bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving maternal, newborn and child health outcomes through a community-based women’s health education program: a cluster randomised controlled trial in western Kenya
Authors: Maldonado Lauren Y , Bone Jeffrey , Scanlon Michael L , Anusu Gertrude , Chelagat Sheilah , Jumah Anjellah , Ikemeri Justus E , Songok Julia J , Christoffersen-Deb Astrid , Ruhl Laura J 
Published: December 2020

IntroductionCommunity-based women’s health education groups may improve maternal, newborn and child health (MNCH); however, evidence from sub-Saharan Africa is lacking. Chamas for Change (Chamas) is a community health volunteer (CHV)-led, group-based health education programme for pregnant and postpartum women in western Kenya. We evaluated Chamas’ effect on facility-based deliveries and other MNCH outcomes.MethodsWe conducted a cluster randomised controlled trial involving 74 community health units in Trans Nzoia County. We included pregnant women who presented to health facilities for their first antenatal care visits by 32 weeks gestation. We randomised clusters 1:1 without stratification or matching; we masked data collectors, investigators and analysts to allocation. Intervention clusters were invited to bimonthly, group-based, CHV-led health lessons (Chamas); control clusters had monthly, individual CHV home visits (standard of care). The primary outcome was facility-based delivery at 12-month follow-up. We conducted an intention-to-treat approach with multilevel logistic regression models using individual-level data.ResultsBetween 27 November 2017 and 8 March 2018, we enrolled 1920 participants from 37 intervention and 37 control clusters. A total of 1550 (80.7%) participants completed the study with 822 (82.5%) and 728 (78.8%) in the intervention and control arms, respectively. Facility-based deliveries improved in the intervention arm (80.9% vs 73.0%; risk difference (RD) 7.4%, 95% CI 3.0 to 12.5, OR=1.58, 95% CI 0.97 to 2.55, p=0.057). Chamas participants also demonstrated higher rates of 48 hours postpartum visits (RD 15.3%, 95% CI 12.0 to 19.6), exclusive breastfeeding (RD 11.9%, 95% CI 7.2 to 16.9), contraceptive adoption (RD 7.2%, 95% CI 2.6 to 12.9) and infant immunisation completion (RD 15.6%, 95% CI 11.5 to 20.9).ConclusionChamas participation was associated with significantly improved MNCH outcomes compared with the standard of care. This trial contributes robust data from sub-Saharan Africa to support community-based, women’s health education groups for MNCH in resource-limited settings.Trial registration numberNCT03187873.
Intensified immunosuppressive therapy in patients with immune checkpoint inhibitor-induced myocarditis
Authors: Cautela Jennifer , Zeriouh Sarah , Gaubert Melanie , Bonello Laurent , Laine Marc , Peyrol Michael , Paganelli Franck , Lalevee Nathalie , Barlesi Fabrice , Thuny Franck 
Published: December 2020

BackgroundMyocarditis is a rare but life-threatening adverse event of cancer treatments with immune checkpoint inhibitors (ICIs). Recent guidelines recommend the use of high doses of corticosteroids as a first-line treatment, followed by intensified immunosuppressive therapy (IIST) in the case of unfavorable evolution. However, this strategy is empirical, and no studies have specifically addressed this issue. Therefore, we aimed to investigate and compare the clinical course, management and outcome of ICI-induced myocarditis patients requiring or not requiring IIST.MethodsThis case–control study included all patients consecutively admitted to The Mediterranean University Center of Cardio-Oncology (Aix-Marseille University, France) for the diagnosis of ICI-induced myocarditis according to Bonaca’s criteria and treated with or without IIST. In addition, we searched PubMed and included patients from previously published case reports treated with IIST in the analysis. The clinical, biological, imaging, treatment, all-cause death and cardiovascular death data of patients who required IIST were compared with those of patients who did not.ResultsA total of 60 patients (69±12 years) were included (36 were treated with IIST and 24 were not). Patients requiring IIST were more likely to have received a combination of ICIs (39% vs 8%, p=0.01), and developed the first symptoms/signs of myocarditis earlier after the onset of ICI therapy (median, 18 days vs 60 days, p=0.002). They had a significantly higher prevalence of sustained ventricular arrhythmia, complete atrioventricular block, cardiogenic shock and troponin elevation. Moreover, they were more likely to have other immune-related adverse events simultaneously (p<0.0001), especially myositis (p=0.0002) and myasthenia gravis (p=0.009). Patients who required IIST were more likely to die from any cause (50% vs 21%, p=0.02). Among them, patients who received infliximab were more likely to die from cardiovascular causes (OR, 12.0; 95% CI 2.1 to 67.1; p=0.005).ConclusionThe need for IIST was more common in patients who developed myocarditis very early after the start of ICI therapy, as well as when hemodynamic/electrical instability or neuromuscular adverse events occurred. Treatment with infliximab might be associated with an increased risk of cardiovascular death.
Characterisation of patients with severe asthma in the UK Severe Asthma Registry in the biologic era
Authors: Jackson David J , Busby John , Pfeffer Paul E , Menzies-Gow Andrew , Brown Thomas , Gore Robin , Doherty Martin , Mansur Adel H , Message Simon , Niven Robert , Patel Mitesh , Heaney Liam G 
Published: December 2020

