bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice, confidence and continuity of breast self-examination among women in Thailand during COVID-19 pandemic: a cross-sectional study
Authors: Taneepanichskul Surasak , Chuemchit Montakarn , Wongsasuluk Pokkate , Sirichokchatchawan Wandee , Hounnaklang Nuchanad , Zongram Onuma , Sematong Saowanee , Viwattanakulvanid Pramon , Herman Bumi 
Published: August 2023

ObjectiveBreast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic.Design and settingWe conducted a cross-sectional study in Thailand’s north and northeast region from March 2020 to November 2022.ParticipantsThis study involved 405 women aged 30–70 years old.Variables and outcomesDemographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors.Results75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21–40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p<0.05).ConclusionDespite having a higher percentage than other studies in different countries prior to the pandemic, it is still crucial to improve knowledge of BSE to encourage BSE practice, confidence and continuity of BSE in Thai women. Moreover, the BSE campaign should target women with prolonged exposure to oestrogen and sedentary lifestyle.
Patient-reported, health economic and psychosocial outcomes in patients with Friedreich ataxia (PROFA): protocol of an observational study using momentary data assessments via mobile health app
Authors: Buchholz Maresa , Weber Niklas , Borel Stephanie , Sayah Sabrina , Durr Alexandra , Xie Feng , Schulz Jörg B , Reetz Kathrin , Boesch Sylvia , Klopstock Thomas , Karin Ivan , Schöls Ludger , Grobe-Einsler Marcus , Klockgether Thomas , Davies Elin Haf , Schmeder Madeleine , Nadke Andreas , Michalowsky Bernhard 
Published: August 2023

IntroductionFriedreich ataxia (FA) is the most common hereditary ataxia in Europe, characterised by progressively worsening movement and speech impairments with a typical onset before the age of 25 years. The symptoms affect the patients’ health-related quality of life (HRQoL) and psychosocial health. FA leads to an increasing need for care, associated with an economic burden. Little is known about the impact of FA on daily lives and HRQoL. To fill that gap, we will assess patient-reported, psychosocial and economic outcomes using momentary data assessment via a mobile health application (app).Methods and analysisThe PROFA Study is a prospective observational study. Patients with FA (n=200) will be recruited at six European study centres (Germany, France and Austria). We will interview patients at baseline in the study centre and subsequently assess the patients’ health at home via mobile health app. Patients will self-report ataxia severity, HRQoL, speech and hearing disabilities, coping strategies and well-being, health services usage, adverse health events and productivity losses due to informal care on a daily to monthly basis on the app for 6 months. Our study aims to (1) validate measurements of HRQoL and psychosocial health, (2) assess the usability of the mobile health app, and (3) use descriptive and multivariate statistics to analyse patient-reported and economic outcomes and the interaction effects between these outcomes. Insights into the app’s usability could be used for future studies using momentary data assessments to measure outcomes of patients with FA.Ethics and disseminationEthical approval has been obtained from the Ethics Committee of the University Medicine of Greifswald, (BB096/22a, 26 October 2022) and from all local ethics committees of the participating study sites. Findings of the study will be published in peer-reviewed journals, presented at relevant international/national congresses and disseminated to German and French Patient Advocacy Organizations.Trial registration numberClinicalTrials.gov Registry (NCT05943002); Pre-results.
Clinical features and response at head-up tilt test of patients with situational syncope
Authors: Russo Vincenzo , Parente Erika , Comune Angelo , Laezza Nunzia , Rago Anna , Nigro Gerardo , Brignole Michele 
Published: August 2023

