bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in the availability and cost of essential medicines for non-communicable diseases in Uganda: A descriptive time series analysis
Authors: Armstrong-Hough Mari , Sharma Srish , Kishore Sandeep P. , Akiteng Ann R. , Schwartz Jeremy I. 
Published: December 2020

Background
Availability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time.

Methods
We carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases.

Results
Availability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price.

Conclusions
We conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.
Longitudinal trends and determinants of patient-reported side effects on ART–a Swedish national registry study
Authors: Mellgren Åsa , Eriksson Lars E. , Reinius Maria , Marrone Gaetano , Svedhem Veronica 
Published: December 2020

Introduction
The use of patient-reported outcomes (PROs) to systematically quantify adverse events (AE) will assist in the improvement of medical care and the QoL of patients living with HIV (PLWH). The aim of this study was to investigate the associations between self-reported side effects and other PROs, demographics and laboratory data, and further evaluate the Health Questionnaire (HQ) as a tool for following trends in patient-reported side effects over time in relation to trends in prescribed third agent in ART.

Materials and methods
The Swedish National Registry InfCareHiv includes an annual self-reported nine-item HQwhich is used in patient-centered HIV care in all Swedish HIV units. In this study, the experience of side effects was addressed. We analyzed 9,476 HQs completed by 4,186 PLWH together with details about their prescribed ART and relevant biomarkers collected during 2011–2017. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient and mixed logistic regression.

Results
The cross-sectional analysis of the HQs showed that the frequency of reported side effects decreased from 32% (2011) to 15% (2017). During the same period, there was a shift in ART prescription from efavirenz (EFV) to dolutegravir (DTG) (positive correlation coefficient r = 0.94, p = 0.0016). Further, PLWH who reported being satisfied with their physical health (OR: 0.47, p = <0.001) or psychological health (OR: 0.70, p = 0.001) were less likely to report side effects than those less satisfied.

Conclusions
Self-reported side effects were found to have a close relationship with the patient’s ratings of their overall health situation and demonstrated a strong correlation with the sharp decline in use of EFV and rise in use of DTG, with reported side effects being halved. This study supports the feasibility of using the HQ as a tool for longitudinal follow up of trends in PROs.
The shared experiences of insured members and the uninsured in health care access and utilization under Ghana’s national health insurance scheme: Evidence from the Hohoe Municipality
Authors: Umar Suraiya , Fusheini Adam , Ayanore Martin Amogre 
Published: December 2020

Background
The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 to remove financial barriers and to promote equitable access to health care services. Post implementation has been characterized by increases in access and utilization of services among the insured. The uninsured have been less likely to utilize services due to unaffordability of health care costs. In this study, we explored the experiences of the insured members of the NHIS, the uninsured and health professionals in accessing and utilizing health care services under the NHIS in the Hohoe Municipality of Ghana.

Methods
Qualitative in-depth interviews were held with twenty-five NHIS insured, twenty-five uninsured, and five health care professionals, who were randomly sampled from the Hohoe Municipality to collect data for this study. Data was analyzed using thematic analysis.

Results
Participants identified both enablers or motivating factors and barriers to health care services of the insured and uninsured. The major factors motivating members to access and use health care services were illness severity and symptom persistence. On the other hand, barriers identified included perceived poor service quality and lack of health insurance among the insured and uninsured respectively. Other barriers participants identified included financial constraints, poor attitudes of service providers, and prolonged waiting time. However, the level of care received were reportedly about the same among the insured and uninsured with access to quality health care much dependent on ability to pay, which favors the rich and thereby creating inequity in accessing the needed quality care services.

