bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sub-national perspectives on the implementation of a national community health worker programme in Gauteng Province, South Africa
Authors: Munshi Shehnaz , Christofides Nicola J , Eyles John 
Published: November 2019

IntroductionIn 2011, in line with principles for Universal Health Coverage, South Africa formalised community health workers (CHWs) into the national health system in order to strengthen primary healthcare. The national policy proposed that teams of CHWs, called Ward-based Primary Healthcare Outreach Teams (WBPHCOTs), supervised by a professional nurse were implemented. This paper explores WBPHCOTs’ and managers’ perspectives on the implementation of the CHW programme in one district in South Africa at the early stages of implementationguided by the Implementation Stages Framework.MethodsWe conducted a qualitative study consisting of five focus group discussions and 14 in-depth interviews with CHWs, team leaders and managers. A content analysis of data was conducted.ResultsThere were significant weaknesses in early implementation resulting from a vague national policy and a rushed implementation plan. During the installation stage, adaptations were made to address gaps including the appointment of subdistrict managers and enrolled nurses as team leaders. Staff preparation of CHWs and team leaders to perform their roles was inadequate. To compensate, team members supported each another and assisted with technical skills where they could. Structural issues, such as CHWs receiving a stipend rather than being employed, were an ongoing implementation challenge. Another challenge was that facility managers were employed by the local government authority while the CHW programme was perceived to be a provincial programme.ConclusionThe implementation of complex programmes requires a shared vision held by all stakeholders. Adaptations occur at different implementation stages, which require a feedback mechanism to inform the implementation in other settings. The CHW programme represented a policy advance but lacked detail with respect to human resources, budget, supervision, training and sustainability, which made it a difficult furrow to plough. This study points to how progressive reform remains fraught without due attention to the minutiae of practice.
Physical activity is associated with improvements in other lifestyle behaviours
Authors: Hajat Cother , Kotzen Daniel , Stein Emma , Yach Derek 
Published: November 2019

IntroductionWe tested whether physical activity (PA) engagement is subsequently associated with additional health-promoting behaviours in a large-scale, real-world programme leveraging technology and behavioural science to reward healthy lifestyle behaviours.MethodsIn this observational, longitudinal study, we compared participants’ verified and self-reported health behaviours prior to and following their first verified engagement in PA recorded on the Vitality programme between 2014 and 2017.ResultsOf 34 061 participants, the mean duration in the programme was 40.1 (SD 12.6) months, and the median time until the first PA was 13.1 (SD 16.6) months, with a mean age of 42.0 (SD 11.1) years and 14 881 (43.7%) being male. Baseline weekly PA minutes were mean 62.8 (SD 129.7), 98 (SD 26.0) and 282.9 (SD 230.0) for the low, moderate and high groups, respectively. In the 12 months following the first PA, the low group increased weekly active minutes by 156% (40 (95% CI 28.6 to 51.0) to 102 (95% CI 94.5 to 109.8)); the moderate group increased weekly active minutes by 60% (85.0 (95% CI 76.4 to 93.5) to 136 (95% CI 130.2 to 141.8)); and no change was seen for the high group. Overall, individuals exhibited an increase of 26% in their weekly active minutes from an average of 130 min (95% CI 121.2 to 139.4) to 164 min (95% CI 157.5 to 169.8). Overall, fruit and vegetable daily servings increased from 2.7 (95% CI 2.6 to 2.8) to 2.9 (95% CI 2.9 to 3.0); Kessler Stress Scores decreased from 17.4 (95% CI 17.2 to 17.6) to 17.0 (95% CI 16.9 to 17.1); sedentary hours decreased from 11.3 (95% CI 11.1 to 11.5) to 10.8 (95% CI 10.7 to 11.0); alcohol consumption decreased from 1.8 (95% CI 1.7 to 2.0) to 1.6 (95% CI 1.5 to 1.7) weekly units; sleep increased from 7.1 (95% CI 7.06 to 7.16) to 7.2 (95% CI 7.13 to 7.20) hours/night.ConclusionsPA was followed by other health-promoting behaviours. PA interventions should also evaluate the indirect impact on other health behaviours.
Genetic variability and potential effects on clinical trial outcomes: perspectives in Parkinson’s disease
Authors: Leonard Hampton , Blauwendraat Cornelis , Krohn Lynne , Faghri Faraz , Iwaki Hirotaka , Ferguson Glen , Day-Williams Aaron G , Stone David J , Singleton Andrew B , Nalls Mike A , Gan-Or Ziv 
Published: November 2019

