bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health students’ knowledge and infectious disease exposure: findings from a cross-sectional study in Namibia
Authors: Rennie Timothy W , Udjombala Bubbles , Chipeio Melody , Kraeker Christian , Hunter Christian J 
Published: May 2019

Abstract

Background
Namibia has recently introduced a number of health training programmes that expose students to infectious disease risks such as human immunodeficiency virus (HIV) and tuberculosis (TB). We explored the knowledge of students in relation to HIV and TB and whether or not there was evidence of exposure.

Methods
We conducted two cross-sectional surveys of Namibian health students (medicine and pharmacy) in 2018.

Results
There was a strong association between knowledge and exposure to HIV, but not TB (i.e. explicit exposure versus latent). Regression analysis suggested the time-related risk (age/year of study) to be predictive of knowledge in both studies. The training rotation in the respiratory unit predicted TB knowledge and post-exposure prophylaxis predicted HIV knowledge.

Conclusions
Knowledge of TB and HIV appears mostly related to the duration of study in health students. Exposure or specific experience may enhance knowledge. Future training in infection control may be better focussed on improving knowledge in earlier years.
Role stress, social support and occupational burnout among physicians in China: a path analysis approach
Authors: Ma Hui , Qiao HuiFen , Qu HaiTao , Wang Hui , Huang Yun , Cheng Hao , Teng ChangJun , Diao KaiLi , Zhang XiangRong , Zhang Ning 
Published: May 2019

Abstract

Background
Occupational burnout in physicians is prevalent and can have many negative effects. The purposes of this study were to explore the prevalence of occupational burnout and to analyze the effects of social support and role stress on occupational burnout among Chinese physicians.

Methods
Using multistage-stratified cluster random sampling, physicians were selected to participate in the study and completed three questionnaires: the Chinese Maslach Burnout Inventory; the Cross-Cultural Role Conflict, Ambiguity and Overload Scale; and the Social Support Rating Scale. A path analysis was run to test the effects of role stress and social support on occupational burnout.

Results
Of 2530 physicians, 864 (34.2%) were experiencing moderate occupational burnout and 140 (5.5%) were experiencing severe occupational burnout. The path analysis results indicated that role conflict had direct positive effects on emotional exhaustion (EE) and depersonalization (DP), and role ambiguity had direct positive effects on DP and decreased personal accomplishment (DPA). Coworker support had direct negative effects on EE and positive effects on DP, family support had direct negative effects on DP and DPA. Coworker support mediated the effects of role ambiguity on EE and DP, and family support mediated the effects of role ambiguity on DP and DPA.

Conclusions
These findings suggest that occupational burnout is common in Chinese physicians, and that role stress and social support play important roles in occupational burnout. Interventions that aim to reduce role stress and increase social support can be effective approaches to prevent occupational burnout among physicians.
Reduction of inappropriate medication in older populations by electronic decision support (the PRIMA-eDS project): a survey of general practitioners’ experiences
Authors: Rieckert Anja , Teichmann Anne-Lisa , Drewelow Eva , Kriechmayr Celine , Piccoliori Giuliano , Woodham Adrine , Sönnichsen Andreas 
Published: May 2019

Abstract

Objective
We sought to investigate the experiences of general practitioners (GPs) with an electronic decision support tool to reduce inappropriate polypharmacy in older patients (the PRIMA-eDS [Polypharmacy in chronic diseases: Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support] tool) in a multinational sample of GPs and to quantify the findings from a prior qualitative study on the PRIMA-eDS-tool.

Materials and Methods
Alongside the cluster randomized controlled PRIMA-eDS trial, a survey was conducted in all 5 participating study centers (Bolzano, Italy; Manchester, United Kingdom; Salzburg, Austria; Rostock, Germany; and Witten, Germany) between October 2016 and July 2017. Data were analyzed using descriptive statistics and chi-square tests.