Conclusion
The implication of the financial barriers to health care access identified is that the poor and uninsured still suffer from health care access challenges, which questions the efficiency and core goal of the NHIS in removing financial barrier to health care access. This has the potential of undermining Ghana’s ability to meet the Sustainable Development Goal 3.8 of universal health coverage by the year 2030.
Performance of self-reported measures of alcohol use and of harmful drinking patterns against ethyl glucuronide hair testing among young Swiss men
Authors: Iglesias Katia , Lannoy Séverine , Sporkert Frank , Daeppen Jean-Bernard , Gmel Gerhard , Baggio Stéphanie 
Published: December 2020

Background
There is a need for empirical studies assessing the psychometric properties of self-reported alcohol use as measures of excessive chronic drinking (ECD) compared to those of objective measures, such as ethyl glucuronide (EtG).

Objectives
To test the quality of self-reported measures of alcohol use and of risky single-occasion drinking (RSOD) to detect ECD assessed by EtG.

Methods
A total of 227 samples of hair from young Swiss men were used for the determination of EtG. Self-reported measures of alcohol use (previous twelve-month and previous-week alcohol use) and RSOD were assessed. Using EtG (<30 pg/mg) as the gold standard of ECD assessment, the sensitivity and specificity were computed, and the AUROC were compared for alcohol use measures and RSOD. Logistic regressions were used to test the contribution of RSOD to the understanding of ECD after controlling for alcohol use.

Results
A total of 23.3% of participants presented with ECD. Previous twelve-month alcohol use with a cut-off of >15 drinks per week (sensitivity = 75.5%, specificity = 78.7%) and weekly RSOD (sensitivity = 75.5%, specificity = 70.1%) yielded acceptable psychometric properties. No cut-off for previous-week alcohol use gave acceptable results. In the multivariate logistic regression, after controlling for the previous twelve months of alcohol use, RSOD was still significantly associated with EtG (p = .016).

Conclusion
Self-reported measures of the previous twelve months of alcohol use and RSOD were acceptable measures of ECD for population-based screening. Self-reported RSOD appeared to be an interesting screening measure, in addition to the previous twelve months of alcohol use, to understand ECD among young people.
Community-setting pneumonia-associated hospitalizations by level of urbanization—New York City versus other areas of New York State, 2010–2014
Authors: Wu Melody , Whittemore Katherine , Huang Chaorui C. , Corrado Rachel E. , Culp Gretchen M. , Lim Sungwoo , Schluger Neil W. , Daskalakis Demetre C. , Lucero David E. , Vora Neil M. 
Published: December 2020

Background
New York City (NYC) reported a higher pneumonia and influenza death rate than the rest of New York State during 2010–2014. Most NYC pneumonia and influenza deaths are attributed to pneumonia caused by infection acquired in the community, and these deaths typically occur in hospitals.

Methods
We identified hospitalizations of New York State residents aged ≥20 years discharged from New York State hospitals during 2010–2014 with a principal diagnosis of community-setting pneumonia or a secondary diagnosis of community-setting pneumonia if the principal diagnosis was respiratory failure or sepsis. We examined mean annual age-adjusted community-setting pneumonia-associated hospitalization (CSPAH) rates and proportion of CSPAH with in-hospital death, overall and by sociodemographic group, and produced a multivariable negative binomial model to assess hospitalization rate ratios.

Results
Compared with non-NYC urban, suburban, and rural areas of New York State, NYC had the highest mean annual age-adjusted CSPAH rate at 475.3 per 100,000 population and the highest percentage of CSPAH with in-hospital death at 13.7%. NYC also had the highest proportion of CSPAH patients residing in higher-poverty-level areas. Adjusting for age, sex, and area-based poverty, NYC residents experienced 1.3 (95% confidence interval [CI], 1.2–1.4), non-NYC urban residents 1.4 (95% CI, 1.3–1.6), and suburban residents 1.2 (95% CI, 1.1–1.3) times the rate of CSPAH than rural residents.

