bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opportunities and Challenges for the Utilization of Cervical Screening Among Womens Living in Mekelle, Tigray Ethiopia, 2021
Authors: Adane Shewit , Zenebe Kahsay , Asrat Mekdes , Haftu Abera , Hagos Hadagay , mehari Mihret-ab 
Published: October 2023

Abstract
Introduction: Cervical cancer is the second most common cancer among women in Ethiopia. Despite the recommendations by different national and international organizations for cervical cancer screening, service utilization remains low. Besides, the existing studies are unable to explore the lived experiences of women with cervical cancer screening.
Objective: To explore the opportunities and challenges for cervical cancer screening among women living in Mekelle, Tigray, Ethiopia, 2021 GC.
Methodology: Phenomenological study design was employed and women who are married, had a history of childbirth, are native Tigrigna speakers, and had lived at least six months in the study area were interviewed. Data was collected using in-depth interview guides and a total of fifteen in-depth interviews were conducted. Audios were transcribed first and translated to English version then after, a code book was developed. Then data was imported to ATLAS ti 7 software and codes were categorized, themes and families were identified. Finally, the data was analyzed using thematic analysis.
Result: In this study, a total of fifteen women were interviewed and their minimum and maximum age were 32&47 years, respectively. Opportunities and challenges were explored from the participants’ perspective; they explained that health extension workers, access to information, and seeing screened and treated women were among the opportunities for cervical cancer screening and in the counterpart carelessness, less awareness and embarrassment were the challenges mentioned by the respondents which were recognized as obstacles not to attend cervical cancer screening. They explained that again failure to attend cervical cancer screening may end up with infertility and death.
Conclusions and recommendations: Health extension workers, access to information, and seeing screened and treated women were opportunities to utilize cervical cancer screening, whereas carelessness, lack of awareness, and embarrassment were challenges that hindered screening for cervical cancer. As the cervical cancer screening service is essential in protecting and promoting women’s lives, the health system should give emphasis to scale up screening for cervical cancer in order to prevent morbidity and mortality due to cervical cancer by mobilizing both community members and health professionals.
Use of Urine Neutrophil Gelatinase Associated Lipocalin for Nephrotoxic Medication Acute Kidney Injury Screening in Neonates
Authors: Slagle Cara , Hemmelgarn Trina , Gavigan Hailey , Krallman Kelli , Goldstein Stuart 
Published: October 2023

Abstract
Background
Daily serum creatinine monitoring protocols for acute kidney injury (AKI) are invasive and may lead to surveillance resistance. We aimed to understand if use of urine neutrophil gelatinase-associated lipocalin (uNGAL) could increase high-risk nephrotoxic medication (NTMx) associated AKI screening adherence in neonates.
Methods
Statistical process control methods prior to and post implementation were trended. The primary outcome, screening adherence, was defined as either daily serum creatinine or uNGAL assessment through 2 days post high-risk NTMx exposure.
Results
1291 monitoring days from the pre-implementation era (4/2020-6/2021) were compared to1377 monitoring days from the post-era (6/2021-10/2022). AKI screening adherence increased (81–92%) following implementation of optional uNGAL screening. Urine NGAL accounted for 35% of screening obtained with a 40% reduction in blood sampling for serum creatinine.
Conclusions
Incorporation of uNGAL as a complementary screening tool to serum creatinine demonstrated sustained increased AKI surveillance in our Baby NINJA monitoring program.
Stressful life events and stressful combat experiences have an indirect effect on symptoms of post-traumatic stress through mindfulness facets in UK Military Veterans
Authors: Harper Leanne , Jones Andrew , Goodwin Laura , Christiansen Paul , Gillespie Steven M. 
Published: October 2023

