bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude and practice concerning healthcare-associated infections among healthcare workers in Wuhan, China: cross-sectional study
Authors: Wu Wenwen , Wang Wenru , Yuan Yufeng , Lin Likai , Tan Yibin , Yang Jinru , Dai Li , Wang Ying 
Published: January 2021

ObjectivesTo assess the knowledge, attitude and practice (KAP) concerning healthcare-associated infections (HAIs) among healthcare givers and to identify the factors influencing KAP.DesignThis was a hospital-based, cross-sectional study.SettingTwo public hospitals in Wuhan, central China.ParticipantsParticipants were recruited among healthcare workers (HCWs) of one general hospital and one children’s hospital in Wuhan city between 1 June and 30 September 2019.Primary and secondary outcome measuresThe outcomes were KAPs concerning HAIs.ResultsData from 455 HCWs were included in the final data analysis. The mean scores of KAP and total KAP were 15.67±3.32, 25.00±2.75, 43.44±5.15 and 84.76±6.72, respectively. The following factors were significantly associated with the total KAP score concerning HAIs, explaining 61% of the variance (p<0.001): gender (β=2.36, 95% CI 1.11 to 4.40), age (β=6.65, 95% CI 5.07 to 7.74), position (β=7.02, 95% CI 3.88 to 8.45), type of employment (β=−1.08, 95% CI −2.08 to −0.07), with HAI education within last year (β=−2.98, 95% CI −4.23 to −1.72), with invasive operation authority (β=−4.22, 95% CI −5.46 to −2.99), antibacterial drug training (β=−4.38, 95% CI −5.45 to −3.31) and with antibacterial drug training and clinical consultation (β=−4.35, 95% CI −5.38 to −3.32).ConclusionThe controllable factors identified in this study can be used by hospital managers to implement measures that improve KAP among HCWs. Moreover, these measures should be customised, based on uncontrollable factors to suit the specific characteristics of medical staff and to improve KAP. Training programmes should be designed for medical workers to increase their awareness of HAIs and to foster positive attitudes and practices.
Impact of microfinance health interventions on health-related outcomes among female informal workers in Pakistan: a retrospective quasi-experimental study
Authors: Jafree Sara Rizvi , Zakar Rubeena , Ahsan Humna , Mustafa Mudasir , Fischer Florian 
Published: January 2021

ObjectiveThe purpose of this study is to assess the impact of microfinance health interventions (health insurance and health-awareness programmes) on health-related outcomes among female informal workers in Pakistan.DesignWe conducted a retrospective, quasi-experimental study among a total of 442 female borrowers from seven microfinance providers (MFPs) across four provinces of Pakistan in 2018. A standardised tool was used for data collection. Probit regression was used to identify the probability of female borrowers gaining improvements in health outcomes based on their sociodemographic characteristics. Propensity score matching (PSM) was used to assess the overall impact of health interventions.Primary outcome measuresFour health-related outcomes reported by the women were used: perception of good health overall, ability to visit a general practitioner, ability to purchase prescribed medicine and intake of multivitamins.ResultsWe found that women receiving health interventions had a greater probability of better health outcomes when they were from Punjab province, borrowing in groups and attending monthly meetings at MFPs. Even with a small loan amount, all four health-related outcomes were significantly associated with receiving health insurance and health-awareness programmes. PSM results show a greater likelihood of overall perceived good health (nearest neighbour matching (NNM) =17.4%; kernel matching (KM) =11.8%) when health insurance is provided and a significant improvement in the ability to purchase prescribed medicine when a health-awareness programme is provided (NNM=10.1%; KM=11.7%).ConclusionHealth and social policies are vital to secure health and well-being among poor women working in the informal sector. Targeting improved equity across female population groups for health interventions will in the long run improve poor women’s health, income-earning abilities and capacity expansion for small businesses.
Benefits and safety of transdermal glyceryl trinitrate in acute stroke: a systematic review and meta-analysis of randomised trials (protocol)
Authors: Lim Beng Leong , Lee Wei Feng , Ng Wei Ming , Tay Wei Ling , Chan Wui Ling 
Published: January 2021

