bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: a mixed-methods study
Authors: Kamba Pakoyo Fadhiru , Mulangwa John , Kaggwa Bruhan , Kitutu Freddy Eric , Sewankambo Nelson Kaulukusi , Katabira Elly Tebasoboke , Byakika-Kibwika Pauline , Adome Richard Odoi , Bollinger Robert Cyril 
Published: February 2020

Abstract
Background
Controlled prescription drug use disorders are a growing global health challenge in Sub-Saharan Africa. Effective supply chain regulations on dispensing and stock control are important for controlling this epidemic. Since compliance with these regulations in resource-limited countries is poor, there is need to understand its predictors in order to reduce the risk of prescription drug use disorders.

Methods
A mixed-methods study utilizing a structured questionnaire and a simulated client guide was undertaken in Kampala and Mbale towns in Uganda. The questionnaire recorded self-reported dispensing and verified stock control practices and their covariates from 101 private pharmacies. The guide recorded actual dispensing practices from 27 pharmacies. Snowball sampling was done to enrich the sample with pharmacies that stock opioids. The mean compliance with good dispensing and stock control practices was calculated. Multivariate logistic regression analyses were applied to identify predictors of compliance.

Results
The mean compliance with dispensing and stock control requirements was 82.9% and 23%, respectively. Twenty percent and 40% of the pharmacies dispensed pethidine without a prescription and with invalid prescriptions, respectively. Having a pharmacist on duty (OR = 5.17; p = 0.02), prior in-service training on narcotics regulations (OR = 3.51; p = 0.04), and previous narcotics audits by the regulator (OR = 5.11; p = 0.01) were independent predictors of compliance with stock control requirements. Pharmacies with a previous history of poor compliance with dispensing requirements were less likely to demonstrate good compliance (OR = 0.21; p = 0.01).

Conclusions
There is suboptimal compliance to controlled prescription drug regulations among Uganda’s pharmacies. A previous history of poor compliance to dispensing requirements predicted low compliance in subsequent assessments. Training and regulatory audits increased compliance in stock control but not dispensing. Expansion of training and audits to more pharmacies and/or incentives for compliance are necessary.
Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction
Authors: Aflatooni Justin O. , Meeks Brett D. , Froehle Andrew W. , Bonner Kevin F. 
Published: February 2020

Abstract
Background
Biceps tenotomy and tenodesis are surgical treatments for pathology of the proximal tendon of the long head of the biceps. There is debate over which procedure provides better patient outcomes.

Purpose
Compare patient-reported outcomes and satisfaction between biceps tenotomy and tenodesis.

Methods
This retrospective cohort study including all patients undergoing arthroscopic biceps tenodesis or tenotomy as part of more extensive shoulder surgery with a single surgeon. Concomitant procedures included rotator cuff repair, subacromial decompression, acromioclavicular joint resection, and debridement. Patients 36–81 years old were contacted by phone at > 2-year post-operatively to complete a biceps-specific outcome questionnaire. Subject decision not to participate was the sole exclusion criterion. Satisfaction scores and frequencies of potential biceps-related downsides (biceps cramping/spasms, biceps pain, shoulder pain, weakness, cosmetic deformity) were analyzed for the effects of procedure, sex, and age.

Results
Satisfaction score distributions were similar between patients with tenodesis and patients with tenotomy (χ2 = 8.34, P = 0.08), although slightly more patients with tenodesis than patients with tenotomy reported being satisfied or very satisfied (96% versus 91%). Perceived downsides occurred more frequently among patients with tenotomy than in patients with tenodesis: 59% of patients with tenotomy reported ≥ 1 downside, versus 37% of patients with tenodesis (P < 0.01). In patients reporting ≥ 1 downside, distributions of total downsides differed between procedures (χ2 = 10.04, P = 0.04): patients with tenotomy were more likely to report multiple concurrent downsides than were patients with tenodesis (31% versus 16%). Each individual downside tended to be reported as present by a greater proportion of patients with tenotomy than patients with tenodesis. Sex had no effect on satisfaction or downsides, but there was a trend for older patients to report higher satisfaction and fewer downsides.

