring cross-population of knowledge between palliative care specialists and non-specialists, in addition to collateral information provided by other health professionals and patients’ families. Regular, cost- and time-effective mentoring and ongoing professional development are perceived to be essential in empowering physicians to meet clinical challenges in this area.
Family caregivers’ conceptualisation of quality end-of-life care for people with dementia: A qualitative study
Authors: Davies Nathan , Rait Greta , Maio Laura , Iliffe Steve 
Published: October 2016

Background: People with dementia have been described as the ‘disadvantaged dying’ with poor end-of-life care. Towards the end of life, people with dementia cannot report on the care they receive. It is therefore important to talk to caregivers; however, few have explored the views about end-of-life care from the caregivers’ perspective. The majority of research on family caregivers has focussed on the burden and psychological impact of caring for a relative with dementia. Aim: This study aimed to explore the views of family caregivers about quality end-of-life care for people with dementia. Design: Qualitative study using in-depth interviews and analysed using thematic analysis. Setting/participants: Purposive sampling from a third sector organisation’s caregiver network was used to recruit 47 caregivers in England (2012–2013), consisting of (1) family caregivers of someone who had recently received a diagnosis of dementia, (2) family caregivers currently caring for someone with dementia and (3) bereaved family caregivers. Results: Three over-arching themes were derived from the interviewees’ discourse, including maintaining the person within, fostering respect and dignity and showing compassion and kindness. Conclusion: End-of-life care for people with dementia does not differ from care throughout the dementia trajectory. Throughout the findings, there is an implicit underlying theme of conflict: conflict between family caregivers and an increasingly systematised service of care and conflict between family caregivers and professionals. This study has in particular demonstrated the importance of the psycho-social aspects of care, aligning with the holistic definition of palliative care.
Effect of high rate rTMS on somatosensory evoked potential in migraine
Authors: Kalita Jayantee , Bhoi Sanjeev K , Misra Usha K 
Published: October 2016

Background Sensitization and impaired habituation of cortical neurons have been reported in migraineurs. Repetitive transcranial magnetic stimulation (rTMS) may change these phenomena and be the basis of therapeutic response. We report the effect of 10 Hz rTMS on sensitization and habituation of median somatosensory evoked potential (SEP) in migraineurs, and correlate these changes with clinical response. Methods Migraineurs having four or more episodes of headache per month were included and their clinical details were noted. Three sessions of 10 Hz rTMS, 600 pulses in 412.4 seconds were delivered on the left frontal cortex corresponding to the hot spot of right abductor digiti minimi, on alternate days. Median SEP was done before and 30 minutes after the third rTMS session. Sensitization (block I N20 amplitude) and impaired habituation (if N20 amplitude of block 2 or 3 were not suppressed compared to block I) were noted. The reduction in frequency and severity of headache in the next month were noted and correlated with SEP changes. Results Ninety-four migraineurs were included; 56 received true rTMS and 38 sham stimulation. Following stimulation, reduction in N20 amplitude of block 1 correlated with a reduction in frequency and severity of headache at one month. The impaired habituation significantly improved in the true rTMS group compared to sham stimulation, and correlated with a reduction in the severity of headache but not with frequency. Conclusion In migraineurs, 10 Hz rTMS improves habituation and may be the biological basis of headache relief.
European Co-production Funds and Latin American Cinema: Processes of Othering and Bourgeois Cinephilia in Claudia Llosa's La teta asustada
Authors: Shaw Deborah 
Published: October 2016

AbstractLatin American women's filmmaking has an unprecedented international profile thanks to the films of the Peruvian director Claudia Llosa, and the Argentine directors Lucía Puenzo and Lucrecia Martel. What is frequently unacknowledged when discussing the work of these award-winning filmmakers is the fact that all of their films are co-productions with Europe, and that programmes such as Cinéfondation, a programme aligned with the Cannes film festival, the Hubert Bals Fund, the World Cinema Fund and Ibermedia have been instrumental in their production. This article will tell this story through a discussion of the work of Claudia Llosa with an introduction to the issues raised by her award winning festival film Madeinusa (2006), and a focus on La teta asustada/The Milk of Sorrow (2009). It will consider the arguments of theorists who critique what they see as neo-colonial European interventions in ‘world cinema’, and those who celebrate the enabling work of the funding bodies. The chapter asks where can we place the cultural production of Llosa within these paradigms? Does the film confirm the critical positions by being subject to a process of othering for a European cinephile festival audience? Does it create its protagonist Fausta, an Andean migrant to Lima, from racist, neo-colonial stereotypes as some critics claim? Or, does it raise important questions relating to class and ethnic divisions within contemporary Peruvian society? The article ends with a discussion of how Llosa's second film, that presents the urban poor and the colonial class from a bourgeois point of view, compares with the films of Lucrecia Martel and Lucía Puenzo which provide a bourgeois point of view on the bourgeoisie itself.
Conspiracy theories as stigmatized knowledge
Authors: Barkun Michael 
Published: October 2016

AbstractMost conspiracy theories exist as part of “stigmatized knowledge” – that is, knowledge claims that have not been accepted by those institutions we rely upon for truth validation. Not uncommonly, believers in conspiracy theories also accept other forms of stigmatized knowledge, such as unorthodox forms of healing and beliefs about Atlantis and UFOs. Rejection by authorities is for them a sign that a belief must be true. However, the linkage of conspiracy theories with stigmatized knowledge has been weakening, because stigmatized knowledge itself is growing more problematic. What was once clearly recognizable as “the fringe” is now beginning to merge with the mainstream. This process of “mainstreaming the fringe” is the result of numerous factors, including the ubiquity of the Internet, the growing suspicion of authority, and the spread of once esoteric themes in popular culture. Only a permeable membrane now separates the fringe from the mainstream. Thus conspiracism is no longer the province only of small, isolated coteries. It now has the potential to make the leap into public discourse. This, of course, does not apply to every conspiracy theory, but it happens enough to suggest that we are at an important transition point. The recent controversy in the United States over whether a conspiracy existed to hide President Obama's alleged foreign birth – a claim that years earlier would never have emerged beyond small radical groups – suggests the nature of the change. It also suggests the dangers that political cultures may face in the future.