IntroductionHigh blood pressure (BP) in acute stroke has adverse outcomes. Transdermal glyceryl trinitrate (GTN) has beneficial properties in controlling BP. The 2016 meta-analysis and 2017 Cochrane review showed that transdermal GTN was beneficial in a small patient subgroup with stroke onset ≤6 hours. Larger studies focusing on this patient subgroup have since been conducted. We report the protocol for an updated systematic review and meta-analysis on the safety and benefits of transdermal GTN in acute stroke.Methods and analysisWe will search Medline, Pubmed, Embase, CINAHL and Cochrane Library from inception until June 2020 for randomised trials that report the efficacy and safety of transdermal GTN versus placebo/control therapy among adult patients with acute stroke. Primary outcomes include in-hospital mortality, BP lowering and late functional status. Secondary outcomes include early, late, resource utilisation and surrogate outcomes. Safety outcomes include reported adverse events. Reviewers will first screen titles and abstracts, and then full texts, to identify eligible studies. Independently and in duplicate, they will extract data, assess risk of bias (RoB) using a modified Cochrane RoB tool and quality of evidence using Grading of Recommendations, Assessment, Development and Evaluation. Disagreement will be resolved by discussion and consultation with an external reviewer if necessary. Using a random-effects model, we will report effect sizes using relative risks and 95% CIs. We will perform predefined subgroup analyses: intracerebral haemorrhage versus ischaemic stroke; minor (NIHSS (National Institutes of Health Stroke Scale) ≤five) versus major (NIHSS >five) ischaemic stroke; ischaemic stroke with versus without thrombolysis; prehospital versus non-prehospital settings; time from stroke to randomisation ≤6 versus >6 hours and high versus low overall RoB studies. We will also perform trial sequential analysis for the primary outcomes.Ethics and disseminationEthics board approval is unnecessary. PROSPERO registration has been obtained. The results will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020173093.
Novel non-invasive particles in exhaled air method to explore the lining fluid of small airways—a European population-based cohort study
Authors: Hussain-Alkhateeb Laith , Bake Björn , Holm Mathias , Emilsson Össur , Mirgorodskaya Ekaterina , Olin Anna-Carin 
Published: January 2021

IntroductionRespiratory tract lining fluid of small airways mainly consists of surfactant that can be investigated by collection of the particles of exhaled aerosol (PExA) method. This offers an exciting prospect to monitor small airway pathology, including subjects with asthma and smokers.AimTo explore the influence of anthropometric factors and gender on phospholipids, surfactant protein A (SP-A) and albumin of the lining fluid of small airwaysand to examine the association with asthma and smoking. Furthermore, to examine if the surfactant components can predict lung function in terms of spirometry variables.MethodThis study employs the population-based cohort of the European Community Respiratory Health Survey III, including participants from Gothenburg city, Sweden (n=200). The PExA method enabled quantitative description and analytical analysis of phospholipids, SP-A and albumin of the lining fluid of small airways.ResultsAge was a significant predictor of the phospholipids. The components PC14:0/16:0, PC16:0/18:2 (PC, phosphatidylcholine) and SP-A were higher among subjects with asthma, whereas albumin was lower. Among smokers, there were higher levels particularly of di-palmitoyl-di-phosphatidyl-choline compared with non-smokers. Most phospholipids significantly predicted the spirometry variables.ConclusionThis non-invasive PExA method appears to have great potential to explore the role of lipids and proteins of surfactant in respiratory disease.
Understanding implementation factors and participant experiences of a cluster randomised controlled trial to prevent falls among older Aboriginal people: a process evaluation protocol
Authors: Macniven Rona , Coombes Julieann , Wilson Roland , Simon Aaron , Mackean Tamara , Hunter Kate , Ma Tracey , Gwynn Josephine , Sherrington Catherine , Tiedemann Anne , Hill Anne-Marie , Delbaere Kim , Lewis Carolyn , Bennett-Brook Keziah , Howie Adam , Stewart Georgia , Shakespeare Madison , Rogers Kris , Ivers Rebecca Q , Clapham Kathleen 
Published: January 2021