BackgroundThe UK Severe Asthma Registry (UKSAR) is the world’s largest national severe asthma registry collecting standardised data on referrals to UK specialist services. Novel biologic therapies have transformed the management of type 2(T2)-high severe asthma but have highlighted unmet need in patients with persisting symptoms despite suppression of T2-cytokine pathways with corticosteroids.MethodsDemographic, clinical and treatments characteristics for patients meeting European Respiratory Society / American Thoracic Society severe asthma criteria were examined for 2225 patients attending 15 specialist severe asthma centres. We assessed differences in biomarker low patients (fractional exhaled nitric oxide (FeNO) <25 ppb, blood eosinophils <150/μL) compared with a biomarker high population (FeNO ≥25 ppb, blood eosinophils ≥150/µL).ResultsAge (mean 49.6 (14.3) y), age of asthma onset (24.2 (19.1) y) and female predominance (62.4%) were consistent with prior severe asthma cohorts. Poor symptom control (Asthma Control Questionnaire-6: 2.9 (1.4)) with high exacerbation rate (4 (IQR: 2, 7)) were common despite high-dose treatment (51.7% on maintenance oral corticosteroids (mOCS)). 68.9% were prescribed biologic therapies including mepolizumab (50.3%), benralizumab (26.1%) and omalizumab (22.6%). T2-low patients had higher body mass index (32.1 vs 30.2, p<0.001), depression/anxiety prevalence (12.3% vs 7.6%, p=0.04) and mOCS use (57.9% vs 42.1%, p<0.001). Many T2-low asthmatics had evidence of a historically elevated blood eosinophil count (0.35 (0.13, 0.60)).ConclusionsThe UKSAR describes the characteristics of a large cohort of asthmatics referred to UK specialist severe asthma services. It offers the prospect of providing novel insights across a range of research areas and highlights substantial unmet need with poor asthma control, impaired lung function and high exacerbation rates. T2-high phenotypes predominate with significant differences apparent from T2-low patients. However, T2-low patients frequently have prior blood eosinophilia consistent with possible excessive corticosteroid exposure.
Neuromuscular fatigue of the elbow flexors during repeated maximal arm cycling sprints: the effects of forearm position
Authors: Lockyer Evan J. , Buckle Natasha C.M. , Collins Brandon W. , Button D.C. 
Published: December 2020

Repeated sprint exercise (RSE) is often used to induce neuromuscular fatigue (NMF). It is currently not known whether NMF is influenced by different forearm positions during arm cycling RSE. The purpose of this study was to investigate the effects of a pronated versus supinated forearm position on elbow flexor NMF during arm cycling RSE. Participants (n = 12) completed ten 10-s maximal arm cycling sprints interspersed by 60 s of rest on 2 separate days using either a pronated or supinated forearm position. All sprints were performed on an arm cycle ergometer in a reverse direction. Prior to and following RSE, NMF measurements (i.e., maximal voluntary contraction (MVC), potentiated twitch (PT), electromyography median frequencies) were recorded. Sprint performance measures, ratings of perceived exertion (RPE) and pain were also recorded. Irrespective of forearm position, sprint performance decreased as sprint number increased. These decreases were accompanied by significant increases in RPE (p < 0.001, ηp2 = 0.869) and pain (p < 0.001, ηp2 = 0.745). Participants produced greater power output during pronated compared with supinated sprinting (p < 0.001, ηp2 = 0.728). At post-sprinting, the percentage decrease in elbow flexor MVC and PT force from pre-sprinting was significantly greater following supinated than pronated sprinting (p < 0.001), suggesting greater peripheral fatigue occurred in this position. The data suggest that supinated arm cycling RSE results in inferior performance and greater NMF compared with pronated arm cycling RSE. Novelty: NMF of the elbow flexors is influenced by forearm position during arm cycling RSE. Supinated arm cycling sprints resulted in worse repeated sprint performance and also greater NMF than pronated RSE.
Don't let good grammar spoil good writing
Authors: Yaffe Philip 
Published: December 2020