Abstract
Purpose This study tested whether stressful life events and stressful combat experiences are associated with post-traumatic stress symptomology (PTS-S), via facets of mindfulness, in UK military personnel.Methods A sample of 435 UK veterans were recruited to a cross-sectional, online study. Participants completed self-report measures of stressful life and combat experiences, mindfulness facets, and a symptom checklist for post-traumatic stress.Results There were indirect effects of stressful life events and stressful combat experiences on PTS-S, through a four-factor model of mindfulness, in a non-clinical sample of UK military veterans, adjusting for age and reason for leaving service (X2/df = 2.091, CF I = 0.898, TLI = 0.891, SRMR = 0.062, RMSEA = 0.050). There were significant indirect effects of stressful life events (β = 0.089, SE = 0.002, p < 0.001) and stressful combat experiences (β = 0.006, SE = 0.002, p < 0.001) on PTS-S through mindful Non-judging awareness. Indirect effect through other facets of mindfulness were all non-significant.Conclusion The adverse effects of stressful life events and stressful combat experiences on PTS-S were buffered in participants with greater non-judgemental, mindful awareness. This could support tailored interventions for people who have been exposed to traumatic experiences.
Research on doctor‒patient communication teaching for oncology residents: A new teaching model
Authors: Yang Dong , Ai Xiaohong , Cai Manbo , Tong Qin , Mei Kai , Yang Qiao , Li Pian , Li Zhimin , He Junyan , Li Yi 
Published: October 2023

Abstract
Background
At present, there is no specific teaching method for doctor‒patient communication for oncology residents. This study combined BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) teaching model and SBAR (situation-background-assessment-recommendation) communication model to try a new teaching and assessment model of doctor-patient communication, aiming to explore and improve the teaching method of doctor-patient communication for oncology residents.
Methods
Ninety residents were randomly divided into two groups: the experimental group (n = 45) was trained with the BOPPPS teaching model combined with the SBAR communication model, the routine teaching method was adopted in the control group (n = 45). Indicators of assessment included doctor‒patient communication skills, satisfaction with teaching, and patient satisfaction.
Results
The scores for doctor‒patient communication ability were significantly better in experimental group than control group (P < 0.05). The degree of satisfaction degree (very satisfied + satisfied) of the experimental group were higher than control group (P < 0.05). The overall teaching satisfaction of the experimental group was 100.00%, the control group was 77.78%, P < 0.001. Patients’ satisfaction with the residents in the experimental group (93.3%) was significantly higher than control group (80.0%), P = 0.043.
Conclusion
The application of the BOPPPS combined with the SBAR can effectively enhance residents’ doctor‒patient communication ability and improve teaching satisfaction and patient satisfaction. This new model can effectively improve resident physician‒patient communication ability, which is worth actively promoting in clinical teaching work.
ERCC1 and ERCC2 genes expression and their SNPs variants identify a favorable signature for SCLC patients treated with platinum-based chemotherapy
Authors: Caliman Enrico , Fancelli Sara , Scolari Federico , Pasqui Adriano , Manneschi Clara , Lavacchi Daniele , Mazzoni Francesca , Gensini Francesca , Pasini Valeria , Comin Camilla Eva , Voltolini Luca , Pillozzi Serena , Antonuzzo Lorenzo 
Published: October 2023

Abstract
Background: Platinum chemotherapy (CT) remains the backbone of systemic therapy for patients with small-cell lung cancer (SCLC). The nucleotide excision repair (NER) pathway plays a central role in the repair of the DNA damages exerted by platinum agents. Alteration in this repair mechanism may affect patients survival.
Methods: We retrospectively collected data from 38 patients with extended disease (ED)-SCLC treated with platinum-CT at Clinical Oncology Unit, Careggi University Hospital, Florence (Italy), between 2015 to 2020. On patient tumor samples, we performed mRNA expression analysis and characterization of single nucleotide polymorphisms (SNPs) of three NER pathway genes, namely ERCC1, ERCC2 and ERCC5.
Results: Overall, we found a higher expression of ERCC genes in SCLC patients compared to the healthy controls. Patients with low ERCC1 and ERCC5 expression levels had a better median progression free survival (mPFS=7.1 vs 4.9 months, p=0.39 for ERCC1 and mPFS=6.9 vs 4.8 months, p=0.093 for ERCC5) and overall survival (mOS=8.7 vs 6.0 months, p=0.4 for ERCC1 and mOS=7.2 vs 6.2 months, p=0.13 for ERCC5). Genotyping analysis of five SNPs of ERCC genes showed a longer survival in patients harboring the wild-type genotype or the heterozygous variant of the ERCC1 rs11615 SNP (p=0.24 for PFS and p=0.14 for OS) and of the rs13181 and rs1799793 ERCC2 SNPs (p=0.43 and p=0.26 for PFS and p=0.21 and p=0.16 for OS, respectively) compared to patients with homozygous mutant genotypes.
Conclusions: The integrated analysis of ERCC genes expression and their SNPs variants seems to identify patients with better survival benefits to platinum-CT.
A model that discusses human behavior entirely
Authors: Cai Kaiyu , Wang Lianhui 
Published: October 2023