ObjectiveThe study compared clinical characteristics and response at head-up tilt test (HUTT) between situational (SS) and vasovagal syncope (VVS).MethodsConsecutive patients who underwent nitroglycerin-potentiated HUTT were retrospectively dichotomised into two groups: those with a history of SS and those with a history of VVS. The patients with SS were further subdivided into patients with SS alone and with SS and at least one episode of VVS.Results1285 patients were enrolled: 246 (19.1%) had SS (SS alone in 121 and SS+VVS in 125). Patients with SS were older (48.8±20.0 vs 44.4±19.1, p=0.007) and more frequently male (57.3% vs 47.7%, p=0.001). At multivariable analysis, smoking habit (OR 2.28; p<0.0001), history of traumatic syncope (OR 2.29; p=0.0001) and ACE inhibitors/angiotensin II receptor blockers (OR 4.74; p<0.0001) were independently associated with SS. HUTT was positive in 175 (71.1%) patients with SS and in 737 (70.9%) patients with VVS (p=0.9). Patients with SS showed more mixed (42.3% vs 32.0%, p=0.002) and vasodepressor forms (10.6% vs 6.1%, p=0.01) and less cardioinhibitory responses compared with others (18.3% vs 32.8%, p<0.0001).ConclusionsCompared with VVS, patients with SS have different clinical characteristics and a higher prevalence of hypotensive drugs leading to hypotensive susceptibility. The positivity rate of HUTT is high and similar to that of VVS, although patients with SS show a higher prevalence of hypotensive responses.
Impact of recurrent ischaemic and bleeding events on quality of life in patients with acute coronary syndrome: Insights from the FORCE-ACS registry
Authors: van der Sangen Niels M R , Azzahhafi Jaouad , Chan Pin Yin Dean R P P , Rayhi Senna , van Weede Victoria M , Walhout Ronald J , Tjon Joe Gin Melvyn , Pisters Ron , Nicastia Deborah M , Langerveld Jorina , Vlachojannis Georgios J , van Bommel Rutger J , Appelman Yolande , Henriques José P S , ten Berg Jurriën M , Kikkert Wouter J 
Published: August 2023

ObjectivePatients with acute coronary syndrome (ACS) remain at high risk for recurrent ischaemic and bleeding events during follow-up. Our study aimed to quantify and compare the impact of these adverse events on quality of life (QoL).MethodsData from patients with ACS prospectively enrolled in the FORCE-ACS registry between January 2015 and December 2019 were used for this study. The primary ischaemic and bleeding events of interest were hospital readmission for ACS and Bleeding Academic Research Consortium type 2 or 3 bleeding during 12 months follow-up. QoL was measured using the EQ-5D Visual Analogue Scale (VAS) score and the 12-item Short Form Survey version 2 derived Physical Component Summary (PCS) and Mental Health Component Summary (MCS) scores at 12 months follow-up.ResultsIn total, 3339 patients (mean age 66.8 years, 27.9% women) were included. During follow-up, ischaemic events occurred in 202 patients (6.0%) and bleeding events in 565 patients (16.9%). After adjustment for demographic and clinical characteristics, ischaemic events remained independently associated with lower QoL regardless of metric used. Bleeding was also independently associated with lower EQ-5D VAS and PCS scores, but not with a lower MCS score. The QoL decrement associated with ischaemic events was numerically larger than the decrement associated with bleeding.ConclusionsIschaemic and bleeding events remain prevalent and are independently associated with lower QoL at 12 months follow-up in patients previously admitted for ACS. The incidence and impact of these adverse events should be considered when balancing individual ischaemic and bleeding risks.
Advanced breast, cervical and prostate cancer- Patient needs: systematic review
Authors: Pabón-Salazar Yusley Katerine , Vela-Prieto César José , Mera-Urbano Gladys Amanda , García-Perdomo Herney Andrés , Polanco-Pasaje Jhon Edwin 
Published: August 2023

