bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate change and human health in Alpine environments: an interdisciplinary impact chain approach understanding today's risks to address tomorrow's challenges
Authors: Roveri Giulia , Crespi Alice , Eisendle Frederik , Rauch Simon , Corradini Philipp , Steger Stefan , Zebisch Marc , Strapazzon Giacomo 
Published: October 2024

The European Alps, home to a blend of permanent residents and millions of annual tourists, are found to be particularly sensitive to climate change. This article employs the impact chain concept to explore the interplay between climate change and health in Alpine areas, offering an interdisciplinary assessment of current and future health consequences and potential adaptation strategies.Rising temperatures, shifting precipitation patterns and increasing extreme weather events have profound implications for the Alpine regions. Temperatures have risen significantly over the past century, with projections indicating further increases and more frequent heatwaves. These trends increase the risk of heat-related health issues especially for vulnerable groups, including the elderly, frail individuals, children and recreationists. Furthermore, changing precipitation patterns, glacier retreat and permafrost melting adversely impact slope stability increasing the risk of gravity-driven natural hazards like landslides, avalanches and rockfalls. This poses direct threats, elevates the risk of multi-casualty incidents and strains search and rescue teams.The environmental changes also impact Alpine flora and fauna, altering the distribution and transmission of vector-borne diseases. Such events directly impact healthcare administration and management programmes, which are already challenged by surges in tourism and ensuring access to care.In conclusion, Alpine regions must proactively address these climate change-related health risks through an interdisciplinary approach, considering both preventive and responsive adaptation strategies, which we describe in this article.
Challenges and opportunities for strengthening palliative care services in primary healthcare facilities: perspectives of health facilities in-charges in Dar es Salaam, Tanzania
Authors: Sirili Nathanael , Yoram Furahini , Mkusa Veronica , Malichewe Christina V , Kiwango George , Lyamai Juda Thadeus John , Nyongole Obadia Venance 
Published: October 2024

BackgroundWith the rise of non-communicable diseases in Tanzania, palliative care (PC) is increasingly needed to improve the quality of life for these patients through pain and symptom management and providing psychological care, social and spiritual support. Despite a larger portion of the population having access to healthcare services at primary healthcare (PHC) facilities in Tanzania, PC services are limited and less organised at this level. This study explored the challenges facing the provision of PC and the opportunities for strengthening PC services at PHC facilities in Tanzania.MethodsWe adopted an exploratory qualitative case study to conduct in-depth interviews with 15 health facilities in charge from 15 purposefully selected PHC facilities in Dar es Salaam City, Tanzania, in August 2023. We analysed the gathered information using qualitative content analysis.ResultsTwo categories emerged from the analysis of the gathered information. These are (1) challenges facing the provision of PC services at PHC facilities and (2) opportunities for strengthening PC services at PHC facilities. The challenges are grouped as provider-level, facility-level and patient-level challenges. The opportunities are organised into three subcategories. These are the increasing demand for PC services, the availability of multiple supporting systems and a functional referral system.ConclusionThis study underscores the challenges and opportunities for providing PC services at PHC facilities. These findings call for a collaborative effort from health system players to strengthen the available PC services. The efforts should include expanding the coverage of PC services at the PHC facilities and healthcare providers’ training. Expansion of PC services should include introducing them in places where they are unavailable and improving them where they are not available. PC training should consider preservice training in the health training institutions’ curricula and continued medical education to the existing staff. Furthermore, we recommend community health education to raise awareness of PC services.
Comparison of the efficacy and safety of low-dose antihypertensive combinations in patients with hypertension: protocol for a systematic review and network meta-analysis
Authors: Zhao Xiexiong , Liu Tao , He Yu-Nan , Fang Weilun , Li Xiaogang , Jiang Weihong 
Published: October 2024