Abstract
The complexity of human behavior results in a lack of understanding of its entirety, which inhibits recognition and progression. Here, we develop a model to describe all kinds of human behaviors and illustrate its excellent applicability in several important activities, i.e., progression, development and differentiation, freedom attainment, and sustainability maintenance.
ThPOK and Runx3 Regulate the Differentiation of CD4+CD8αα+ IELs in Oral Lichen Planus
Authors: Bao Chao-Fan , Wang Fang , Wang Xiao-Feng , Jiang Qin , Zhou Gang 
Published: October 2023

Abstract
Oral Lichen planus (OLP) is a common T cell-mediated oral mucosal immune inflammatory disease. Intraepithelial lymphocytes (IELs) are a unique subset of T cells that play an important role in regulating immune response. However, its regulatory function in immunopathogenesis of OLP remains unknown. In this study, immunofluorescence and immunohistochemistry were used to identify the phenotype of IELs in OLP. Immunohistochemistry, flow cytometry and immunocytochemistry were performed to investigate the mechanism of differentiation regulation of IELs by T-helper-inducing POZ/Krueppel-like factor (ThPOK) and RUNX family transcription factor 3 (Runx3) in OLP. The results showed that the level of CD8α expression and CD8αα+ cells were significantly upregulated in the epithelium of OLP lesions, whereas they were downregulated in peripheral blood mononuclear cells (PBMCs) of OLP. CD8β was not expressed in the epithelium of OLP lesions. CD4, CD8α and Runx3 expression were increased and ThPOK expression was decreased in the epithelium of OLP lesions. Moreover, CD4+CD8α+ cells were significantly upregulated in the epithelium of OLP. Furthermore, CD8α expression was positively correlated with Runx3 expression while ThPOK expression was negatively correlated with Runx3 expression. After retinoic acid (RA) and transforming growth factor-β1 (TGF-β1) stimulation, CD8α and Runx3 expression was upregulated and ThPOK expression was downregulated in OLP naïve CD4+ T cells. In conclusion, our study demonstrated that CD4+CD8αα+ IELs may be the major phenotype of IELs in OLP, and they are regulated negatively by ThPOK and positively by Runx3.
Augmented quantization: a general approach to mixture models
Authors: Sire Charlie , Rullière Didier , Riche Rodolphe Le , Rohmer Jérémy , Richet Yann , Pheulpin Lucie 
Published: October 2023

Abstract
The estimation of mixture models is a key to understanding and visualizing the distribution of multivariate data.
Most approaches to learning mixture models involve likelihoods and are not adapted to distributions with finite support or without a well-defined density function.

This study proposes the Augmented Quantization method, which is a reformulation of the classical quantization problem but which uses the $p$-Wasserstein distance.
This metric can be computed in very general distribution spaces, in particular with varying supports.
The clustering interpretation of quantization is revisited with distances between distributions.
The Augmented Quantization algorithm can handle mixtures of discrete and continuous measures, with finite or infinite supports.
Each step of the algorithm is supported by local minimizations of the generalized quantization error.
The performance of Augmented Quantization is first demonstrated through analytical toy problems.
Subsequently, it is applied to a practical case study involving river flooding, wherein mixtures of Dirac and uniform distributions are built in the input space, enabling the identification of the most influential variables.
Progression of astigmatism and myopia in children after school lockdown during the COVID-19 pandemic
Authors: Teoh Ru Jian Jonathan , Ng Wei Loon , Rosland Siti Famira , Hannan Nabilatul , Chan Li Yen , Bahari Nor Akmal , Rahmat Jamalia 
Published: October 2023