Conclusions
Biceps tenotomy and tenodesis are both viable treatments for proximal biceps tendon pathology, yielding high patient satisfaction. There were trends toward greater satisfaction and fewer problems in patients with tenodesis. Still, younger patients with tenodesis did report perceived downsides. Alternatively, older patients tended to be more satisfied with both procedures overall. Regardless of procedure, most patients receiving either tenotomy or tenodesis would undergo their respective surgery again.

Level of Evidence
Level III evidence, retrospective comparative cohort study
Tripartite signalling by NMDA receptors
Authors: Rajani Vishaal , Sengar Ameet S. , Salter Michael W. 
Published: February 2020

AbstractN-methyl-d-aspartate receptors (NMDARs) are excitatory glutamatergic receptors that are fundamental for many neuronal processes, including synaptic plasticity. NMDARs are comprised of four subunits derived from heterogeneous subunit families, yielding a complex diversity in NMDAR form and function. The quadruply-liganded state of binding of two glutamate and two glycine molecules to the receptor drives channel gating, allowing for monovalent cation flux, Ca2+ entry and the initiation of Ca2+-dependent signalling. In addition to this ionotropic function, non-ionotropic signalling can be initiated through the exclusive binding of glycine or of glutamate to the NMDAR. This binding may trigger a transmembrane conformational change of the receptor, inducing intracellular protein-protein signalling between the cytoplasmic domain and secondary messengers. In this review, we outline signalling cascades that can be activated by NMDARs and propose that the receptor transduces signalling through three parallel streams: (i) signalling via both glycine and glutamate binding, (ii) signalling via glycine binding, and (iii) signalling via glutamate binding. This variety in signal transduction mechanisms and downstream signalling cascades complements the widespread prevalence and rich diversity of NMDAR activity throughout the central nervous system and in disease pathology.
Early trajectories of skin thickening are associated with severity and mortality in systemic sclerosis
Authors:   the French National Scleroderma Cohort Network, Ledoult Emmanuel , Launay David , Béhal Hélène , Mouthon Luc , Pugnet Grégory , Lega Jean-Christophe , Agard Christian , Allanore Yannick , Jego Patrick , Fauchais Anne-Laure , Harlé Jean-Robert , Berthier Sabine , Aouba Achille , Mekinian Arsène , Diot Elisabeth , Truchetet Marie-Elise , Boulon Carine , Duhamel Alain , Hachulla Eric , Sobanski Vincent 
Published: February 2020

Abstract
Background
Systemic sclerosis (SSc) is a severe and highly heterogeneous disease. The modified Rodnan skin score (mRSS) is a widely used tool for the assessment of the extent and degree of skin thickness. This study aimed to identify the classes of patients with early similar skin thickening trajectories without any a priori assumptions and study their associations with organ involvement and survival.

Methods
From the French SSc national cohort, patients with a disease duration of less than 2 years at inclusion and with at least 2 mRSS available within the first 4 years of follow-up were enrolled. Classes of patients with similar mRSS trajectories were identified based on a latent class mixed model. The clinical characteristics and survival rate were compared between the obtained classes.

Results
A total of 198 patients fulfilled the inclusion criteria, with a total of 641 mRSS available. The median disease duration and follow-up were 0.8 (interquartile range 0.4; 1.2) and 6.3 (3.8; 8.9) years, respectively. Individual trajectories of mRSS were highly heterogeneous between patients. Models with 1–6 latent classes of trajectories were sequentially assessed, and the 5-class model represented the best fit to data. Each class was characterized by a unique global trajectory of mRSS. The median disease duration did not differ significantly between classes. Baseline organ involvement was more frequent in classes with significant change over time (classes 2–5) than in class 1 (low baseline mRSS without significant change over time). Using Cox regression, we observed a progressively increasing risk of death from classes 1 to 5.