BackgroundThere are high rates registered globally of breast cancer, cervical and prostate. People going through have needs that cause an impact in their life’s quality, especially in the final stages of the illness.GoalTo characterise the most evaluated and afflicted physical, emotional, roll, cognitive, social and spiritual needs of patients in the final stages of breast, cervical and prostate cancer.Interventions/MethodsA thorough systematic search of databases such as Medline (Ovid) and Embase, from databases’ creation throughout 31 December 2021. Quantitative studies were included to evaluate, from the adoption of tools, the dimensions or needs of people going under three types of cancer on final stages.ResultsTwelve studies were included. More common symptoms such as nausea/vomiting and pain were the most evaluated with 83%. Fifty-eight per cent of papers studied the emotional function of people with breast and prostate cancer. Other 42% included roll, cognitive and social appreciations. Sexual, cognitive and physical, in that line, were the most affected. The most common questionnaires used to measure oncological patients on final stages were those from European Organisation for Research and Treatment of Cancer on its C-30, BR-23, C-15 PAL and CR-25 versions.ConclusionsOn breast and prostate cancer, the most affected aspect was the sexual dysfunction, while for cervical cancer, the physical function was the most altered one. Spiritual dimension was not included in any of the evaluated literature.
Efficient multiparty quantum secret sharing based on a novel structure and single qubits
Authors: Kuo Shu-Yu , Tseng Kuo-Chun , Yang Chia-Ching , Chou Yao-Hsin 
Published: August 2023

AbstractQuantum secret sharing (QSS) is a significant branch of quantum cryptography and can be widely used in various applications. Quantum secret sharing schemes can be developed by utilizing different features of quantum mechanics, and quantum secure direct communication (QSDC) is an effective way to achieve secret sharing using single qubits. The utilization of QSDC offers certain benefits, such as low cost, high security, and great potential for implementation with current technologies. However, the purpose of QSDC is different from that of QSS, which causes some vulnerabilities, such as dishonest participant attacks. We discover two critical factors that affect the security of traditional protocols. Firstly, they skip a few steps from the QSDC protocol to the QSS protocol. Secondly, the participants have different privileges. This can lead to participants with more privileges engaging in potential attack behavior. In light of these issues, this study proposes a new multiparty QSS scheme to address these vulnerabilities. The proposed protocol ensures the independence of each participant and grants them equal privileges. Analysis results demonstrate that it can defend against malicious attackers, retain the advantages of the QSDC protocol, and further reduce transmission costs. It achieves an excellent balance between security and performance.
Sparse Approximate Multifrontal Factorization with Composite Compression Methods
Authors: Claus Lisa , Ghysels Pieter , Liu Yang , Nhan Thái Anh , Thirumalaisamy Ramakrishnan , Bhalla Amneet Pal Singh , Li Sherry 
Published: August 2023

This article presents a fast and approximate multifrontal solver for large sparse linear systems. In a recent work by Liu et al., we showed the efficiency of a multifrontal solver leveraging the butterfly algorithm and its hierarchical matrix extension, HODBF (hierarchical off-diagonal butterfly) compression to compress large frontal matrices. The resulting multifrontal solver can attain quasi-linear computation and memory complexity when applied to sparse linear systems arising from spatial discretization of high-frequency wave equations. To further reduce the overall number of operations and especially the factorization memory usage to scale to larger problem sizes, in this article we develop a composite multifrontal solver that employs the HODBF format for large-sized fronts, a reduced-memory version of the nonhierarchical block low-rank format for medium-sized fronts, and a lossy compression format for small-sized fronts. This allows us to solve sparse linear systems of dimension up to 2.7 × larger than before and leads to a memory consumption that is reduced by 70% while ensuring the same execution time. The code is made publicly available in GitHub.
QuanDA: GPU Accelerated Quantitative Deep Neural Network Analysis
Authors: Naseer Mahum , Hasan Osman , Shafique Muhammad 
Published: August 2023

Over the past years, numerous studies demonstrated the vulnerability of deep neural networks (DNNs) to make correct classifications in the presence of small noise. This motivated the formal analysis of DNNs to ensure that they delineate acceptable behavior. However, in the case that the DNN’s behavior is unacceptable for the desired application, these
qualitative
approaches are ill equipped to determine the precise degree to which the DNN behaves unacceptably.