IntroductionHypertension, a prevalent cardiovascular disease globally, poses significant health risks and economic burden. Evolving treatment targets necessitate more intensive strategies, such as low-dose triple or quadruple drug combinations. However, a systematic comparison of different low-dose antihypertensive combinations is still lacking. The aim of the present study is to systematically and comprehensively evaluate the blood pressure-lowering effect and the associated safety of diverse low-dose polypharmacy combinations in patients with hypertension.Methods and analysisIn this systematic review and network meta-analysis, randomised controlled trials comparing diverse low-dose polypharmacy combinations with placebo or active treatments in patients with hypertension will be eligible for inclusion. The primary outcomes are a reduction in systolic/diastolic blood pressure, the rate of target blood pressure, adverse effects, serious adverse effects and all-cause dropout after treatment. PubMed, Web of Science, Embase, Cochrane Library, Chinese Science Citation Database, Wanfang Medical Network, VIP Database and clinical trial registries will be systematically searched for relevant studies published from inception date to 18 January 2024. No language restrictions will be applied during the search process. Two independent reviewers will identify eligible trials and extract the data. Traditional pairwise meta-analysis will be conducted to analyse direct comparisons. A frequentist approach will be used to analyse the primary outcome for network comparisons, and cumulative rank probabilities will present the treatment hierarchy of all endpoints. Sensitivity analysis will be conducted using a Bayesian framework under a random-effects model. Subgroup analyses will be conducted according to sample size, quality of study and sponsorship, if the data allow. The Cochrane Risk of Bias Tool 2.0 will be used to assess the quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation system will be used to assess the strength of evidence.Ethics and disseminationSince this study relies solely on published literature, no ethics approval is necessary. The results will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42024503239.
Association between sleep quality and uncertainty stress among healthcare professionals in hospitals in China: a nationwide cross-sectional survey
Authors: Pan Jianjiang , Cai Xixuan , Chen Liying , Wu Lihong , Xia Jingjing , Lu Jingjing 
Published: October 2024

ObjectivesSleep quality is a critical concern among healthcare professionals, yet the role of uncertainty stress has been inadequately explored. This study aims to explore the associations between sleep quality and uncertainty stress among healthcare professionals working in Chinese hospitals.DesignCross-sectional survey.SettingData were collected via a cross-sectional survey administered to healthcare professionals across three Chinese provinces from 29 September 2022 to 18 January 2023.ParticipantsA total of 1902 participants contributed valid responses for analysis.Primary outcome measureSleep quality.ResultsOut of 1902 respondents, 26.4% reported uncertainty stress and 50.5% experienced insomnia. Binary logistic regression analysis revealed that higher uncertainty stress significantly predicted poor sleep quality (OR=3.89; 95% CI 3.06, 4.95; p<0.001) while controlling for sociodemographic characteristics. Furthermore, linear regression analysis confirmed the similar relationship between uncertainty stress and sleep quality (β=3.10; 95% CI 2.67, 3.52; p<0.001).ConclusionsThe study highlights a significant association between uncertainty stress and impaired sleep quality among Chinese healthcare professionals. These findings suggest the necessity for targeted strategies to mitigate uncertainty stress, which may potentially promote better sleep and overall well-being in healthcare settings.
Innovative management strategies for addressing paediatric medical staff shortages in underdeveloped cities in developing countries
Authors: Yan Xingxue , Yu Jinshi , Zhang Peng , Zhang Jinrui , Luo Shuying , Yu Yingying 
Published: October 2024

BackgroundPaediatric professional scarcity and uneven distribution is acute in underdeveloped regions, exacerbated by COVID-19’s workload surge and burnout, highlighting the need for strengthened prevention and response measures.AimPropose an effective talent management model to address the challenge of paediatric medical personnel shortage and lack of management experience in Underdeveloped cities of developing countries.MethodsA crisis management plan has been implemented in a paediatric hospital in Henan, China, with a talent framework to ensure a skilled, stable workforce.ResultsAn advanced talent management system is vital to address paediatric talent scarcity. Leveraging the national Children’s Regional Medical Center, fostering international cooperation, sharing knowledge and harnessing regional policies are key to effective paediatric talent management through leveraging, promotion, and driving initiatives.ConclusionsEfficient talent management methods have a significant positive impact on addressing the paediatric talent crisis, enabling departments and institutions to effectively manage medical talent through scientific strategies, ultimately contributing to the alleviation of medical resource deficiencies.
D-Brane effective Lagrangian in spacetimes with boundaries
Authors: Baradaran-Hosseini Ali , Garousi Mohammad R. 
Published: October 2024

AbstractIn this study, we explore the transformation of $$D_p$$

D
p

-branes to $$D_{p-1}$$

D

p
-
1

-branes under T-duality when the D-brane is embedded in a spacetime with a boundary. Our goal is to derive the higher-derivative corrections to the Dirac–Born–Infeld (DBI) Lagrangian for both the bulk and boundary terms. For the bulk terms, we calculate the $$\alpha '$$

α
′

corrections for the massless open string fields, up to the 8th order in the dimensionless Maxwell field strength. We demonstrate that the bulk Lagrangian can satisfy the T-duality constraint without residual total derivative terms in the base space. This determines the most general independent couplings of the massless open string fields in the bulk Lagrangian, encompassing 145 coupling constants, up to three parameters. Two of these parameters are physical and are determined by disk-level S-matrix elements, while the third is unphysical and can be eliminated by field redefinitions and integration by parts. The final result for the bulk Lagrangian consists of 49 couplings. For the boundary terms, the application of T-duality symmetry to massless open and closed string fields enables us to extend the DBI Lagrangian to include the boundary unit normal vector field $$n_\mu $$

n
μ

and its first derivative.
Topportunities at the LHC: rare top decays with light singlets
Authors: Bahl Henning , Koren Seth , Wang Lian-Tao 
Published: October 2024