Conclusions
Early identification of clinical phenotype based on skin thickening trajectories could predict morbi-mortality in SSc. This study suggested that mRSS trajectories characterization might be pivotal for clinical practice and future trial designs.
Finding and extending ancient simple sequence repeat-derived regions in the human genome
Authors: Shortt Jonathan A. , Ruggiero Robert P. , Cox Corey , Wacholder Aaron C. , Pollock David D. 
Published: February 2020

Abstract
Background
Previously, 3% of the human genome has been annotated as simple sequence repeats (SSRs), similar to the proportion annotated as protein coding. The origin of much of the genome is not well annotated, however, and some of the unidentified regions are likely to be ancient SSR-derived regions not identified by current methods. The identification of these regions is complicated because SSRs appear to evolve through complex cycles of expansion and contraction, often interrupted by mutations that alter both the repeated motif and mutation rate. We applied an empirical, kmer-based, approach to identify genome regions that are likely derived from SSRs.

Results
The sequences flanking annotated SSRs are enriched for similar sequences and for SSRs with similar motifs, suggesting that the evolutionary remains of SSR activity abound in regions near obvious SSRs. Using our previously described P-clouds approach, we identified ‘SSR-clouds’, groups of similar kmers (or ‘oligos’) that are enriched near a training set of unbroken SSR loci, and then used the SSR-clouds to detect likely SSR-derived regions throughout the genome.

Conclusions
Our analysis indicates that the amount of likely SSR-derived sequence in the human genome is 6.77%, over twice as much as previous estimates, including millions of newly identified ancient SSR-derived loci. SSR-clouds identified poly-A sequences adjacent to transposable element termini in over 74% of the oldest class of Alu (roughly, AluJ), validating the sensitivity of the approach. Poly-A’s annotated by SSR-clouds also had a length distribution that was more consistent with their poly-A origins, with mean about 35 bp even in older Alus. This work demonstrates that the high sensitivity provided by SSR-Clouds improves the detection of SSR-derived regions and will enable deeper analysis of how decaying repeats contribute to genome structure.
Widespread loss of the silencing epigenetic mark H3K9me3 in astrocytes and neurons along with hippocampal-dependent cognitive impairment in C9orf72 BAC transgenic mice
Authors: Jury Nur , Abarzua Sebastian , Diaz Ivan , Guerra Miguel V. , Ampuero Estibaliz , Cubillos Paula , Martinez Pablo , Herrera-Soto Andrea , Arredondo Cristian , Rojas Fabiola , Manterola Marcia , Rojas Adriana , Montecino Martín , Varela-Nallar Lorena , van Zundert Brigitte 
Published: February 2020

Abstract
Background
Hexanucleotide repeat expansions of the G4C2 motif in a non-coding region of the C9ORF72 gene are the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Tissues from C9ALS/FTD patients and from mouse models of ALS show RNA foci, dipeptide-repeat proteins, and notably, widespread alterations in the transcriptome. Epigenetic processes regulate gene expression without changing DNA sequences and therefore could account for the altered transcriptome profiles in C9ALS/FTD; here, we explore whether the critical repressive marks H3K9me2 and H3K9me3 are altered in a recently developed C9ALS/FTD BAC mouse model (C9BAC).

Results
Chromocenters that constitute pericentric constitutive heterochromatin were visualized as DAPI- or Nucblue-dense foci in nuclei. Cultured C9BAC astrocytes exhibited a reduced staining signal for H3K9me3 (but not for H3K9me2) at chromocenters that was accompanied by a marked decline in the global nuclear level of this mark. Similar depletion of H3K9me3 at chromocenters was detected in astrocytes and neurons of the spinal cord, motor cortex, and hippocampus of C9BAC mice. The alterations of H3K9me3 in the hippocampus of C9BAC mice led us to identify previously undetected neuronal loss in CA1, CA3, and dentate gyrus, as well as hippocampal-dependent cognitive deficits.