Results
Ninety-one (n = 160) percent of the 176 questionnaires were returned. Thirty-two percent of the respondents reported that they did not cease drugs because of the medication check. The 68% who had discontinued drugs comprise 57% who had stopped on average 1 drug and 11% who had stopped 2 drugs or more per patient. The PRIMA-eDS tool was found to be useful (69%) and the recommendations were found to help to increase awareness (86%). The greatest barrier to implementing deprescribing recommendations was the perceived necessity of the medication (69%). The majority of respondents (65%) would use the electronic medication check in routine practice if it was part of the electronic health record.

Conclusions
GPs generally viewed the PRIMA-eDS medication check as useful and as informative. Recommendations were not always followed due to various reasons. Many GPs would use the medication check if integrated into the electronic health record.
Facing Up To Risk
Authors: Fried Barbara H 
Published: May 2019

AbstractBy banishing decision-making in the face of uncertainty (risk) to the margins of tort theory, nonconsequentialist legal philosophers have obscured the quotidian, unavoidable, and ubiquitous tradeoffs we face in almost every arena of life. This article explores the historical antecedents of the marginalization of risk in contemporary moral philosophy, and details how legal philosophers have deflected the challenge that risk poses to any nonconsequentialist theory of tort liability.
ATP11B deficiency leads to impairment of hippocampal synaptic plasticity
Authors: Wang Jiao , Li Weihao , Zhou Fangfang , Feng Ruili , Wang Fushuai , Zhang Shibo , Li Jie , Li Qian , Wang Yajiang , Xie Jiang , Wen Tieqiao 
Published: May 2019

Abstract
Synaptic plasticity is known to regulate and support signal transduction between neurons, while synaptic dysfunction contributes to multiple neurological and other brain disorders; however, the specific mechanism underlying this process remains unclear. In the present study, abnormal neural and dendritic morphology was observed in the hippocampus following knockout of Atp11b both in vitro and in vivo. Moreover, ATP11B modified synaptic ultrastructure and promoted spine remodeling via the asymmetrical distribution of phosphatidylserine and enhancement of glutamate release, glutamate receptor expression, and intracellular Ca2+ concentration. Furthermore, experimental results also indicate that ATP11B regulated synaptic plasticity in hippocampal neurons through the MAPK14 signaling pathway. In conclusion, our data shed light on the possible mechanisms underlying the regulation of synaptic plasticity and lay the foundation for the exploration of proteins involved in signal transduction during this process.
The Trials (and Tribulations) of Complementary and Alternative Medicine in Oncology
Authors: Ludmir Ethan B , Jethanandani Amit , Mainwaring Walker , Miller Austin B , Lin Timothy A , Espinoza Andres F , Verma Vivek , VanderWalde Noam A , Grossberg Aaron J , Guadagnolo B Ashleigh , Koong Albert C , Jagsi Reshma , Thomas Charles R , Fuller C David 
Published: May 2019

Abstract
Two decades following the creation of the Office of Cancer Complementary and Alternative Medicine at the National Cancer Institute, the status of complementary and alternative medicine (CAM) research within oncology remains opaque. To better understand the landscape of CAM studies in oncology, we identified CAM-related phase III randomized controlled trials (RCTs) through ClinicalTrials.gov and compared these CAM trials to all non-CAM oncologic RCTs. Pearson χ2 testing was used to compare proportions across groups; all tests were two-sided. Comparing the 25 identified CAM RCTs with 739 non-CAM RCTs, CAM studies were more likely to be sponsored by a cooperative group (64.0% vs 28.6%, P &lt; .001) and less likely to be industry funded (8.0% vs 76.5%, P &lt; .001). CAM trials disproportionately excluded disease-related outcomes as endpoints (8.0% vs 84.6%, P &lt; .001), were unsupported by prior early-phase data (55.0% vs 96.1%, P &lt; .001), and did not meet the primary endpoint (8.7% vs 53.0%, P &lt; .001). Given the observed relationship between encouraging pilot data and subsequent phase III trial success, we contend that future CAM RCTs may yield more promising findings if better supported by appropriately designed and well-characterized early-phase signals.
Severe yellow fever in Brazil: clinical characteristics and management
Authors: Ho Yeh-Li , Joelsons Daniel , Leite Gabriel F C , Malbouisson Luiz M S , Song Alice T W , Perondi Beatriz , Andrade Lucia C , Pinto Lécio F , D’Albuquerque Luiz A C , Segurado Aluisio A C ,   Hospital das Clínicas Yellow Fever Assistance Group
Published: May 2019