BackgroundClassical randomisation of clinical trial patients creates a source of genetic variance that may be contributing to the high failure rate seen in neurodegenerative disease trials. Our objective was to quantify genetic difference between randomised trial arms and determine how imbalance can affect trial outcomes.Methods5851 patients with Parkinson’s disease of European ancestry data and two simulated virtual cohorts based on public data were used. Data were resampled at different sizes for 1000 iterations and randomly assigned to the two arms of a simulated trial. False-negative and false-positive rates were estimated using simulated clinical trials, and per cent difference in genetic risk score (GRS) and allele frequency was calculated to quantify variance between arms.Results5851 patients with Parkinson’s disease (mean (SD) age, 61.02 (12.61) years; 2095 women (35.81%)) as well as simulated patients from virtually created cohorts were used in the study. Approximately 90% of the iterations had at least one statistically significant difference in individual risk SNPs between each trial arm. Approximately 5%–6% of iterations had a statistically significant difference between trial arms in mean GRS. For significant iterations, the average per cent difference for mean GRS between trial arms was 130.87%, 95% CI 120.89 to 140.85 (n=200). Glucocerebrocidase (GBA) gene-only simulations see an average 18.86%, 95% CI 18.01 to 19.71 difference in GRS scores between trial arms (n=50). When adding a drug effect of −0.5 points in MDS-UPDRS per year at n=50, 33.9% of trials resulted in false negatives.ConclusionsOur data support the hypothesis that within genetically unmatched clinical trials, genetic heterogeneity could confound true therapeutic effects as expected. Clinical trials should undergo pretrial genetic adjustment or, at the minimum, post-trial adjustment and analysis for failed trials.
Resource utilisation among patients transferred for intracerebral haemorrhage
Authors: Zachrison Kori Sauser , Aaronson Emily , Mahmood Sadiqa , Rosand Jonathan , Viswanathan Anand , Schwamm Lee H , Goldstein Joshua N 
Published: November 2019

BackgroundPatients with intracerebral haemorrhage (ICH) are frequently transferred between hospitals for higher level of care. We aimed to identify factors associated with resource utilisation among patients with ICH admitted to a single academic hospital.MethodsWe used a prospectively collected registry of consecutive patients with primary ICH at an urban academic hospital between 1 January 2005 and 31 December 2015. The primary outcome was use of either intensive care unit (ICU) admission or surgical intervention. Logistic regression examined factors associated with the outcome, controlling for age, sex, Glasgow coma score (GCS) and ICH score.ResultsOf the 2008 patients included, 887 (44.2%) received ICU stay or surgical intervention. These patients were younger (71 vs 74 years, p<0.001), less often white (83.9% vs 89.3%, p<0.001), had lower baseline GCS (12 vs 14, p<0.001) and more frequently had intraventricular haemorrhage (58.6% vs 43.4%, p<0.001). Factors independently associated with ICU stay or surgical intervention were age >65 years (OR 0.38, 95% CI 0.21 to 0.69), GCS <15 (1.23, 95% CI 1.01 to 1.52) and ICH score >0 (OR 2.23, 95% CI 1.70 to 2.91).ConclusionAmong this cohort of primary patients with ICH, GCS of 15 and ICH score of 0 were associated with less frequent use of ICU or intervention. These results should be validated in a larger sample but may be valuable for hospitals considering which patients with ICH could safely remain at the referring facility.
Cardiorespiratory fitness and muscular endurance responses immediately and 2 months after a whole-body Tabata or vigorous-intensity continuous training intervention
Authors: Islam Hashim , Siemens Tina L. , Matusiak Jennifer B.L. , Sawula Laura , Bonafiglia Jacob T. , Preobrazenski Nicholas , Jung Mary E. , Gurd Brendon J. 
Published: November 2019

