bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study
Authors: Abuosi Aaron Asibi , Akoriyea Samuel Kaba , Ntow-Kummi Gloria , Akanuwe Joseph , Abor Patience Aseweh , Daniels Anita Anima , Alhassan Robert Kaba 
Published: September 2020

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.
Network-based method for regions with statistically frequent interchromosomal interactions at single-cell resolution
Authors: Bulathsinghalage Chanaka , Liu Lu 
Published: September 2020

Abstract
Background
Chromosome conformation capture-based methods, especially Hi-C, enable scientists to detect genome-wide chromatin interactions and study the spatial organization of chromatin, which plays important roles in gene expression regulation, DNA replication and repair etc. Thus, developing computational methods to unravel patterns behind the data becomes critical. Existing computational methods focus on intrachromosomal interactions and ignore interchromosomal interactions partly because there is no prior knowledge for interchromosomal interactions and the frequency of interchromosomal interactions is much lower while the search space is much larger. With the development of single-cell technologies, the advent of single-cell Hi-C makes interrogating the spatial structure of chromatin at single-cell resolution possible. It also brings a new type of frequency information, the number of single cells with chromatin interactions between two disjoint chromosome regions.

Results
Considering the lack of computational methods on interchromosomal interactions and the unsurprisingly frequent intrachromosomal interactions along the diagonal of a chromatin contact map, we propose a computational method dedicated to analyzing interchromosomal interactions of single-cell Hi-C with this new frequency information. To the best of our knowledge, our proposed tool is the first to identify regions with statistically frequent interchromosomal interactions at single-cell resolution. We demonstrate that the tool utilizing networks and binomial statistical tests can identify interesting structural regions through visualization, comparison and enrichment analysis and it also supports different configurations to provide users with flexibility.

Conclusions
It will be a useful tool for analyzing single-cell Hi-C interchromosomal interactions.
LncRNA LUCAT1/miR-181a-5p axis promotes proliferation and invasion of breast cancer via targeting KLF6 and KLF15
Authors: Liu Yun , Cheng Teng , Du Yaying , Hu Xiaopeng , Xia Wenfei 
Published: September 2020

Abstract
Background
Long non-coding RNAs (lncRNAs) are novel regulatory molecules in breast cancer development. LncRNA LUCAT1 is a potential tumor promoter in human cancers. In this study, we aimed to explore the role of LUCAT1 in human breast cancer tissues and cells.

Methods
A total of 31 breast cancer patients who underwent tumor resection, but without chemo- or radiotherapy or acute lung/heart/kidney diseases, provided tumor and adjacent normal tissues. Bioinformatic analysis, qRT-PCR, and luciferase reporter assay were carried out during the study.

Results
qRT-PCR analysis indicated that, compared with the adjacent tissues and MCF-10A normal breast epithelial cells, LUCAT1 was markedly up-regulated in the breast cancer tissues and five BC cell lines, including MDA-MB-231, MDA-MB-468, MDA-MB-435, SKBR3, and MCF-7. The knockdown of LUCAT1, through the transfection of small interfering RNA (siRNA) specific to LUCAT1, resulted in inhibition of proliferation in breast cancer cells. The expression levels of miR-181a-5p were decreased in the breast cancer tissues and five BC cell lines. Bioinformatic analysis and luciferase reporter assay suggested the interaction between miR-181a-5p and LUCAT1. In addition, the effects of LUCAT1 on promoting cell proliferation were attenuated by overexpression of miR-181a-5p through the transfection of miR-181a-5p mimic. Moreover, bioinformatics and luciferase reporter assay confirmed that miR-181a-5p targeted the 3′-UTR region of KLF6 and KLF15 mRNA, which were two tumor suppressor genes. LUCAT1/miR-181a-5p axis regulated the expression of KLF6 and KLF15 both in vitro and in vivo.

Conclusions
Our data indicate that LUCAT1/miR-181a-5p axis can serve as a novel therapeutic target in breast cancer.
The burden of tuberculosis and attributable risk factors in Brazil, 1990–2017: results from the Global Burden of Disease Study 2017
Authors: Martins-Melo Francisco Rogerlândio , Bezerra Juliana Maria Trindade , Barbosa David Soeiro , Carneiro Mariângela , Andrade Kleydson Bonfim , Ribeiro Antonio Luiz Pinho , Naghavi Mohsen , Werneck Guilherme Loureiro 
Published: September 2020

Abstract
Background
Tuberculosis (TB) continues to be an important cause of fatal and non-fatal burden in Brazil. In this study, we present estimates for TB burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017).

Methods
This descriptive study used GBD 2017 findings to report years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of TB in Brazil by sex, age group, HIV status, and Brazilian states, from 1990 to 2017. We also present the TB burden attributable to independent risk factors such as smoking, alcohol use, and diabetes. Results are reported in absolute number and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UIs).