Abstract

Background
Little is known about clinical characteristics and management of severe yellow fever as previous yellow fever epidemics often occurred in times or areas with little access to intensive care units (ICU). We aim to describe the clinical characteristics of severe yellow fever cases requiring admission to the ICU during the 2018 yellow fever outbreak in São Paulo, Brazil. Furthermore, we report on preliminary lessons learnt regarding clinical management of severe yellow fever.

Methods
Retrospective descriptive cohort study. Demographic data, laboratory test results on admission, clinical follow-up, and clinical outcomes were evaluated.

Results
From 10 January to 11 March 2018, 79 patients with laboratory confirmed yellow fever were admitted to the ICU in a tertiary hospital in Sao Paolo because of rapid clinical deterioration. On admission, the median AST was 7,000 IU/L, ALT 3,936 IU/L, total bilirubin 5.3 ml/dL, platelet 74 × 103/mm3, INR 2.24 and factor V 37%. Seizures occurred in 24% of patients, even without substantial intracranial hypertension. The high frequency of pancreatitis and rapidly progressive severe metabolic acidosis were notable findings. 73% of patients required renal replacement therapy. The in-hospital fatality rate was 67%. Patients with diabetes mellitus had a higher case fatality rate (CFR) of 80%, while patients without diabetes had a CFR of 65%. Leading causes of death were severe gastrointestinal bleeding, epileptic status, severe metabolic acidosis, necrohemorrhagic pancreatitis, and multi-organ failure.

Conclusions
Severe yellow fever is associated with a high CFR. The following management lessons were learnt: Anticonvulsant drugs in patients with any symptoms of hepatic encephalopathy or arterial ammonia levels >70 μmol/L was commenced which reduced the frequency of seizures from 28% to 17%. Other new therapy strategies included early institution of plasma exchange. Due to the high frequency of gastric bleeding, therapeutic doses of intravenous proton pump inhibitors should be administered.
The effects of Arabidopsis genome duplication on the chromatin organization and transcriptional regulation
Authors: Zhang Hui , Zheng Ruiqin , Wang Yunlong , Zhang Yu , Hong Ping , Fang Yaping , Li Guoliang , Fang Yuda 
Published: May 2019

Abstract
Autopolyploidy is widespread in higher plants and important for agricultural yield and quality. However, the effects of genome duplication on the chromatin organization and transcriptional regulation are largely unknown in plants. Using High-throughput Chromosome Conformation Capture (Hi-C), we showed that autotetraploid Arabidopsis presented more inter-chromosomal interactions and fewer short-range chromatin interactions compared with its diploid progenitor. In addition, genome duplication contributed to the switching of some loose and compact structure domains with altered H3K4me3 and H3K27me3 histone modification status. 539 genes were identified with altered transcriptions and chromatin interactions in autotetraploid Arabidopsis. Especially, we found that genome duplication changed chromatin looping and H3K27me3 histone modification in Flowering Locus C. We propose that genome doubling modulates the transcription genome-wide by changed chromatin interactions and at the specific locus by altered chromatin loops and histone modifications.
Barbara Johnson
Authors: Valens Keja 
Published: May 2019