Young adults (52 females, 16 males; age = 21 ± 3 years; V̇O2peak: 41 ± 6 mL/(kg·min)) were randomized into 3 groups: (i) no-exercise control (CTL; n = 15), (ii) Tabata (n = 27), or (iii) vigorous-intensity continuous training (VICT; n = 26) groups for a 4-week supervised training period (4 sessions/week). V̇O2peak, time-to-fatigue (TTF), 5 km time-trial performance (TT), and muscular endurance were assessed at baseline, post-training (POST), and 2-month follow-up (FU). Response confidence intervals (CI) were used to classify individuals as likely responders (R; CI > 0). Both exercise interventions increased TTF and TT at POST (both p < 0.01), but these benefits were maintained at FU after VICT only (p < 0.01). Push-up performance was increased at POST and FU (both p < 0.01) after Tabata. VICT resulted in a greater proportion of TTF R versus both groups at POST (CTL: 1/15; VICT: 19/26; Tabata: 9/27) and versus Tabata at FU (3/15; 13/26; 4/27). VICT also had a greater proportion of TT R versus CTL at POST (2/15; 17/26; 10/27). Tabata had a greater proportion of R for maximum push-up repetitions versus both groups at POST (3/15; 6/26; 18/27) and versus CTL at FU (2/15; 10/26; 18/27). Collectively, VICT appears to be more effective for improving cardiorespiratory fitness, whereas whole-body Tabata confers larger improvements in push-up performance following short-term training. Novelty: Vigorous-intensity continuous training elicits larger improvements in cardiorespiratory fitness versus whole-body Tabata. Individual response profiles parallel group-level changes in cardiorespiratory fitness and muscular endurance.
Blood flow restriction impairs the inflammatory adaptations of strength training in overweight men: a clinical randomized trial
Authors: da Silva Igor Martins , Santos Maeli Andressa , Galvão Simone Lunelli , Dorneles Gilson P. , Lira Fabio Santos , Romão Pedro R.T. , Peres Alessandra 
Published: November 2019

The aim of this study was to evaluate the impact of high-intensity strength training (ST) or low-intensity strength training with blood flow restriction (ST-BFR) on monocyte subsets, the expression of C-C chemokine receptor 5 (CCR5), and CD16 on monocytes, and tumor necrosis factor alpha (TNF-α) production of overweight men. Thirty overweight men were randomly assigned to conventional ST or ST-BFR. Both groups performed exercises of knee extension and biceps curl with equal volume (3 sessions/week) over 8 weeks, and the peripheral frequency of monocytes (CD14+CD16−, classical monocytes; CD14+CD16+, intermediate monocytes; CD14−CD16+, nonclassical monocytes), the mean fluorescence intensity (MFI) of CCR5 and CD16 on CD14+ monocytes; and the production of TNF-α by lipopolysaccharide (LPS)-stimulated cells were quantified. Eight weeks of ST increased the frequency of CD14+CD16− monocytes (p = 0.04) and reduced the percentage of CD14−CD16+ (p = 0.02) and the production of TNF-α by LPS-stimulated cells (p = 0.03). The MFI of CD16 on CD14+ monocytes decreased after the ST intervention (p = 0.02). No difference in monocyte subsets, CCR5 or CD16 expression, and TNF-α production were identified after ST-BFR intervention (p > 0.05). The adoption of ST promotes anti-inflammatory effects on monocyte subsets of overweight men, but this effect was lost when BFR was adopted. Novelty High-intensity strength training reduces the production of TNF-α and the peripheral frequency of CD16+ monocytes in overweight men. Blood flow restriction method blunts the strength training adaptations on monocyte subsets and pro-inflammatory TNF-α production in overweight men.
A General Nonstationary and Time-Varying Mixed Signal Blind Source Separation Method Based on Online Gaussian Process
Authors: He Pengju , Qi Mi , Li Wenhui , Tang Mengyang , Zhao Ziwei 
Published: November 2019