Conclusions
Our data indicate that a loss of the repressive mark H3K9me3 in astrocytes and neurons in the central nervous system of C9BAC mice represents a signature during neurodegeneration and memory deficit of C9ALS/FTD.
Miller Fisher syndrome with bilateral vocal cord paralysis: a case report
Authors: Ramakrishna Karan N. , Tambe Vikrant , Kattamanchi Adithya , Dhamoon Amit S. 
Published: February 2020

AbstractBackgroundMiller Fisher syndrome is a variant of acute inflammatory demyelinating polyneuropathy classically characterized by ataxia, ophthalmoplegia, and areflexia. Miller Fisher syndrome can present with uncommon symptoms such as bulbar, facial, and somatic muscle palsies and micturition disturbance.Case presentationWe describe the case of a 76-year-old white man with new-onset ataxia, stridor, areflexia, and upper and lower extremity weakness who required intubation at presentation. An initial work-up including imaging studies and serum tests was inconclusive. Eventually, neurophysiological testing and cerebrospinal fluid analysis suggested a diagnosis of Miller Fisher syndrome. Our patient responded to treatment with intravenous immunoglobulin and supportive therapy.ConclusionThe occurrence of acute or subacute descending paralysis with involvement of bulbar muscles and respiratory failure can often divert clinicians to a diagnosis of neuromuscular junction disorders (such as botulism or myasthenia gravis), vascular causes like stroke, or electrolyte and metabolic abnormalities. Early identification of Miller Fisher syndrome with appropriate testing is essential to prompt treatment and prevention of further, potentially fatal, deterioration.
Accelerating the computation for real-time application of the sinc function using graphics processing units
Authors: Kim Sangwoo , Lee Chulhyun 
Published: February 2020

AbstractIn magnetic resonance imaging, the fidelity of image reconstruction is an important criterion. It has been suggested that the infinite-extent sinc kernel is the ideal interpolation kernel for ensuring the reconstruction quality of non-Cartesian trajectories. However, the application of the sinc function has been limited owing to its computational overheads. Recently, graphics processing units (GPUs) have been employed as fast computation tools because of their efficient and versatile parallel computation abilities. We implemented an accelerated convolution function with the sinc kernel using GPUs computing and evaluated the reconstruction performance. The computation time was significantly improved: Computation using the proposed method was approximately 270 times faster than that on a central processing unit (CPU) and approximately 4.6 times faster than that on a CPU optimized by level-3 Basic Linear Algebra Subprograms. The images reconstructed using the fast sinc function exhibited no adverse errors at all matrix sizes (resolutions). The total reconstruction time was approximately 0.3–3 s for all matrices, indicating that the sinc function could be a practical option for image reconstruction. Ultimately, its application would present a fundamental improvement to the performance of image reconstruction, and the GPU implementation of the convolution function with the sinc kernel could resolve various challenges in image data processing.
Pneumatically-driven stretching machine for ankle dorsiflexion: safety concepts and effectiveness test involving healthy young subjects
Authors: Shiraishi Yuma , Okamoto Shogo , Yamada Naomi , Inoue Koki , Akiyama Yasuhiro , Yamada Yoji 
Published: February 2020

AbstractStretching is a major treatment for restoring the ankle range of motion while decreasing the ankle stiffness. An automatic stretching machine can provide long-term continual stretching at home. However, no commercial stretching machines are currently available, and therefore, no safety guidelines exist for them. In this study, we prototyped a stretching machine using a chassis from a commercial foot exerciser for preventing disuse syndrome, and then proposed three safety concepts as general requirements for stretching machines. The concepts were determined based on risk assessments, which included (1) preventing excessive force from being applied to the foot, (2) responding to the ankle stiffness and the range of motion of each different individual, and (3) preventing unintended operations by the user. The above concepts allowed us to develop a stretching machine taking into account safety measures. Further, the stretching effect of the prototype was tested on sixteen healthy young subjects ($$22.3 \pm 3.6\hbox { years}$$22.3±3.6years). We found that the passive resistance of the subjects at specific dorsiflexion angles decreased significantly after stretching the ankle using the prototyped machine.
Improved fruit fly algorithm on structural optimization
Authors: Li Yancang , Han Muxuan 
Published: February 2020