Barbara Johnson (b. 1947–d. 2009) bridged the heyday of deconstruction and the turn to theory in the 1970s and the ascendance of cultural studies and the turn to ethics in the early 21st century. As Johnson moved the insights of deconstruction into areas such as feminisms, African-American studies, and cultural studies, her attention to “differences within” engaged not only language and rhetoric but also politics, popular culture, and the power of differentiation to both oppress and express particular subjects. Johnson’s career, cut short by a neurodegenerative disease, is framed by her work in translation of Derrida’s Dissemination at the beginning of her career and Mallarmé’s Divagations toward its end. She cast her critical and theoretical project as the translation of structuralism and poststructuralism into literary insight, a process that is easily recognizable in her most anthologized, reprinted, and oft-cited essays, “The Frame of Reference,” “Melville’s Fist,” “Apostrophe, Animation, and Abortion,” and “Metaphor, Metonymy, and Voice in Their Eyes Were Watching God.” Johnson’s work transports critical frames and moves across a variety of genres and fields, from psychoanalysis to law and from Romanticism to 20th-century American popular culture. Her unparalleled readings—of words, concepts, stories, poems—examine how texts do, and undo, what they say. In the process, Johnson’s writing playfully and often surprisingly displaces authority (even her own) to reveal the poetic and political work of multivalence. The wide range of anthologies that include essays by Johnson attest to the tremendous scope of her work and to the difficulty of summarizing even where its major contributions lie.
Antonio Pucci
Authors: Predelli Maria Bendinelli 
Published: May 2019

Leaving aside Dante, Petrarch, and Boccaccio—the three exceptional figures of the Italian Trecento—Antonio Pucci (b. c. 1310–d. 1388) is perhaps the most notable writer of the literary Florentine landscape of that period. His abundant production includes an astonishing variety of genres and themes and reveals his alertness in tuning in with new trends in literary expression; his language is fascinating for its richness and spontaneity, and for its proximity to the oral means of communication; and his temperament reveals a passionate connection to the political and social aspects of his city. The scholars of the late 1800s studied and appreciated Pucci as a “popular” writer, one that expressed in simple and sincere ways the sentiments of the Florentine middle and lower classes, commonly pointing out, however, the poverty of his style and his absence from the incipient humanist revolution. In his overview of autobiographical, gnomic, political, and popular poetry (Critica 29 [1931]: 241–263), Benedetto Croce (followed by later critics) presented him as a popular journalist, thinking no doubt of the serventesi in which he narrated and commented the major events that marked the life of the Commune (e.g., the flood of 1333, the rise and fall of a seigneurial regime, various episodes of the war between Florence and Pisa, the plague of 1348). Over the last hundred years, a number of scholars have paid greater attention to his writings, collecting anthologies of his lyrics and providing editions of single works. Interestingly enough, some critical editions (Le Noie, Contrasto delle donne, Sonnets) were first produced in the United States in the first half of the 20th century. This critical attention also enhanced Pucci’s cultural status: scholars began to gather evidence of Pucci’s familiarity with Boccaccio, and highlighted his important role as a mediator between elite and popular culture. New editions of his cantari appeared, and new works were more or less persuasively attributed to him. More recently, Pucci’s writings have also been taken into account to explore issues related to gender studies, particularly in North America. To delve into Pucci’s writings, and correctly circumscribe them, a great portion of the research has been devoted to manuscript studies. The last section to this bibliography also includes a few items concerning the ways and milieux in which Pucci’s name and works persisted in the century after his death. Bibliographical items of the 18th, 19th, and early 20th centuries are only exceptionally listed in this article, as they can be found in Speight 1954, cited under Bibliographies and Other Research Tools.
Medieval York
Authors: Merlo Perring Stefania 
Published: May 2019