Results
In 2017, the number of DALYs due to TB (HIV-negative and HIV-positive combined) in Brazil was 284,323 (95% UI: 240,269–349,265). Among HIV-negative individuals, the number of DALYs was 196,366 (95% UI: 189,645–202,394), while 87,957 DALYs (95% UI: 50,624–146,870) were estimated among HIV-positive individuals. Between 1990 and 2017, the absolute number and age-standardized rates of DALYs due to TB at the national level decreased by 47.0% and 68.5%, respectively. In 2017, the sex–age-specific TB burden was highest among males and in children under-1 year and the age groups 45–59 years. The Brazilian states with the highest age-standardized DALY rates in 2017 were Rio de Janeiro, Pernambuco, and Amazonas. Age-standardized DALY rates decreased for all 27 Brazilian states between 1990 and 2017. Alcohol use accounted for 47.5% of national DALYs due to TB among HIV-negative individuals in 2017, smoking for 17.9%, and diabetes for 7.7%.

Conclusions
GBD 2017 results show that, despite the remarkable progress in reducing the DALY rates during the period, TB remains as an important and preventable cause of health lost to due premature death and disability in Brazil. The findings reinforce the importance of strengthening TB control strategies in Brazil through integrated and multisectoral actions that enable the access to prevention, early diagnosis, and timely treatment, with emphasis on high-risk groups and populations most vulnerable to the disease in the country.
Inequalities in infant mortality in Brazil at subnational levels in Brazil, 1990 to 2015
Authors: Szwarcwald Célia Landmann , Almeida Wanessa da Silva de , Teixeira Renato Azeredo , França Elisabeth Barboza , de Miranda Marina Jorge , Malta Deborah Carvalho 
Published: September 2020

Abstract
Background
In this study, infant mortality rate (IMR) inequalities are analyzed from 1990 to 2015 in different geographic scales.

Methods
The Ministry of Health (MoH) IMR estimates by Federative Units (FU) were compared to those obtained by the Global Burden of Disease (GBD) group. In order to measure the inequalities of the IMR by FU, the ratios from highest to lowest from 1990 to 2015 were calculated. Maps were elaborated in 2000, 2010, and 2015 at the municipality level. To analyze the effect of income, IMR inequalities by GDP per capita were analyzed, comparing Brazil and the FU to other same-income level countries in 2015, and the IMR municipal estimates were analyzed by income deciles, in 2000 and 2010.

Results
IMR decreased from 47.1 to 13.4 per 1000 live births (LB) from 1990 to 2015, with an annual decrease rate of 4.9%. The decline was less pronounced for the early neonatal annual rate (3.5%). The Northeast region showed the most significant annual decline (6.2%). The IMR estimates carried out by the GBD were about 20% higher than those obtained by the MoH, but in terms of their inequalities, the ratio from the highest to the lowest IMR among the 27 FU decreased from 4 to 2, for both methods. The percentage of municipalities with IMR higher than 40 per 1000 LB decreased from 23% to 2%, between 2000 and 2015. Comparing the IMR distribution by income deciles, all inequality measures of the IMR decreased markedly from 2000 to 2010.

Conclusion
The results showed a marked decrease in the IMR inequalities in Brazil, regardless of the geographic breakdown and the calculation method. Despite clear signs of progress in curbing infant mortality, there are still challenges in reducing its level, such as the concentration of deaths in the early neonatal period, and the specific increases of post neonatal mortality in 2016, after the recent cuts in social investments.
Physical inactivity as a risk factor for all-cause mortality in Brazil (1990–2017)
Authors: Silva Diego Augusto Santos , Tremblay Mark Stephen , Marinho Fatima , Ribeiro Antonio Luiz Pinho , Cousin Ewerton , Nascimento Bruno Ramos , Valença Neto Paulo da Fonseca , Naghavi Mohsen , Malta Deborah Carvalho 
Published: September 2020

Abstract
Background
The aim of this study was to estimate the mortality from all causes as a result of physical inactivity in Brazil and in Brazilian states over 28 years (1990–2017).

Methods
Data from the Global Burden of Disease (GBD) study for Brazil and states were used. The metrics used were the summary exposure value (SEV), the number of deaths, age-standardized mortality rates, and the fraction of population risk attributable to physical inactivity.

Results
The Brazilian population presented risk of exposure to physical inactivity of (age-standardized SEV) of 59% (95% U.I. 22–97) in 1990 and 59% in 2017 (95% U.I. 25–99). Physical inactivity contributed a significant number of deaths (1990, 22,537, 95% U.I. 12,157–34,745; 2017, 32,410, 95% U.I. 17,976–49,657) in the analyzed period. These values represented mortality rates standardized by age (per 100,000 inhabitants) of 31 (95% U.I. 17–48) in 1990 and 15 (95% U.I. 8–23) in 2017. From 1990 to 2017, a decrease in standardized death rate from all causes attributable to physical inactivity was observed in Brazil (− 52%, 95% U.I. − 54 to − 49). The Brazilian states with better socioeconomic conditions presented greater reductions in age-standardized mortality (male: rho = 0.80; female: rho 0.84) over the period of 28 years.