IntroductionProcess evaluations examining programme implementation are often conducted in conjunction with effectiveness studies. Their inclusion in studies with Aboriginal participants can give an understanding of programme delivery in Aboriginal community contexts. TheIronbark: Standing Strong and Tallprogramme was codesigned with Aboriginal communities and includes exercise and facilitated ‘yarning’ discussion about fall risk and prevention strategies. The programme pilot showed favourable outcomes and acceptability for Aboriginal people aged 45 years and over. TheIronbark: Standing Strong and Tallprogramme is now being compared with a ‘Healthy Community’ programme in a cluster randomised controlled trial within Aboriginal health and community services. An embedded process evaluation aims to explore relationships between participation and programme outcomes and the quality of programme implementation.Methods and analysisThe process evaluation will use a mixed methods design, guided by Indigenous research methodology. It will evaluate quantitative data (number of completed sessions, site coaching checklist tool, participant and facilitator questionnaire data and a participant habit formation scale), as well as qualitative data (open-ended responses from project and site staff and semistructured interviews using yarning with study participants and site managers). A programme logic model was developed to explain the intended inputs, activities, outputs and outcomes, which guided this process evaluation design.ConclusionThis process evaluation of a fall prevention programme for older Aboriginal people using a mixed methods design and data triangulation will allow for a comprehensive understanding of study findings. Multiple study sites allow for generalisability of findings and exploration of variation across sites.Trial registration numberACTRN12619000349145.
Social inequality and the syndemic of chronic disease and COVID-19: county-level analysis in the USA
Authors: Islam Nazrul , Lacey Ben , Shabnam Sharmin , Erzurumluoglu A Mesut , Dambha-Miller Hajira , Chowell Gerardo , Kawachi Ichiro , Marmot Michael 
Published: January 2021

BackgroundGiven the effect of chronic diseases on risk of severe COVID-19 infection, the present pandemic may have a particularly profound impact on socially disadvantaged counties.MethodsCounties in the USA were categorised into five groups by level of social vulnerability, using the Social Vulnerability Index (a widely used measure of social disadvantage) developed by the US Centers for Disease Control and Prevention. The incidence and mortality from COVID-19, and the prevalence of major chronic conditions were calculated relative to the least vulnerable quintile using Poisson regression models.ResultsAmong 3141 counties, there were 5 010 496 cases and 161 058 deaths from COVID-19 by 10 August 2020. Relative to the least vulnerable quintile, counties in the most vulnerable quintile had twice the rates of COVID-19 cases and deaths (rate ratios 2.11 (95% CI 1.97 to 2.26) and 2.42 (95% CI 2.22 to 2.64), respectively). Similarly, the prevalence of major chronic conditions was 24%–41% higher in the most vulnerable counties. Geographical clustering of counties with high COVID-19 mortality, high chronic disease prevalence and high social vulnerability was found, especially in southern USA.ConclusionSome counties are experiencing a confluence of epidemics from COVID-19 and chronic diseases in the context of social disadvantage. Such counties are likely to require enhanced public health and social support.
Effect of erenumab on functional outcomes in patients with episodic migraine in whom 2–4 preventives were not useful: results from the LIBERTY study
Authors: Lanteri-Minet Michel , Goadsby Peter J , Reuter Uwe , Wen Shihua , Hours-Zesiger Peggy , Ferrari Michel D , Klatt Jan 
Published: January 2021

ObjectiveTo evaluate the effect of erenumab on patient-reported, functional outcomes in patients with episodic migraine (EM) in whom 2–4 preventives were not useful from the Phase 3b LIBERTY study.MethodsAs previously reported, 246 patients with EM with 2–4 prior failed preventives were randomised 1:1 to subcutaneous erenumab 140 mg or placebo every 4 weeks for 12 weeks. This analysis evaluated Migraine Physical Function Impact Diary (MPFID), Headache Impact Test (HIT-6) and Work Productivity and Activity Impairment (WPAI) scores at Week 12. P values were nominal without multiplicity adjustment.ResultsErenumab significantly improved MPFID-Physical Impairment (PI) and Everyday Activities (EA) scores versus placebo (treatment difference (TD) (95% CI) MPFID-PI: −3.5 (−5.7 to –1.2) (p=0.003); MPFID-EA: −3.9 (−6.1 to –1.7)) (p<0.001) at 12 weeks. Patients on erenumab were more likely to have a ≥5-point reduction in MPFID score (OR vs placebo (95% CI) MPFID-EA: 2.1 (1.2 to 3.6); MPFID-PI: 2.5 (1.4 to 4.5)). A similar trend was observed for HIT-6 (TD: −3.0; p<0.001); significantly higher proportions of patients on erenumab reported a ≥5-point reduction (OR (95% CI): 2.4 (1.4 to 4.1)). In three out of four WPAI domains, erenumab showed improvement versus placebo.ConclusionAt 12 weeks, erenumab was efficacious on functional outcomes in patients with EM in whom 2–4 preventives were not useful.Trial registration detailsClinicalTrials.gov identifier: NCT03096834.
Cerebrovascular assessments to help understand brain-related changes associated with aerobic exercise after stroke
Authors: Atwi Sarah , Sweeny Michelle , Cohen Ellen , Robertson Andrew D. , Marzolini Susan , Swardfager Walter , Swartz Richard H. , Oh Paul I. , MacIntosh Bradley J. 
Published: January 2021