Abstract
Lockdown during the COVID-19 pandemic was found to increase the prevalence of astigmatism and myopia among schoolchildren. This cross-sectional study was conducted to evaluate the effects of the school lockdown during the COVID-19 pandemic on the changes in astigmatism and myopia in children with pre-existing astigmatism. A total of 247 children aged 5-17 years with refractive astigmatism who had been followed up in a pediatric ophthalmology clinic were included in this single-center study. Changes in refractive astigmatism and myopia before and after a year of school lockdown were recorded. A questionnaire focusing on demographic data, digital screen time, daytime outdoor activities duration, daily online classes duration, type of digital devices used, and type of light source used during screen time was administered. The median age of participants was 9.0 years (5, 17). The median cylindrical power and spherical equivalence of the children worsened after school lockdown (p=.011 and p= <.001 respectively). Subgroup analysis by age found that astigmatic progression was significant in primary school children (7-12 years old), while myopic progression was significant in primary and secondary school children (13-17 years old). There was a positive correlation between astigmatism and myopia progression (r (166) = .23, p = .003). During the lockdown, digital screen time and daily online classes duration increased while daily outdoor activities duration reduced. There were accelerated astigmatic and myopic progressions in children after the school lockdown due to the COVID-19 pandemic. Further studies are required to investigate the underlying etiology of the changes in refractive errors in school-going children post school lockdown.
The Female-to-Male Surgical Sterilization Ratio as an Indicator of Gender-Equity Gap in Colombia
Authors: Rosselli Diego , Carvajal Camila , Medina-Salazar Juan José , Rojas Juan Diego , Soto Valentina , Díaz Laura 
Published: October 2023

Abstract
Background: Within the spectrum of health-related concerns, sexual and reproductive health stands out as a domain where gender-based disparities against women are notably pronounced. The introduction of male surgical sterilization procedures has the potential to mitigate this gender inequity.
Methods: The Colombian Ministry of Health manages the SISPRO information system, encompassing comprehensive records of all medical procedures. Providers must input data for surgical interventions to secure reimbursement from health insurers. Data spanning the five-year period from 2017 to 2021 was collected nationwide for vasectomy and tubal sterilization procedures, including patient age, geographical location, and fees paid to providers in Colombian pesos (COP). Male-to-female (F/M) ratios were computed for each of Colombia's 32 departments and Bogota Capital District, further categorized into five regions: Amazon, Andes, Caribbean, Orinoco, and Pacific. Sterilization rates were determined for each region and the entire country by dividing procedure counts by the respective female or male populations, as reported by the National Statistics Department (DANE) in 2019. Conversion to US dollars (USD) was performed using the 2019 average official exchange rate (1 USD = 3,208.09 COP).
Results: Over this period, SISPRO registered 279,486 tubal sterilization procedures and 68,384 vasectomies. The average national F/M ratio stood at 4.09. Bogota, the capital city, exhibited the lowest F/M ratio (1.94), while Sucre, a Caribbean department, recorded the highest (76.9). Generally, the Caribbean region displayed the highest F/M ratios (average 25.95) and the lowest sterilization rates per 1000 for both females (9.40) and males (0.36). The national averages were 11.0 and 2.8, respectively. Vasectomy cost an average of USD $95.16 per procedure, whereas tubal ligation procedures averaged USD $146.70.
Conclusions: Multidisciplinary societal-based mechanisms for male contraception participation must be actively integrated into communities, with particular emphasis on the Caribbean region.
Research priorities in HIV, aging and rehabilitation: Building on a Framework with the Canada-International HIV and Rehabilitation Research Collaborative
Authors: O’Brien Kelly K. , Ibáñez-Carrasco Francisco , Birtwell Kelly , Donald Graeme , Brown Darren A. , Eaton Andrew D. , Kasadha Bakita , Stanmore Emma , Clair-Sullivan Natalie St. , Townsend Liam , Vera Jaime H. , Solomon Patricia 
Published: October 2023