Conclusions
These findings support the promotion of physical activity in the Brazilian population for the prevention of early mortality.
Hypofractionated radiation therapy comparing a standard radiotherapy schedule (over 3 weeks) with a novel 1-week schedule in adjuvant breast cancer: an open-label randomized controlled study (HYPORT-Adjuvant)—study protocol for a multicentre, randomized phase III trial
Authors: Chatterjee Sanjoy , Chakraborty Santam ,   HYPORT Adjuvant Author Group, Chakraborty Santam , Backianathan Selvamani , Lal Punita , Gupta Subhash , Ahmed Rosina , Misra Shagun , Solomon Patricia , Balakrishan Rajesh , Guha Debashree , Das K. J. Maria , Mahata Anurupa , Mandal Samar , Kumari Abha , Godson Henry Finlay , Ganguly Sandip , Dey Debdeep , Chatterjee Sanjoy 
Published: September 2020

Abstract
Background
Hypofractionated radiotherapy is the current standard for adjuvant radiotherapy across many centres. Further hypofractionation may be possible but remains to be investigated in non-Caucasian populations with more advanced disease, with a higher proportion of patients requiring mastectomy as well as tumour bed boost. We are reporting the design of randomized controlled trial testing the hypothesis that a 1-week (5 fractions) regimen of radiotherapy will be non-inferior to a standard 3-week (15 fractions) schedule.

Methods
We describe a multicentre, randomized controlled trial recruiting patients at large academic centres across India. Patients without distant metastases who merit adjuvant radiotherapy will be eligible for inclusion in the study. Patients in the control arm will receive adjuvant radiotherapy to the breast or chest wall (with/without regional nodes) to a dose of 40 Gy/15 fractions/3 weeks, while those in the experimental arm will receive a dose of 26 Gy/5 fractions/1 week (to the same volume). The use of a simultaneous integrated boost (dose of 8 Gy and 6 Gy, respectively) is allowed in patients who have undergone breast conservation. A sample size of 2100 patients provides an 80% power to detect a non-inferiority of 3% in the 5-year locoregional recurrence rate with a one-sided type I error of 2.5%, assuming that the locoregional recurrence rate in the control arm is 5% at 5 years (corresponding to a hazard ratio of 1.63). Patients will be recruited over a period of 5 years and followed up for a further 5 years thereafter.

Discussion
If a five-fraction regimen of breast cancer is proven to be non-inferior, this will result in a significant improvement in the access to radiotherapy, as well as reduced costs of treatment. The trial gives an opportunity to standardize and quality-assure radiotherapy practices across the nation at the same time. Along with the results of the FAST-Forward trial, the safety of this intervention in advanced node-positive disease requiring regional nodal radiation will be established.

Trial registration
The trial has been registered at the Clinical Trial Registry of India (CTRI) vide registration number: CTRI/2018/12/016816 (December 31, 2018) as well as the ClinicalTrial.gov website at NCT03788213 (December 28, 2018).
Emergency department-based 3D echocardiogram use: a case series
Authors: Matthews Sajith , Levy Phillip D. 
Published: September 2020

Abstract
Background
Three-dimensional echocardiography (3DE) with real-time volumetric imaging can be a vital modality in clinical practice. Despite its potential, it remains underutilized in the acute care setting.

Case presentation
We present two cases describing the use of 3DE in the emergency department (ED) for acute heart failure (AHF) and discuss the potential benefits of routine use in acute care settings.

Conclusions
Three-dimensional echocardiography offers unique information as it relates to cardiac structure and function, and can be valuable for diagnosis and clinical decision-making in the ED.
Juvenile Huntington’s disease: two case reports and a review of the literature
Authors: Lesinskienė Sigita , Rojaka Darja , Praninskienė Rūta , Morkūnienė Aušra , Matulevičienė Aušra , Utkus Algirdas 
Published: September 2020

Abstract
Background
Huntington’s disease is a rare, autosomal dominant neurodegenerative disease characterized by motor, cognitive, and psychiatric symptoms. Usually, the disease symptoms first appear around the age of 40, but in 5–10% of cases, they manifest before the age of 21. This is then referred to as juvenile Huntington’s disease. According to the small number of cases reported in the literature, the course of juvenile Huntington’s disease significantly differs from adult onset and shows significant interpatient variability, making every case unique.