The medieval period in York spans from the end of the Roman rule in Britain in 410 ce to the early 16th century, when the Reformation had a dramatic impact on religious and secular institutions and urban space. The Roman fortress of Eboracum was founded in c. 71 ce in a strategic location at the confluence of two rivers. The annexed civil settlement in the late 2nd century became a provincial capital. Roman emperors resided in Eboracum to control the northern border; Constantine was proclaimed emperor there in 313 ce and Christianity was established by 314 ce. After the Roman period, archaeological sources suggest that there was human activity on the site; however, there is no clear evidence for continuity of urban life. From 627 ce written sources indicate that a wooden church dedicated to Saint Peter was founded within the walls of the Roman fortress by bishop Paulinus, a Gregorian missionary sent to convert the local pagan population. Archaeological evidence shows, however, that the Anglian settlement of Eoforvic was located by the rivers outside of the Roman walls. By 866 ce, at the time of the Viking conquest, York must have been a prosperous town, with commercial and cultural exchanges with the Carolingian world. Under Viking and Anglian rulers, the Anglo-Scandinavian town of Jorvik flourished. Churches, cemeteries, and possibly centers of secular power were located within the Roman walls, while densely populated residential and commercial areas were developed along the rivers. Trade and cultural exchange were established with Northern Europe and the wider Viking network. In 1066 the Norman Conquest had a great impact on York’s urban environment and institutions. Changes that occurred in the 11th century shaped the form and life of the city and influenced its development for centuries to come. The cathedral, the Minster, was re-founded and rebuilt; two castles were built in Norman style to control the rivers; Roman gates and defenses were enhanced; and parish churches, monasteries, royal mansions, houses, and bridges were built in stone within the city walls. By the 13th century York had grown in economic importance; in 1212 the city communality obtained a royal charter and a civic government was developed. In the 14th century York was a center of wool trade and the wealthiest city in Northern England; private and public buildings were extensively rebuilt and a rich civic culture was flourishing. Despite the 15th century economic crisis, York remained the regional capital of Northern England until the end of the medieval period.
Walter Van Tilburg Clark
Authors: Chisum Jeffrey 
Published: May 2019

Walter Van Tilburg Clark (b. 1909–d. 1971) was born in Maine, but spent his formative years growing up in Reno, Nevada, where his father served as president of the University of Nevada. Clark’s body of work (notably The Ox-Bow Incident) established him as one of the preeminent writers of the American West during the middle of the 20th century (he was friends with Wallace Stegner, the “Dean of Western Writers”), and in 1988, he was one of the first writers inducted into the Nevada Writers Hall of Fame. Clark’s fiction blends elements of the genre western with a careful eye for the local landscape and a spiritual ambivalence toward nature. The Ox-Box Incident (1940), about a lynch mob that erroneously executes a trio of innocent men, is his best-known work (it was made into an Academy Award–nominated film in 1943), though it’s perhaps the least characteristic of his artistic concerns. Clark’s second novel, The City of Trembling Leaves (1945), is a Künstlerroman that details the growth and maturation of a young, budding composer named Tim Hazard. The novel is a powerfully evocative depiction of early-20th-century Reno, and the scene-setting, characterizations, and development of central themes are all expressive of Clark’s prowess as a fiction writer. His final two creative works—The Track of the Cat (1949) and The Watchful Gods and Other Stories (1950)—are arguably his best. The Track of the Cat is a tense, tightly wound novel about a marauding mountain lion which has been preying on the cattle of the isolated Bridger family, and which begins to prey upon the humans as well. The Watchful Gods, meanwhile, shows Clark’s range as a storyteller, with the title story being perhaps the purest and most focused narrative expression of his main thematic concerns (especially the spiritual connection between humans and the natural environment). Clark did not publish any fiction after The Watchful Gods. This dry spell, from one of the most promising writers of the American West, remains one of the great enigmas of Clark’s career. The secondary literature on Clark ranges from scholarly analysis to exploration of the narrative themes in his work to biographical and archival work. Generally speaking, Clark’s fiction is interpreted through the lens of western American literary criticism and history, with many scholars treating it as both an exemplar of and deviation from western generic conventions.