Conclusions
In New York State, NYC as well as other urban areas and suburban areas had higher rates of CSPAH than rural areas. Further research is needed into drivers of CSPAH deaths, which may be associated with poverty.
A Multi-disciplinary Mixed-Methods Study of Group Dynamics in Active Learning Space
Authors: Gordy Xiaoshan Zhu , Carr Elizabeth O. , Zhang Lei , Bailey Jessica H. 
Published: December 2020

Active learning space emerged at the turn of the twenty-first century. The active learning space design represents not only an overhaul of traditional classrooms’ physical appearances but also reflects a paradigm shift from teacher-centered learning to student-centered learning. Current available research mainly focused on student academic performance as well as student and faculty perceptions. No research has been conducted to investigate interactions at the student level to find out what interactions are taking place in the active learning space and how they affect student learning. This study employed a sequential exploratory mixed-methods design inquiring into student learning in an active learning space first through student focus group discussions and then with an online student survey. The major themes emerged from the focus group discussions were utilized to develop the online survey. The purpose of this survey was to cross-validate qualitative outcomes and further seek answers to unanswered questions triggered by qualitative findings. The qualitative data indicated that the spatial equity in the active learning space put students in positive mindsets and induced active classroom participation. The interconnected screens made it easy for students to view class content and collaborate with peers. The group work conducted in the space fostered mutual learning, promoted learning accountability and improved peer relations. The quantitative survey data on group dynamics validated and reinforced qualitative findings. This paper will help educators better understand student behaviors in the active learning space and better design space-appropriate pedagogical strategies.
Shape Factor Asymptotic Analysis I
Authors: WANG Frank Xuyan 
Published: December 2020

We proposed using shape factor to distinguish probability distributions, and using relative minimum or maximum values of shape factor to locate distribution parameter allowable ranges for distribution fitting in our previous study. In this paper, the shape factor asymptotic analysis is employed to study such conditional minimum or maximum, to cross validate results found from numerical study and empirical formula we obtained and published earlier. The shape factor defined as kurtosis divided by skewness squared is characterized as the unique maximum choice of among all factors that is greater than or equal to 1 for all probability distributions. For all distributions from a specific distribution family, there may exists such that. The least upper bound of all such is defined as the distribution family’s characteristic number. The useful extreme values of the shape factor for various distributions that are found numerically before, the Beta, Kumaraswamy, Weibull, and GB2 distributions are derived using asymptotic analysis. The match of the numerical and the analytical results may arguably be considered proof of each other. The characteristic numbers of these distributions are also calculated. The study of the extreme value of the shape factor, or the shape factor asymptotic analysis, help reveal properties of the original shape factor, and reveal relationship between distributions, such as that between the Kumaraswamy distribution and the Weibull distribution.
Impact of Political Uncertainty on Pakistan Stock Exchange: An Event Study Approach
Authors: SULEHRI Fiaz Ahmad , ALI Amjad 
Published: December 2020

Pakistan is struggling against many problems; out of which political instability and terrorism are crucial problems. These issues hindered the economic growth of the country as well as the confidence of investors. This study has investigated the impact of political events on Pakistan Stock Exchange.
This paper uses a standard event study methodology. Data relating to the stock market index has been collected from the website of Pakistan Stock Exchange and relating to political events has been collected from the newspapers of Business Recorder and DAWN. A total of 18 political events was considered in the study out of which 08 events were coded as positive and other 10 were deemed negative. The first day abnormal return, a five-day cumulative abnormal return and ten-day cumulative return was calculated for all of the events. This study found evidence that political events affected the stock market in Pakistan, but their impact is different considering the economic and political implications of these events. Certain events had the strongest impact on the stock market like Nuclear tests for effective defense, the Supreme Court had revoked the Presidential order and Nawaz Sharif had been reinstated, General elections held in the country and the 14th amendment because 14th amendment was related to the elimination of corruption in political parties. Overall, this study laid the foundation to make further explorations into the phenomenon of uncertainty caused by political events in relevance to the stock market in Pakistan.
Antioxidant activity and acute toxicity of two Lagenaria siceraria (Molina) Standl. varieties from Sudan
Authors: MARIOD Abdalbasit Adam , MUSTAFA Makarim Mutasim , NOUR Abdelazim , ABDALLA Mahmood Ameen , SALAMA Suzy Munir , AL WAJEEH Nahla Saeed 
Published: December 2020