Evidence suggests exercise is “good medicine” after stroke, yet consensus is lacking on the time to initiate, type, exertion level, and duration per session. It remains a challenge to identify outcome measures for stroke−exercise trials that are sufficiently sensitive to intervention parameters. Cerebrovascular assessments, namely cerebral blood flow and intracranial pulsatility, are herein discussed as examples of quantitative brain-specific measures that may be useful to monitor exercise-related brain changes and help to guide stroke rehabilitation interventions. Novelty: Cerebral blood flow and arterial stiffness are potential vascular targets for stroke exercise trials.
A Literatura Nazista na América (Roberto Bolaño)
Authors: Secco Lincoln 
Published: January 2021

Literatura Nazista na América é um livro publicado em espanhol em 1996. Ele foi traduzido no Brasil em 2019. São 31 estórias em 13 partes e um epílogo. Esta resenha discute o uso que o autor faz dos gêneros literários (conto, novela, relatos jornalísticos etc) e a combinação de personagens fictícios e reais.
Radiation Impacts Early Atherosclerosis by Suppressing Intimal LDL Accumulation
Authors: Ikeda Jiro , Scipione Corey A. , Hyduk Sharon J. , Althagafi Marwan G. , Atif Jawairia , Dick Sarah A. , Rajora Maneesha , Jang Erika , Emoto Takuo , Murakami Junichi , Ikeda Noriko , Ibrahim Hisham M. , Polenz Chanele K. , Gao Xiaotang , Tai Kelly , Jongstra-Bilen Jenny , Nakashima Ryota , Epelman Slava , Robbins Clinton S. , Zheng Gang , Lee Warren L. , MacParland Sonya A. , Cybulsky Myron I. 
Published: January 2021

Rationale:
Bone marrow transplantation (BMT) is used frequently to study the role of hematopoietic cells in atherosclerosis, but aortic arch lesions are smaller in mice after BMT.

Objective:
To identify the earliest stage of atherosclerosis inhibited by BMT and elucidate potential mechanisms.

Methods and Results:

Ldlr
−/−
mice underwent total body γ-irradiation, bone marrow reconstitution, and 6-week recovery. Atherosclerosis was studied in the ascending aortic arch and compared with mice without BMT. In BMT mice, neutral lipid and myeloid cell topography were lower in lesions after feeding a cholesterol-rich diet for 3, 6, and 12 weeks. Lesion coalescence and height were suppressed dramatically in mice post-BMT, whereas lateral growth was inhibited minimally. Targeted radiation to the upper thorax alone reproduced the BMT phenotype. Classical monocyte recruitment, intimal myeloid cell proliferation, and apoptosis did not account for the post-BMT phenotype. Neutral lipid accumulation was reduced in 5-day lesions, thus we developed quantitative assays for LDL (low-density lipoprotein) accumulation and paracellular leakage using DiI-labeled human LDL and rhodamine B-labeled 70 kD dextran. LDL accumulation was dramatically higher in the intima of
Ldlr
−/−
relative to
Ldlr
+/+
mice, and was inhibited by injection of HDL mimics, suggesting a regulated process. LDL, but not dextran, accumulation was lower in mice post-BMT both at baseline and in 5-day lesions. Since the transcript abundance of molecules implicated in LDL transcytosis was not significantly different in the post-BMT intima, transcriptomics from whole aortic arch intima, and at single-cell resolution, was performed to give insights into pathways modulated by BMT.