AbstractThe discovery of the top quark, the most massive elementary particle yet known, has given us a distinct window into investigating the physics of the Standard Model and beyond. With a plethora of top quarks to be produced in the high luminosity era of the LHC, the exploration of its rare decays holds great promise in revealing potential new physics phenomena. We consider higher-dimensional operators contributing to flavour-changing-neutral-current top decays in the SMEFT and its extension by a light singlet species of spin 0, 1/2, or 1, and exhibit that the HL-LHC (and other future colliders) may observe many exotic top decays in a variety of channels. Light singlets which primarily talk to the SM through such a top interaction may also lead to distinctive long-lived particle signals. Searching for such long-lived particles in top-quark decays has the additional advantage that the SM decay of the other top quark in the same event provides a natural trigger.
Phase space properties of cosmological models in f(Q, T) gravity
Authors: Rathore Shivangi , Singh S. Surendra , Muhammad Shah , Zotos Euaggelos E. 
Published: October 2024

AbstractThe Weyl type f(Q, T) gravity is the modification of f(Q) gravity and f(Q, T) theories, where non-metricity is denoted by Q and T is the trace of the energy–momentum tensor. Together with a geometric explanation for dark energy, the theory can provide an exact interpretation of the transformation of the late-time Universe and the observable data. In this study, we present an accelerated cosmic model of the Universe in f(Q, T) gravity. We consider the model of f(Q, T) gravity as, $$f(Q,T) = -Q+\phi (Q,T)$$

f
(
Q
,
T
)
=
-
Q
+
ϕ
(
Q
,
T
)

. We examine the energy condition for the model of f(Q, T) gravity and find out that our model satisfies the null and strong energy conditions at the same time, it violates the weak and dominant energy conditions. After that, we perform the phase-space study of our cosmological model with and without interaction independently. In case of the absence of interaction, we get six critical points out of which three critical points are stable critical points while the rest three critical points are saddle. When we perform the stability analysis in the presence of interaction, we get three critical points out of which one critical point is stable while the rest two are saddle points. The phase-plot analysis also shows the cosmological models in f(Q, T) gravity.
Non-linear matter power spectrum modeling in interacting dark energy cosmologies
Authors: Silva Emanuelly , Zúñiga-Bolaño Ubaldo , Nunes Rafael C. , Di Valentino Eleonora 
Published: October 2024

AbstractUnderstanding the behavior of the matter power spectrum on non-linear scales beyond the $$\Lambda $$
Λ
CDM model is crucial for accurately predicting the large-scale structure (LSS) of the Universe in non-standard cosmologies. In this work, we present an analysis of the non-linear matter power spectrum within the framework of interacting dark energy-dark matter cosmologies (IDE). We employ N-body simulations and theoretical models to investigate the impact of IDE on these non-linear scales. Beginning with N-body simulations characterized by a fixed parameter space delineated by prior observational research, we adeptly fit the simulated spectra with a simple parametric function, achieving accuracy within 5%. Subsequently, we refine a modified halo model tailored to the IDE cosmology, exhibiting exceptional precision in fitting the simulations down to scales of approximately 1 h/Mpc. To assess the model’s robustness, we conduct a forecast analysis for the Euclid survey, employing our refined model. We find that the coupling parameter $$\xi $$
ξ
will be constrained to $$\sigma (\xi ) = 0.0110$$

σ
(
ξ
)
=
0.0110

. This marks a significant improvement by an order of magnitude compared to any other current observational tests documented in the literature. These primary findings pave the way for a novel preliminary approach, enabling the utilization of IDE models for observational constraints concerning LSS data on non-linear scales.
Precariousness Represents an Independent Risk Factor for Depression in Children With Sickle Cell Disease
Authors: Elenga Narcisse , Lony Janaine , Mafemamissindu Joddy , Thomas Boizan Noelis , Osei Lindsay , Nacher Mathieu 
Published: October 2024