AbstractBackground In 2016, the Canada-International HIV and Rehabilitation Research Collaborative established a framework of research priorities in HIV, aging and rehabilitation. Our aim was to review and identify any new emerging priorities from the perspectives of people living with HIV, clinicians, researchers, and representatives from community organizations. Methods We conducted a multi-stakeholder international consultation with people living with HIV, researchers, clinicians and representatives of community-based organizations. Stakeholders convened for a one-day Forum in Manchester, United Kingdom (UK) to discuss research priorities via a web-based questionnaire and facilitated discussions. We analyzed data using conventional content analytical techniques and mapped emerging priorities onto the foundational framework. Results Thirty-five stakeholders from the UK(n = 29), Canada(n = 5) and Ireland(n = 1) attended the Forum, representing persons living with HIV or representatives from community-based organizations(n = 12;34%), researchers or academics(n = 10;28%), service providers(n = 6;17%), clinicians(n = 4;11%); and trainees(n = 4;11%). Five priorities mapped onto the Framework of Research Priorities across three content areas: A–Episodic Health and Disability Aging with HIV (disability, frailty, social participation), B-Rehabilitation Interventions for Healthy Aging across the Lifespan (role, implementation and impact of digital and web-based rehabilitation interventions) and C–Outcome Measurement in HIV and Aging (digital and web-based rehabilitation health technology to measure physical activity). Stakeholders indicated methodological considerations for implementing digital and web-based rehabilitation interventions into research and practice and the importance of knowledge transfer and exchange among the broader community. Conclusion Results highlight the sustained importance of the framework of research priorities and provide further depth and areas of inquiry related to digital and web-based rehabilitation interventions and technology aging with HIV.
Network hub changes in the pars opercularis indicate impaired inhibition in tic disorder patients
Authors: Chi SuHyuk , Mok Young Eun , Kang June , Gim Jeong-An , Lee Moon-Soo 
Published: October 2023

Abstract
Objectives
This study aimed to utilize graph theory to explore the functional brain networks in individuals with tic disorders and investigate resting-state functional connectivity changes in critical brain regions associated with tic disorders.
Methods
Participants included individuals with tic disorders and age-matched healthy controls aged 6 to 18 years, all from Korea University Guro Hospital. We ensured a medication-naïve cohort by excluding participants exposed to psychotropic medications for at least three weeks before the study. Data included structural and resting-state functional MRI scans, analyzed with the CONN-fMRI Functional Connectivity toolbox v20b. The analysis included 22 patients (18 males, 4 females) and 26 controls (14 males, 12 females).
Results
Significantly increased global efficiency was observed in the left inferior frontal gyrus pars opercularis in tic disorder patients compared to controls. Additionally, this region displayed enhanced resting-state functional connectivity with its right counterpart in patients versus controls. The inferior frontal gyrus pars opercularis, known for its inhibitory role, may reflect adaptive functional adjustments in response to tic symptoms.
Conclusion
Increased hubness of the inferior frontal gyrus pars opercularis possibly represents functional adjustments in response to tic symptoms. The identified brain region with increased efficiency and connectivity presents a promising avenue for further research into tic expression and control mechanisms.
Computing the minimal perimeter polygon for sets of rectangular tiles based on visibility cones
Authors: Wiederhold Petra 
Published: October 2023

Abstract

In the context of digital image modelling and convexity analysis of digital objects, the minimum perimeter polygon (MPP) was defined in the 1970s in several articles by Sklansky, Chazin, Hansen, and Kibler, where sets of pixels were identified with plane mosaics or polygonal tilings, and, the Sklansky-Chazin-Hansen algorithm (1972) and the Sklansky-Kibler algorithm (1976) were proposed for determining the MPP vertices. Both algorithms rely on constructing and iteratively restricting visibility cones, the MPP vertices result as special vertices of the tiles. This paper reviews both classical algorithms for regular complexes which are special sets of rectangular tiles, and an adaptation to square tiles recommended in widely used modern digital image analysis text books (2018, 2020), to construct approximations of simple digital 4-contours. We show that these three algorithms are erroneous, specially, that the Sklansky-Chazin-Hansen algorithm has numerous types of errors, and that their mathematical foundation contains incorrect details. After analysing and correcting these errors, a new version of MPP algorithm for certain sets of rectangular tiles is presented, its correctness is proved, and the classical algorithms are corrected.