We propose a novel
quantitative
DNN analysis framework, QuanDA, which not only checks whether the DNN delineates certain behavior but also provides the estimated probability of the DNN to delineate this particular behavior. Unlike the (few) available quantitative DNN analysis frameworks, QuanDA does not use any implicit assumptions on the probability distribution of the hidden nodes, which enables the framework to propagate close to real probability distributions of the hidden node values to each proceeding DNN layer. Furthermore, our framework leverages CUDA to parallelize the analysis, enabling high-speed GPU implementation for fast analysis. The applicability of the framework is demonstrated using the ACAS Xu benchmark, to provide reachability probability estimates for all network nodes. This paper also provides potential applications of QuanDA for the analysis of DNN safety properties.
The Aqueous Stem Bark Extract of Alstonia boonei Exhibits Anticataract Activity in Sprague Dawley Rat
Authors: Amanfo Adwoa Frema , Kyei Samuel , Boakye Yaw Duah , Akoto Clement Osei , Addo Justice Kwaku , Yeboah Kofi Oduro , Osafo Newman 
Published: August 2023

In Africa, Alstonia boonei is used folklorically for the management of the multitude of conditions including cataract, which accounts for 50% of cases of blindness in the region. The current study set out to probe the traditional use of the aqueous extract of Alstonia boonei stem bark (ABE) as an anticataract remedy using Sprague Dawley rat models. We investigated the probable phytochemical constituents in the extract, in vitro antioxidant potential, and its in vitro aldose reductase inhibition. For the anticataract investigations, diabetic cataract was induced using galactose in 3-week-old Sprague Dawley rats, and age-related cataract was induced by the administration of sodium selenite to 10-day-old rat pups. Cataract scores in both models were determined after treatment with 30, 100, and 300 mgkg−1 doses of ABE and 10 mlkg−1 of distilled water. Lens glutathione, total lens protein, soluble lens proteins (alpha-A) crystallin, and aquaporin 0 levels in the enucleated lens homogenates were determined. Changes in lens to body weight were also determined with histopathological analysis done on the lenses in the selenite-induced cataract model. The presence of alkaloids, tannins, flavonoids, glycosides, and triterpenoids was identified in the extract. The extract inhibited aldose reductase activity with IC50 of 92.30 μgml−1. The 30, 100, and 300 mgkg−1ABE-treated rats recorded significantly (

p

< 0.05) reduced cataract scores indicating a delay in cataractogenesis in galactose-induced cataract and in selenite-induced cataractogenesis as well. Markers of lens transparency such as AQP0, alpha-A crystallin, and total lens proteins and lens glutathione levels were significantly (

p

< 0.05) preserved. In conclusion, this study establishes the anticataract potential of the aqueous stem bark extract of Alstonia boonei in Sprague Dawley rat models.
Gemcitabine, Docetaxel, Capecitabine, Cisplatin, Irinotecan as First-line Treatment for Metastatic Pancreatic Cancer
Authors: Wilbur H. Catherine , Durham Jennifer N. , Lim Su Jin , Purtell Katrina , Bever Katherine M. , Laheru Daniel A. , De Jesus-Acosta Ana , Azad Nilofer S. , Wilt Bradley , Diaz Luis A. , Le Dung T. , Wang Hao 
Published: August 2023

Purpose:
Treatment of advanced pancreatic cancer with a single therapeutic at a maximal dose has been largely ineffective at increasing survival. Combination therapies are commonly studied but often limited by toxicity. We previously showed that low-dose multiagent therapy with gemcitabine, docetaxel (taxotere), capecitabine (xeloda), and cisplatin (GTX-C) was safe, well tolerated, and effective (NCT01459614). Here, we hypothesize that adding irinotecan to GTX-C may improve survival with minimal toxicity.

Experimental Design:
Patients with treatment-naïve metastatic pancreatic adenocarcinoma were treated with gemcitabine, docetaxel (taxotere), capecitabine (xeloda), cisplatin, and irinotecan (GTX-CI). Treatment consisted of capecitabine 500 mg twice daily on days 1–14 and gemcitabine 300 to 500 mg/m2, docetaxel 20 mg/m2, cisplatin 15 to 20 mg/m2, and irinotecan 20 to 60 mg/m2 on days 4 and 11 of a 21-day cycle. The primary objective was 9-month overall survival (OS). Secondary objectives included response rate (RR), disease control rate (DCR), progression-free survival (PFS), and OS.