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.
It seems that if your grammar is good, your writing will be good. However, being overly concerned about good grammar can actually be detrimental to good writing. Here's why.
Performance of Atrial Fibrillation Risk Prediction Models in Over 4 Million Individuals
Authors: Khurshid Shaan , Kartoun Uri , Ashburner Jeffrey M. , Trinquart Ludovic , Philippakis Anthony , Khera Amit V. , Ellinor Patrick T. , Ng Kenney , Lubitz Steven A. 
Published: December 2020

Background:
Atrial fibrillation (AF) is associated with increased risks of stroke and heart failure. Electronic health record (EHR)–based AF risk prediction may facilitate efficient deployment of interventions to diagnose or prevent AF altogether.

Methods:

We externally validated an electronic health record AF (EHR-AF) score in IBM Explorys Life Sciences, a multi-institutional dataset containing statistically deidentified EHR data for over 21 million individuals (Explorys Dataset). We included individuals with complete AF risk data, ≥2 office visits within 2 years, and no prevalent AF. We compared EHR-AF to existing scores including CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology Atrial Fibrillation), C
2
HEST (coronary artery disease or chronic obstructive pulmonary disease, hypertension, elderly, systolic heart failure, thyroid disease), and CHA
2
DS
2
-VASc. We assessed association between AF risk scores and 5-year incident AF, stroke, and heart failure using Cox proportional hazards modeling, 5-year AF discrimination using C indices, and calibration of predicted AF risk to observed AF incidence.

Results:

Of 21 825 853 individuals in the Explorys Dataset, 4 508 180 comprised the analysis (age 62.5, 56.3% female). AF risk scores were strongly associated with 5-year incident AF (hazard ratio per SD increase 1.85 using CHA
2
DS
2
-VASc to 2.88 using EHR-AF), stroke (1.61 using C
2
HEST to 1.92 using CHARGE-AF), and heart failure (1.91 using CHA
2
DS
2
-VASc to 2.58 using EHR-AF). EHR-AF (C index, 0.808 [95% CI, 0.807–0.809]) demonstrated favorable AF discrimination compared to CHARGE-AF (0.806 [95% CI, 0.805–0.807]), C
2
HEST (0.683 [95% CI, 0.682–0.684]), and CHA
2
DS
2
-VASc (0.720 [95% CI, 0.719–0.722]). Of the scores, EHR-AF demonstrated the best calibration to incident AF (calibration slope, 1.002 [95% CI, 0.997–1.007]). In subgroup analyses, AF discrimination using EHR-AF was lower in individuals with stroke (C index, 0.696 [95% CI, 0.692–0.700]) and heart failure (0.621 [95% CI, 0.617–0.625]).

Conclusions:
EHR-AF demonstrates predictive accuracy for incident AF using readily ascertained EHR data. AF risk is associated with incident stroke and heart failure. Use of such risk scores may facilitate decision support and population health management efforts focused on minimizing AF-related morbidity.
Children, Motherhood, and the Social Death of Childless Women: The Social and Theological Construction of Infertility in the Hebrew Bible and in Cameroon
Authors: Yafeh-Deigh Alice 
Published: December 2020

Abstract
This paper reviews the biblical mandate to have children in tension with the claim that God holds the exclusive power to open and close wombs. What are the social and cultural implications of this theological assertion for procreative disadvantaged women in the Hebrew Bible (Sarah [Gen.16], Rebecca [Gen. 25], Rachel [Gen. 29–30], Samson’s mother [Judges 13], and Hannah [1 Sam 1])? Focusing on children’s value, I will examine the implications of procreative sexual ethics for Cameroonian women with permanent infertility. The conclusion further proposes a reconceptualized and subversive motherhood model using the Naomi-Ruth narrative, constructing family beyond biology or genetics.
The Child Snatched Away: Reading Revelation Through a Childist Lens
Authors: Betsworth Sharon 
Published: December 2020