Conclusions:
Radiation exposure inhibits LDL entry into the aortic intima at baseline and the earliest stages of atherosclerosis. Single-cell transcriptomic analysis suggests that LDL uptake by endothelial cells is diverted to lysosomal degradation and reverse cholesterol transport pathways. This reduces intimal accumulation of lipid and impacts lesion initiation and growth.
Canagliflozin Suppresses Atrial Remodeling in a Canine Atrial Fibrillation Model
Authors: Nishinarita Ryo , Niwano Shinichi , Niwano Hiroe , Nakamura Hironori , Saito Daiki , Sato Tetsuro , Matsuura Gen , Arakawa Yuki , Kobayashi Shuhei , Shirakawa Yuki , Horiguchi Ai , Ishizue Naruya , Igarashi Tazuru , Yoshizawa Tomoharu , Oikawa Jun , Hara Yoshinobu , Katsumura Takafumi , Kishihara Jun , Satoh Akira , Fukaya Hidehira , Sakagami Hiroyuki , Ako Junya 
Published: January 2021

Background
Recent clinical trials have demonstrated the possible pleiotropic effects of SGLT2 (sodium–glucose cotransporter 2) inhibitors in clinical cardiovascular diseases. Atrial electrical and structural remodeling is important as an atrial fibrillation (AF) substrate.

Methods and Results

The present study assessed the effect of canagliflozin (CAN), an SGLT2 inhibitor, on atrial remodeling in a canine AF model. The study included 12 beagle dogs, with 10 receiving continuous rapid atrial pacing and 2 acting as the nonpacing group. The 10 dogs that received continuous rapid atrial pacing for 3 weeks were subdivided as follows: pacing control group (n=5) and pacing+CAN (3 mg/kg per day) group (n=5). The atrial effective refractory period, conduction velocity, and AF inducibility were evaluated weekly through atrial epicardial wires. After the protocol, atrial tissues were sampled for histological examination. The degree of reactive oxygen species expression was evaluated by dihydroethidium staining. The atrial effective refractory period reduction was smaller (
P
=0.06) and the degree of conduction velocity decrease was smaller in the pacing+CAN group compared with the pacing control group (
P
=0.009). The AF inducibility gradually increased in the pacing control group, but such an increase was suppressed in the pacing+CAN group (
P
=0.011). The pacing control group exhibited interstitial fibrosis and enhanced oxidative stress, which were suppressed in the pacing+CAN group.

Conclusions
CAN and possibly other SGLT2 inhibitors might be useful for preventing AF and suppressing the promotion of atrial remodeling as an AF substrate.
Some Endangered Feeling
Authors: Armstrong Nancy 
Published: January 2021

Abstract
This essay sees the recent trend in novels that feature damaged, partial, or wayward protagonists as the ascent of a tradition of formal outliers as old as the novel itself to a position of dominance. Rather than formulate a self-contained individual capable of defending itself against whatever forces of nature or society might disperse and refigure it, this other tradition gave into those forces, releasing human subjectivity from the confines of the self-regulating individual. Why now? How does this major turn in the history of the novel contribute to the current reconsideration of human motivation and behavior in light of affect theory? If Robinson Crusoe provided a bellwether for the individual to come, then what can the damaged protagonist of Tom McCarthy's 2005 novel Remainder tell us about the selves we are likely to become?
Whence the Expected Free Energy?
Authors: Millidge Beren , Tschantz Alexander , Buckley Christopher L. 
Published: January 2021

Abstract
The expected free energy (EFE) is a central quantity in the theory of active inference. It is the quantity that all active inference agents are mandated to minimize through action, and its decomposition into extrinsic and intrinsic value terms is key to the balance of exploration and exploitation that active inference agents evince. Despite its importance, the mathematical origins of this quantity and its relation to the variational free energy (VFE) remain unclear. In this letter, we investigate the origins of the EFE in detail and show that it is not simply ”the free energy in the future.” We present a functional that we argue is the natural extension of the VFE but actively discourages exploratory behavior, thus demonstrating that exploration does not directly follow from free energy minimization into the future. We then develop a novel objective, the free energy of the expected future (FEEF), which possesses both the epistemic component of the EFE and an intuitive mathematical grounding as the divergence between predicted and desired futures.
Near Eastern Echoes in Iliad 16.33–35
Authors: Alepidou Apostolia 
Published: January 2021

Abstract
This article reexamines Patroclus’s famous comment on Achilles’s cruelty in which the sea and the rocks take up the role of the latter’s parents (Iliad 16.33–35). The verses reflect Near Eastern myths about the birth of menacing creatures from the sea and the rocks and are particularly associated with the Song of Hedammu and the Song of Ullikummi of the Hurro-Hittite tradition. Thematic, mythological, and dictional parallels among these texts are discussed in order to explore the existence of a common theme with specific connotations in the broader region of West Asia.