Results:
The regimen was well tolerated. The recommended phase II dose was gemcitabine 500 mg/m2, docetaxel 20 mg/m2, capecitabine 500 mg po bid, cisplatin 20 mg/m2, and irinotecan 20 mg/m2. Median follow-up in phase II was 11.02 months (2.37–45.17). Nine-month OS rate was 57% [95% confidence interval (CI): (41–77)]. RR was 57% [95% CI: (37–75) 50% PR and 7% CR]. DCR was 87% [95% CI: (69–96)]. Median OS and PFS were 11.02 [95% CI: (8.54–21.09)] and 8.34 [95% CI: (6.34–NA)] months, respectively.

Conclusions:
The addition of irinotecan to GTX-C was safe and well tolerated. While the study did not meet its primary objective, the responses were clinically meaningful using a well-tolerated regimen.

Significance:
We aimed to optimize the previously reported efficacious regimen of low-dose multiagent therapy with GTX-C for the treatment of metastatic pancreatic ductal adenocarcinoma by adding irinotecan. The primary objective was not met, but GTX-CI was well tolerated. The RR of 57%, median PFS of 8.3 months, median OS of 11 months, and 36-month OS rate of 19% suggest clinical benefit. Further optimization of this regimen is warranted.
Children’s Human Right to Be Heard at the Ocean-climate Nexus
Authors: Shields Sophie , Longo Andrea , Strand Mia , Morgera Elisa 
Published: August 2023

Abstract
This article aims to clarify the obligations of States under the law of the sea to put children’s human rights at the heart of decision-making on the protection of the marine environment, particularly at the ocean-climate nexus. The relevance of the provisions of the United Nations Convention on the Rights of the Child and in particular, children’s human right to be heard in the context of existing provisions on deep-sea mining activities under the International Seabed Authority and the Agreement on the Conservation and Sustainable Use of Marine Biological Diversity of Areas Beyond National Jurisdiction are discussed. Reflections on more ambitious approaches to integrating intergenerational dialogue within international ocean fora, as ways to implement intergenerational equity and protect humankind at the ocean-climate nexus, on the basis of good practices in the area of children’s human rights are offered.
Ghana Beyond Aid: A Bargaining Chip for Draconian Economic Policies in Ghana
Authors: Ntim Emmanuel O. , Botchway Thomas P. 
Published: August 2023

Abstract
This article evaluates the austere economic policies implemented by the Akufo- Addo-Administration using the Ghana Beyond Aid vision as a guarantee. For a state that virtually depends on the benevolence of the external world for its economic growth and national development, the enactment of policies to wean its political economy from the generosity of industrialized nations and multinational institutions is not only politically expedient, but also socially gratifying. Nonetheless, instead of the government to concentrate on formulating pragmatic policies that form the niches of the Ghana Beyond Aid agenda with public support, it has rather taken a uniquely detested trajectory of dedicating little attention to the vision in pursuit of policies that have lost touch with the public, but which the vision is occasionally cited as the bargaining chip. This article examines these political nuances using the case study strategy. The paper argues that while it is prudent to implement policies towards the attainment of the Ghana Beyond Aid vision, the political leadership should be guided by public opinion and consensus building to reduce the degree of adversities posed by these policies. The study also makes a case for policy initiatives and strategies to make the beyond aid agenda feasible.
Vocative strategies and accent in Armenian: synchrony and diachrony
Authors: Martirosyan Hrach 
Published: August 2023

Abstract
The vocative, the case of direct address, is a form used for calling out and attracting or maintaining the addressee’s attention. It is not represented in Classical Armenian as an independent case category (§ 1b). At different stages of Armenian the vocative is often characterized by initial accentuation, which is comparable to other Indo-European traditions (§ 2). Accented vocative particles are used both in Classical Armenian and dialects (§ 3). Mostly in dialects, several words, particularly kinship terms and anthroponyms, take endings, one or a few of which may be regarded as relics of older vocative case endings (§ 4). In the Armenian dialects of Syria, one finds a few kinship terms the vocatives of which are compounds with ayr ‘man’ or tikin ‘mistress, lady’ (§ 5)