Abstract
A great deal of biblical interpretation over the past 30 years has focused upon imagery related to women in the book of Revelation. Very little scholarship has discussed children in Revelation, likely because there are very few in the Apocalypse. However, the limited passages in which children are present deserve to be examined with a focus upon the child. This article will discuss two passages in Revelation which refer to children, Rev. 2:18–29 and Rev. 12:1–5, with the latter receiving greater attention. I will analyze these passages using childist interpretation, building upon Kathleen Gallagher Elkins’s study of feminist and childist interpretation, which uses Rev. 12 as a case study to apply both methods to the same text. Imperial-critical reading will enhance the interpretation of these passages. As I discuss Rev. 12, I will also compare the myth of three Greek child gods, Apollo, Dionysius, and Persephone, to the child snatched away in Rev. 12:5, to understand more fully how this child fits within the overall message of Revelation.
Diagoras and Philippus ‘the Atheist’ in Philodemus’ On Piety
Authors: Vassallo Christian 
Published: December 2020

Abstract
At the end of his treatise On Piety, Philodemus systematically criticizes Stoic theology, employing an excursus on Diagoras as part of his critique. Arguing against Diagoras’ detractors, Philodemus, relying on a testimonium by Aristoxenus, claims that, in his poetic writings, Diagoras did not commit any act of impiety. On the contrary, he argues that, despite their practice of calling the gods by name in their treatises, the Stoics ended up destroying the gods more radically than ‘atheists’ like Philippus and others. This paper attempts to shed new light on this Herculanean testimonium to Diagoras and, above all, suggests a solution for identifying the otherwise unknown figure of Philippus ‘the Atheist’.
Answering Yes/No Questions in Biblical Hebrew Dialogue
Authors: Moshavi Adina 
Published: December 2020

Abstract
The question-response interchange in biblical dialogue is of great linguistic as well as literary interest. In order to successfully serve purposes such as characterization and plot development, question-response interactions in a literary composition must authentically reflect the linguistic forms and conversational practices characterizing natural spoken language. The present study analyzes the linguistic characteristics and patterns of use of responses to questions in Biblical Hebrew dialogue. Its findings show that the semantics and syntax of answers to yes/no questions are closely related to the affiliation or misaffiliation of the answer with the question’s accompanying assumptions, expectations, and agendas. These associations between semantic/syntactic types and social cooperativeness, which closely resemble those found in modern spoken conversation, contribute to the authenticity of the style of biblical dialogue, and enable the question-response interaction to function effectively on the literary level.
Non-Accusative ʾt and the Syntactic Profile of Late Biblical Hebrew
Authors: Samet Nili 
Published: December 2020

Abstract
This paper examines the widespread classification of ʾt before the nominative as a trademark of Late Biblical Hebrew. The paper begins by defining the nature and scope of this syntactic usage and reviewing its possible explanations. Next, a full list of the relevant examples is presented and alleged post-biblical cognates are examined. This data leads to the conclusion that contrary to the common scholarly sentiment, ʾt nominativi cannot be considered a late feature within Biblical Hebrew. The evidence from Mishnaic Hebrew that was erroneously associated with ʾt nominativi enables, however, the identification of a hitherto unknown late biblical structure, namely, the demonstrative ʾt ʾšr. Biblical occurrences of this usage are recognizable in Jeremiah, Zechariah, and Qohelet. The paper concludes that while ʾt nominativi is by no means a late usage, the demonstrative ʾt ʾšr may be classified as late with more certainty. This conclusion calls for a re-examination of the syntactic profile of LBH as drawn in the influential works of the field, chiefly those by Kropat and Polzin.
The “Molten Sea” Revisited
Authors: Shapira David 
Published: December 2020

Abstract
According to the biblical account (1 Kgs 7:23–26), in the middle of the courtyard of the temple stood a large water vessel of cast brass. Commentators and researchers have put forward various suggestions as to the form of the Molten Sea and its purpose in the temple.
In this article, I argue that the description in 1 Kings offers definitive conclusions as to the biblical author’s intent regarding the form of the “Sea” and its volume (in בת units), and can resolve the outstanding question in the literature as to the equivalent of a בת in modern units of volume measurement. I shall also point to evidence in support of the view of other researchers that the Molten Sea held a purely symbolic role, while the practical functions of water for sacrificial purposes were provided by the bases (1 Kgs 7:27).
Arabic as a Language of the South Asian Chancery: Bahmani Communications to the Mamluk Sultanate
Authors: Walravens Meia 
Published: December 2020