The present study was conducted to evaluate the antioxidant capacity and acute toxicity of the methanol extract of two Lagenaria siceraria (Molina) Standl. varieties of dried seeds, Sweet gourd Water Jug (WJ) and bitter gourd Basket Ball (BB). The seed extracts were tested for their total phenolic contents (TPC), total flavonoid contents (TFC), ferric reducing antioxidant power (FRAP) and scavenging activity to the stable free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). Both dried seed extracts were then tested for acute toxicity at doses 2 and 5 g kg-1 each. Sixty female and male rats were assigned into five groups per sex. Four groups were given low and high doses of each dried seed extract and the fifth group was given 10 % Tween 20 as a control. Kidneys and livers of all rats were assessed for biochemistry and histopathology. The seed extract of WJ revealed higher TPC, FRAP and DPPH activities compared to BB seeds, while TFC results were reversed. Toxicologically, no toxicity signs were recorded in animals. Biochemistry results were within the normal ranges with a slight increase in bilirubin and Alanine aminotransferase (ALT), and histology of kidneys and livers showed normal architecture. In conclusion, WJ and BB dried seed extracts exhibited high antioxidant activity suggesting promising therapeutic regimen against oxidative stress.
Cytogenetic and molecular studies on two faba bean cultivars revealed their difference in their aluminum tolerance
Authors: HASSANEIN Ahmed M. , MOHAMED Ahmed h. , ABD ALLAH Heba Ahmed , ZAKI Hoida 
Published: December 2020

Two cultivars of faba bean (Vicia faba ‘Giza 843’ and ‘Nobaria 3’) that differ in aluminum (Al) tolerance were used to study cytogenetic and genomic alterations under the influence of Al Cl3 (5, 15, and 25 mmol AlCl3) for different periods (6, 12 and 24 h). Under Al treatments, mitotic index in both cultivars decreased and total chromosomal abnormalities increased. The frequencies of micronuclei and chromosomal abnormalities (C-anaphase, metaphase-star chromosomes, breaks, sticky and disturbed chromosomes during metaphase or anaphase) in ‘Giza 843’ were lower than in ‘Nabaria 3’. Increase of the registered cytogenetic events under the influence of Al stress led to increase the detected polymorphism using RAPD and ISSR markers. Application of RAPD primers gave the same value of polymorphism in both faba bean cultivars under Al stress. Polymorphism average of nine ISSR primers of ’Giza 843’ (65.36 %) was lower than that of ‘Nobaria 3’ (71.59 %). Molecular markers, cytogenetic characteristics and seedling growth data indicate that Al tolerance of ‘Giza 843’ was higher than of ‘Nobaria 3’. This work shows that cytogenetic and ISSR techniques could be used efficiently to distinguish between the ability of two faba bean cultivars to tolerate toxic effects of Al.
Effects of Oven Temperature and Addition of Ethanol on Measurement of Water Content and Specific Gravity of Cement-Stabilized Soft Clay
Authors: Yu Hua , Yi Yaolin , Puppala Anand J. 
Published: December 2020