Most nonstationary and time-varying mixed source separation algorithms are based on the model of instantaneous mixtures. However, the observation signal is a convolutional mixed source in reverberation environment, such as mobile voice received by indoor microphone arrays. In this paper, a time-varying convolution blind source separation (BSS) algorithm for nonstationary signals is proposed, which can separate both time-varying instantaneous mixtures and time-varying convolution mixtures. We employ the variational Bayesian (VB) inference method with Gaussian process (GP) prior for separating the nonstationary source frame by frame from the time-varying convolution signal, in which the prior information of the mixing matrix and the source signal are obtained by the Gaussian autoregressive method, and the posterior distributions of parameters (source signal and mixing matrix) are obtained by the VB learning. In the learning process, the learned parameters and hyperparameters are propagated to the next frame for VB inference as the prior which is combined with the likelihood function to get the posterior distribution. The experimental results show that the proposed algorithm is effective for separating time-varying mixed speech signals.
Synthesis of the rod-like NiS2@C for hydrogen evolution reaction in acidic solution
Authors: Wu Xiujuan , Wang Jie , Zhang Fan , Gong Junyan , Xu Pinghao , Xu Yingchen , Zhang Dongen 
Published: November 2019

The carbon-based NiS2 nanorods (NiS2@C) were prepared by chemical deposition and sulfidation with nickel dimethylglyoximate (Ni(DMG)2) as the starting agent. The nanorods were analyzed by X-ray diffraction, scanning electron microscopy, transmission electron microscopy and X-ray photoelectron spectroscopy for chemical analysis. Structural characterization revealed that NiS2 existed on the surface of the rod and in the internal channels of the rod. In 0.5[Formula: see text]m H2SO4 solution, NiS2@C has lower onset potential and higher current density than NiS2. The results suggest that C improves the electrical conductivity of the NiS2 electrocatalyst, and the carbon film-based rod-like NiS2 is a more effective nanocomposite of hydrogen evolution.
Religion, Law and Politics: the “Trickle-Down” Effects of ECtHR Judgments on Turkey’s Headscarf Battles
Authors: Gülalp Haldun 
Published: November 2019

Abstract
Building on and extending Marc Galanter’s classic thesis on the “radiating effects” of courts, this paper proposes the concept of “trickle-down effects” in order to account for the complex ways in which court judgments may impact political processes, often taking place through the ideological manipulation of the judgments and leading to unintended and unforeseen consequences. The paper specifically examines the headscarf battles in Turkey and the pivotal role that the ECtHR judgments played in it. While the short-term legal impact was the confirmation of the ban on the use of headscarves, presumably supporting the principle of secularism, the long-term impact has been the exact opposite.
Pragmatism and Historicity
Authors: Margolis Joseph 
Published: November 2019

Abstract
This paper provides a straightforward argument that demonstrates the irreconcilability of pragmatism and transcendentalism, by way of Darwin’s failure to account for the emergence of the human self or person and the existential and historied import of the human invention and mastery of language. On the Darwinian issue, I examine the implications of Darwin’s having neglected the most important phase of the evolution of Homo sapiens – the invention and mastery of natural language, which account for the self-transformation of the human primate into a self or person (with the acquisition of competences that appear nowhere else in the animal world); and which signify a novel transformation of the evolutionary process itself – the hybrid entwining of biological and cultural forces in the formation of the self. It’s a consequence of the invention of language that accounts for the historied nature of the human form of life. I treat history and historicity as existential constraints on the human form of cognition, which introduces an ineliminable but benign form of skepticism, which I show to be incompatible with Husserl’s transcendentalism and his attempt to accommodate historicity. I take pragmatism to be committed to an existential treatment of history and historicity, in the context of reviewing George Herbert Mead’s analysis of history and historical time. The two arguments converge on the incompatibility of pragmatism and transcendentalism.
Appropriation, Dialogue, and Dispute: Towards a Theory of Philosophical Engagement with the Past
Authors: Gazit Yael 
Published: November 2019