Case presentation
Our study aims to highlight the complexity and diversity of rare juvenile Huntington’s disease. We report cases of two Caucasian patients with chronic tics referred to the Huntington’s Disease Competence Center of Vilnius University Hospital Santaros Klinikos with suspicion of juvenile Huntington’s disease due to the appearance of chronic motor tics, and behavior problems. The diagnosis of juvenile Huntington’s disease was confirmed on both clinical and genetic grounds. In both cases described, the patients developed symptoms in all three main groups: motor, cognitive, and psychiatric. However, the first patient was experiencing more severe psychiatric symptoms; in the second case, motor symptoms (rigidity, tremor) were more prominent. In both cases, apathy was one of the first symptoms and affected patients’ motivation to participate in treatment actively. These two case descriptions serve as an important message for clinicians seeing patients with chronic tics and gradually worsening mood and behavior, indicating the need to investigate them for rare genetic disorders.

Conclusions
Description of these two clinical cases of juvenile Huntington’s disease provides insight into how differently it manifests and progresses in young patients and the difficulties the patients and their families face. There were different but painful ways for families to accept the diagnosis. Because the disease inevitably affects the patient’s closest ones, it is crucial to also provide adequate psychological and social support to all the family members. Establishment of multidisciplinary specialist centers for Huntington’s disease, as demonstrated by our experience, not only allows timely diagnosis and treatment plans but also ensures thorough disease management and care for patients and systematic support for their families.
Comparison of the accuracy of intraoral scans between complete-arch scan and quadrant scan
Authors: Moon Youn-Gyeong , Lee Kyung-Min 
Published: September 2020

Abstract
Objective
To compare the accuracy of complete-arch scans and quadrant scans obtained using a direct chairside intraoral scanner.

Material and methods
Intraoral scans were obtained from 20 adults without missing teeth except for the third molar. Maxillary and mandibular complete-arch scans were carried out, and 4 quadrant scans for each arch were performed to obtain right posterior, right anterior, left anterior, and left posterior quadrant scans. Complete-arch scans and quadrant scans were compared with corresponding model scans using best-fit surface-based registration. Shell/shell deviations were computed for complete-arch scans and quadrant scans and compared between the complete-arch scans and each quadrant scans. In addition, shell/shell deviations were calculated also for each individual tooth in complete-arch scans to evaluate factors which influence the accuracy of intraoral scans.

Results
Complete-arch scans showed relatively greater errors (0.09 ~ 0.10 mm) when compared to quadrant scans (0.05 ~ 0.06 mm). The errors were greater in the maxillary scans than in the mandibular scans. The evaluation of errors for each tooth showed that the errors were greater in posterior teeth than in anterior teeth. Comparing the right and left errors, the right side posterior teeth showed a more substantial variance than the left side in the mandibular scans.

Conclusion
The scanning accuracy has a difference between complete-arch scanning and quadrant scanning, particularly in the posterior teeth. Careful consideration is needed to avoid scanning inaccuracy for maxillary or mandibular complete-arch, particularly in the posterior area because a complete-arch scan might have potential error than a quadrant scan.
Generic versus brand-name over-the-counter analgesics: knowledge and attitudes among Swedish pharmacy customers
Authors: Håkonsen Helle , Wängberg Maria , Alani Dina , Hedenrud Tove 
Published: September 2020

AbstractBackgroundDue to a liberalisation reform in 2009, the availability of over-the-counter (OTC) analgesics has increased significantly in the Swedish market over the past decade. With the increasing number of generic products available on the market and the possibility of buying OTC drugs from non-pharmacy outlets, a key to safe drug use is that consumers possess the necessary knowledge to differentiate between the different brands and choose the appropriate drug for their ailments. The aim of this study was to investigate Swedish consumers’ knowledge of and attitudes towards generic OTC analgesics.MethodsA sample of 209 Swedish adults (66% women; mean age 43.1 years) who bought OTC analgesics at a community pharmacy in one of the country’s three largest cities responded to a structured questionnaire. The questions related to knowledge of active substances, the use and choice of OTC analgesics (generic or original brand), attitudes towards generic OTC analgesics, information received about OTC analgesics and experience with generic substitution of prescription drugs.ResultsAlmost one in five reported weekly use of OTC analgesics, and 32% assigned minimum three out of four active substances to the correct brand(s) of OTC analgesics. Among the 50 participants (24%) who assigned all four active substances correctly, it was predominantly women and participants with higher education. Four out of five participants were positive towards the cheaper brands, and 69% reportedly chose cheaper generic brands over more expensive brands. Knowledge about the active substances of different brands was associated with positive attitudes towards generic products.ConclusionSwedish pharmacy customers have to a varying extent the knowledge to differentiate between different brands of commonly used OTC analgesics in terms of active substances. There is a predominantly positive attitude towards generic OTC analgesics, although some consider generic drugs to be inferior and stay loyal to the original brands.