Abstract
A growing body of literature on trade and cultural exchange between the Indian Ocean regions has already contributed significantly to our understanding of these processes and the role of language and writing within them. Yet, the question remains how Arabic correspondence played a part in communications between South Asian powers and the rulers in the Red Sea region. In order to begin filling this lacuna, this article studies epistolary writings from the Bahmani Sultanate (748/1347-934/1528) to the Mamluk Sultanate (648/1250-922/1517) during the second half of the ninth/fifteenth century. The contextualisation and discussion of three letters render insight both into the (up to now unstudied) issues at play in Bahmani-Mamluk relations and into the nature of these Arabic texts.
From Context to Content of Human Rights: The Drafting History of the African Charter on Human and Peoples’ Rights and the Enigma of Article 7
Authors: Plagis Misha Ariana , Riemer Lena 
Published: December 2020

Abstract
The context that leads to human rights treaties being drafted or adopted has garnered much attention, especially concerning the developments in the 1970s. However, the link to the content of those human rights treaties is often missing in the analysis. In addition, less attention has been paid to one of the major developments at the time: The adoption of the African Charter on Human and Peoples’ Rights. The article engages with these gaps from the perspective of the drafting process of the African Charter, using the unique wording of article 7 to illustrate four significant political and historical factors that helped determine its content.
Aiding and Abetting and the International Criminal Court’s Bemba et al. Case: The icc Trial and Appeals Chamber Consider Article 25(3)(c) of the Rome Statute
Authors: Ventura Manuel J. 
Published: December 2020

Abstract
This article discusses the icc’s Bemba et al. Trial and Appeal Judgments concerning aiding and abetting under Article 25(3)(c) of the Rome Statute. It analyses three issues that were addressed at trial and some of which were considered on appeal: (i) the actus reus contribution threshold; (ii) encouragement or moral support and the principal perpetrators; and (iii) the mens rea of ‘purpose’. It concludes that the Bemba et al. Trial Judgment provided clarity on the mens rea under Article 25(3)(c), while the Bemba et al. Appeal Judgment settled the question of whether a principal perpetrator needs to be aware of the aider and abettor’s encouragement or moral support for it to have an effect on the crime. However, the Bemba et al. Appeal Judgment ignored the question of whether there is a minimum contribution threshold for the actus reus of aiding and abetting, despite the issue being clearly raised.
Pragmatism and Verbal Behaviourism. Mead’s and Sellars’ Theories of Meaning and Introspection
Authors: Baggio Guido 
Published: December 2020

Abstract
The article highlights George Herbert Mead’s and Wilfrid Sellars’ reliance on a behaviourally-grounded conception of meaning as strictly related to the possibility of distinguishing mental from non-mental phenomena as both related to the semantic dimension. Mead’s position is in fact akin to Wilfrid Sellars’ argument that the concepts of ‘inner events’ are essentially inter-subjective. Thoughts are displayed as consisting of related linguistic acts linked inferentially through intra-linguistic moves that respond to a particular ‘language practice’ governed by norms. Introspection is an ‘inner conversation’ (Mead), namely an ‘inner’ speaking analogous to linguistic activity that does not involve actual equivalents of the words in the mind (Sellars).
A Problem for Environmental Pragmatism: Value Pluralism and the Sustainability Principle
Authors: Loman Okke 
Published: December 2020

Abstract
In this article, I suggest that the recently emerged perspective of environmental pragmatism encompasses self-contradicting principles. For many years, it was deemed impossible for environmental ethics to formulate justified environmental policy. Environmental pragmatism, and its primary scholar Bryan G. Norton, has promoted a new outlook in that debate by proposing an ideal methodology based upon classic American pragmatism. In this methodology, a community can determine what is morally righteous by (i) conducting open-ended inquiry and (ii) considering all relevant stakeholders in a rational discourse. Environmental pragmatism must therefore accommodate reasonable value pluralism. Moreover, Norton claims that these criteria should be complemented with what I call the ‘sustainability criterion’. However, this principle of righteous decision- making appears inconsistent with the two aforementioned commitments. This article considers why this is the case.