Abstract
Water content and specific gravity are two fundamental soil properties. The water content is usually measured by the oven-drying method, and the dried soil is used for specific gravity determination of the soil. However, for cement-stabilized soils, high oven temperature accelerates the cement hydration rate and causes dehydration of some clay minerals, which may affect the measurement accuracy of water content and soil specific gravity. Hence, researchers have proposed the use of ethanol to terminate cement hydration reactions and a low oven temperature to reduce the dehydration of hydration products. To verify the effectiveness, this experimental study investigated the effects of oven temperature (60°C and 110°C) and the addition of ethanol on the measurements of both water content and specific gravity of cement-stabilized soft clay. These measurements are compared with those measured with the freeze-drying method, which is termed as a control measurement. The test results indicated that the effect of ethanol on water content measurement was insignificant. For 7-day stabilized clay, oven drying at 110°C achieved lower errors (3.06–3.63 %) than the oven-drying method at 60°C (7.36–9.44 %). For 180-day cement-stabilized clay, all the oven-drying methods had similar measurement errors (4.02–5.58 %). The effect of drying method on the specific gravity measurement was insignificant, with the percentage of measurement error ranging from 0.19 to 2.17 %.
Handguns and Ammunitions Indicators Extracted from the GSR Analysis
Authors: Lebiedzik J , Johnson DL 
Published: December 2020

Abstract
The computer automated scanning electron microscope, X-ray microanalysis of Firearms Discharge Residue (FDR) can reveal substantial information about the circumstances of their generation beyond the presence of characteristic gunshot residue (GSR). Indicators of the type of weapon and ammunition used can be obtained from the distribution of GSR particle shapes and from the multi-element analysis of the FDR sample. This is demonstrated for a large database of GSR samples from nine different handguns and over 60 different ammunitions. An example classification scheme is presented for the supporting particles generally found present in FDR. When particle type area concentration ratios are normalized to the iron (Fe) particle type, results show it is possible to distinguish much about the metal used in the weapon manufacture, whether it was of large or small caliber, whether the bullets were jacketed or plated, and whether the cartridge cases were of aluminum, brass, or nickel-plated brass. Standardization of such analytical schemes would be advantageous.
The Accuracy and Precision of Third Molar Development as an Indicator of Chronological Age in Hispanics
Authors: Solari AC , Abramovitch K 
Published: December 2020

Abstract
The accuracy and precision of chronological age estimation based on the stages of third molar tooth development was studied in a sample of 679 radiographs from individuals of Hispanic origin. The age range was 14.0 to 25.0 years. Eight raters from the University of Texas Health Science Center at Houston Dental Branch evaluated the radiographs according to Demirjian's schematic definitions of crown and root formation. The objective of this study was to evaluate the chronology of third molar development in Hispanics following the protocol of a previous study. Within the Hispanic population, the rate of male third molar development is greater than that of female third molar development for ten stages of crown-root formation. Also within this Hispanic population sample, the rate of maxillary third molar development is ahead of mandibular third molar development. The mean absolute difference between chronological age and estimated age was ±3.0 years in females and ±2.6 years in males.
Visualization of Postmortem Chondrocyte Damage by Vital Staining and Confocal Laser Scanning 3D Microscopy
Authors: Lasczkowski GE , Aigner T , Gamerdinger U , Weiler G , Bratzke H 
Published: December 2020

Abstract
The present study was designed to investigate whether the combination of vital dyes [calcein acetomethyl ester and ethidium homodimer (LIVE/DEAD(®) Viability/Cytoxicity Kit)] together with confocal laser scanning 3D microscopy was a suitable process to detect postmortem chondrocyte damage, and whether this process could be used to establish postmortem interval.
Human knee cartilage from 13 autopsies (postmortem interval from 1 day to 2.5 months) was incubated with the two dyes. The chondrocytes revealed intense staining according to their vitality. For those cases that were stored mainly at 4°C there was a vitality of approximately 88 to 96% within the first 4.5 days, which decreased to 58% after 6 days and to 9% after 1.5 months. After 2 days and 14 days at summer temperatures there were 70% and 8% vital chondrocytes respectively. Three of the 13 cases showed that altered body and storage conditions limited the efficacy of the method.
Initial data suggested a time and temperature dependent increase in cell breakdown. Under stable cooling conditions the use of vital dyes and confocal laser scanning 3D microscopy to measure chondrocyte loss may be a valuable tool for estimating the postmortem interval.