AbstractTo improve the efficiency of the structural optimization design in truss calculation, an improved fruit fly optimization algorithm was proposed for truss structure optimization. The fruit fly optimization algorithm was a novel swarm intelligence algorithm. In the standard fruit fly optimization algorithm, it is difficult to solve the high-dimensional nonlinear optimization problem and easy to fall into the local optimum. To overcome the shortcomings of the basic fruit fly optimization algorithm, the immune algorithm self–non-self antigen recognition mechanism and the immune system learn–memory–forgetting knowledge processing mechanism were employed. The improved algorithm was introduced to the structural optimization. Optimization results and comparison with other algorithms show that the stability of improved fruit fly optimization algorithm is apparently improved and the efficiency is obviously remarkable. This study provides a more effective solution to structural optimization problems.
Childhood tuberculosis treatment outcome and its association with HIV co-infection in Ethiopia: a systematic review and meta-analysis
Authors: Belay Getaneh Mulualem , Wubneh Chalachew Adugna 
Published: February 2020

Abstract
Background
Tuberculosis is the second leading cause of death from an infectious disease worldwide, next to HIV. Hence, initiating and determining the national tuberculosis treatment program and outcome is crucial. However, the childhood tuberculosis treatment outcome in Ethiopia was not investigated.

Objective
This study determined the pooled estimate of childhood tuberculosis treatment outcome and its association with HIV co-infection.

Methods
PubMed, Google Scholar, Web of Science, reference lists of included studies, and Ethiopian institutional research repositories were used to retrieve all available studies. Searching was limited to the studies that had been conducted in Ethiopia and published in the English language. In this study, observational studies, including cohort, cross-sectional, and case-control studies, were included. The estimate of childhood tuberculosis treatment outcome was determined using a weighted inverse variance random-effects model. The overall variation between studies was checked by the heterogeneity test (I2). The Joanna Briggs Institute (JBI) quality appraisal criteria were used for quality assessment of the studies. The summary estimates were presented with forest plots and tables. Publication bias was also checked with the funnel plot and Egger’s regression test. The outcome measures were successful and unsuccessful treatment outcomes. Successful treatment outcomes are defined as patients who are cured and treatment completed, whereas, an unsuccessful treatment outcome means those patients with defaulter, failure, and death treatment outcomes.

Result
To estimate the overall pooled estimate of successful treatment outcome, 6 studies with 5389 participants were considered. Consequently, the overall pooled estimate of successful treatment outcome was 79.62% (95% CI 73.22, 86.02) of which 72.44% was treatment completed. On the other hand, unsuccessful treatment outcomes, including treatment failure, defaulter, and death, were 0.15%, 5.36%, and 3.54%, respectively. Moreover, this study found that HIV co-infection was significantly associated with childhood tuberculosis treatment outcomes. Poor treatment outcome was higher among children with HIV co-infection with an odds ratio of 3.15 (95% CI 1.67, 5.94) compared to that of HIV-negative children.

Conclusion
The summary estimate of successful childhood tuberculosis treatment outcome was low compared to the threshold suggested by the World Health Organization. HIV co-infection is significantly associated with poor treatment outcome of childhood tuberculosis. Therefore, special attention is better to be given to children infected with HIV. Moreover, adherence to anti-TB has to be strengthened.

Trial registration
The protocol has been registered in PROSPERO with a registration number of CRD42018110570.