Abstract
This article suggests a change of perspective on philosophy’s engagement with its past. It argues that rather than the putative purport of giving life to the past philosopher’s work, philosophical engagement with the past gives life to one’s own. Drawing on the neo-pragmatist thesis of Robert Brandom, it suggests looking to what philosophers do when they attribute meaning to concepts and considering their engagement with the past as appropriation in consequence. By scrutinizing Robert Pippin’s opposing thesis of philosophical engagement with the past as dialogue, and carefully examining Brandom’s, the article suggests an account for appropriation that shows it to be non-dialogical, and hence unable to yield the fruits associated with this conception, but also insightful and rich with other philosophical values. Brandom and John McDowell’s dispute over the interpretation of Wilfrid Sellars provides an illustration of the proposed perspective and of those values.
Seasonal and temperature effect on serum lithium concentrations
Authors: Cheng Sonia , Buckley Nicholas A , Siu William , Chiew Angela L , Vecellio Elia , Chan Betty S 
Published: November 2019

Background: Lithium remains the gold standard treatment for bipolar disorder. However, it has a very narrow therapeutic index (0.6–0.8 mmol/L). It has been suggested that high environmental temperature can lead to dehydration, elevated plasma lithium concentration and then lithium toxicity. Objectives: We aimed to investigate the effect of seasonal and short-term changes in temperature on serum lithium concentrations in Sydney, Australia. Methods: We retrospectively analysed data from all patients who had serum lithium concentrations taken from the Prince of Wales and Sutherland Hospitals between 2008 and 2018. Temperature data came from the Bureau of Meteorology. We examined correlations between lithium concentrations and the preceding 5 days maximum temperatures, month and season. We also performed a longitudinal analysis of the effect of temperature and seasons within selected patients who had repeated levels. Results: A total of 11,912 serum lithium concentrations from 2493 patients were analysed. There was no significant association between higher lithium concentration and preceding higher temperatures ( r = –0.008, p = 0.399). There was also no important seasonal or monthly variation, across all patients or in the smaller cohort with longitudinal data ( n = 123, r = 0.008, 95% confidence interval: [–0.04, 0.06]). Conclusion: There were no clinically important differences in serum lithium concentration related to seasons, months or temperatures, which suggests that patients on lithium are able to adequately maintain hydration during hot weather in Sydney.
Do welfare benefit reassessments of people with mental health conditions lead to worse mental health? A prospective cohort study
Authors: Stuart Ruth , Campbell Sanchika , Osumili Beatrice , Robinson Emily J , Frost-Gaskin Mary , Pacitti Richard , McCrone Paul , Henderson Claire 
Published: November 2019

Background: There have been cases of suicide following the Work Capability Assessment (WCA), a questionnaire and interview for those claiming benefits due to ill health or disability in the United Kingdom. Aims: To examine whether experiencing problems with welfare benefits, including WCA, among people with pre-existing mental health conditions was associated with poorer mental health and wellbeing and increased health service use and costs. Methods: A prospective cohort study of an exposed group ( n = 42) currently seeking help from a Benefits Advice Service in London and a control group ( n = 45) who had recently received advice from the same service. Questionnaires at baseline and 3-, 6- and 12-month follow-ups. Results: The exposed group had higher mean scores for anxiety ( p = .008) and depression ( p = .016) at baseline and the control group higher mean scores for wellbeing at baseline ( p = .034) and 12 months ( p = .035). However, loss to follow-up makes overall results difficult to interpret. The control group had higher incomes throughout the study, particularly at the 12-month follow-up ( p = .004), but the differences could have been accounted for by other factors. Health service costs were skewed by a few participants who used day-care services intensively or had inpatient stays. Over the study period the proportion of exposed participants engaged in benefits reassessment ranged from 50% to 88%, and 40% to 76% of controls. Conclusion: The hardship of living with financial insecurity and a mental health condition made it difficult for our participants to sustain involvement in a 12-month study and the frequency of benefit reviews meant that the experiences of our controls were similar to our exposed group. These limitations limit interpretation but confirm the relevance of our research. The control data raise the question of whether people with mental health conditions are being disproportionately reassessed.