Importance: While the prevalence and impact of depression have been widely described in sickle cell disease, its relationship with precariousness has never been studied.Objective: This study aimed to describe the prevalence of depression and its relationship with clinical and demographic factors including social precariousness in children with sickle cell disease in French Guiana.Methods: We included children aged 12–18 years with sickle cell disease from the Sickle Cell Reference Center in French Guiana. A simple depression questionnaire “Child depression inventory 2” was proposed and completed by a clinical examination and consultation by a psychologist. Using the known assessment of health inequalities and poverty in health screening centres (EPICES) score, we developed a composite precariousness score that uses five items (each item is scored from 0 to 2). According to the chosen items, precariousness was defined as a score ≥5.Results: The prevalence of depression was 42.5% [95% CI: 31.5–54]. The median age was 15 years [95% CI: 13–17]. The age distribution peaked at 14 years in patients with depression. There were 76% of precarious patients in the depressed group and 18% in the control group (p  < 0.0001). In multivariate analysis, genotype SC (OR = 7.66, [1.17; 50.13], p = 0.0338) and precariousness (OR = 15.68, [4.73; 51.94], p  < 0.0001) were associated with higher rates of depression. Baseline hemoglobin levels (OR = 0.48, [0.27; 0.88], p = 0.0173) were also associated with lower rates of depression.Conclusions and Relevance: Despite free healthcare, precariousness is an independent risk factor for depression.
The Association Between Geriatric Nutritional Risk Index and Readmission Within Six Months in Elderly Heart Failure Patients: A Retrospective Cohort Study
Authors: Dong Guoxia , Li Zhihua 
Published: October 2024

Background: The geriatric nutritional risk index (GNRI) is a valuable tool that may predict the prognosis of elderly patients with heart failure (HF). Malnutrition and low GNRI scores have been associated with a higher risk of hospitalization and mortality. This study aimed to investigate the association between GNRI and 6‐month readmission for HF in elderly Chinese patients.Materials and Methods: The study utilized data from hospitalized HF patients by combining electronic medical records from the PhysioNet restricted health data database with external outcome data. In our study, we used the GNRI as the independent variable and assessed its association with the risk of readmission within 6 months. The main analytical methods were multivariable Cox regression, stratified analysis with interaction, threshold effect analysis, and Kaplan–Meier survival curves.Results: This study involved 767 elderly HF patients, 61.3% of whom had malnutrition. In the threshold analysis, HF patients’ 6‐month readmission risk was significantly reduced with increasing GNRI, with a hazard ratio (HR) and 95% confidence interval (CI) of 0.99 (0.97.1). Malnutrition group was associated with a higher risk of readmission within 6 months for HF patients in analyses that were controlled for confounding factors, with HRs and their 95% CI of 1.17 (0.99, 1.38), 1.18 (1, 1.4), and 1.44 (1.08,1.93), respectively. Subgroup analysis showed that GNRI levels had a consistent impact on outcome events, unaffected by covariates.Conclusions: GNRI was negatively correlated with the outcome event of readmission within 6 months in elderly HF patients. Malnutrition group showed a higher risk of readmission within 6 months.
A Comparative Study of Demographic and Clinical Criteria Between Male and Female Patients With Pemphigus Referred to a Referral Hospital in Iran
Authors: Aryanian Zeinab , Balighi Kamran , Esmaeli Nafiseh , Daneshpazhooh Maryam , Mazloomi Tootoonchi Nasim , Razavi Zahra , Beigmohammadi Fereshteh , Gul Umamah , Khayyat Azadeh , Hatami Parvaneh 
Published: October 2024

Background: Pemphigus is a rare autoimmune disease characterized by the formation of blisters on the skin and mucous membranes, caused by autoantibodies against desmoglein, a key protein in cell adhesion. This study aims to compare demographic and clinical criteria between male and female patients with pemphigus referred to a referral hospital, utilizing data from the pemphigus diseases registry.Method: This retrospective cross‐sectional analysis focused on several key aspects age at disease onset, severity (measured by the Pemphigus Disease Area Index [PDAI]), types of pemphigus, duration of disease, and diagnostic criteria including the presence of antidesmoglein antibodies and findings from direct immunofluorescence (DIF). By examining these variables among a cohort selected based on their diagnosis of pemphigus, the study aimed to identify significant gender differences in disease manifestation, diagnosis, and progression. This approach is crucial for tailoring more effective gender‐specific management and treatment strategies for this rare autoimmune condition.Results: In a comprehensive analysis of 1218 pemphigus patients in the year 2021 from the hospital’s registry, comprising 543 males (44.6%) and 675 females (55.4%), significant gender differences were identified in 9 out of 44 variables examined. The study revealed that males had a higher age at disease onset, more frequent clinical manifestations in the head, neck, and trunk areas, and greater severity of disease as measured by the PDAI score compared to females. Conversely, females exhibited higher instances of mucosal manifestations and a higher PDAI score for mucosal erosion blister of the lower gingiva. No significant gender differences were found in 21 variables, including the overall age of patients, specific clinical manifestations across various mucous membranes, types of pemphigus, and PDAI scores for mucosal erosions in particular locations, indicating a nuanced gender impact on the presentation and severity of pemphigus that necessitates tailored clinical approaches.Conclusion: The study highlights significant gender differences in the presentation and severity of pemphigus, underscoring the importance of gender‐specific approaches in the diagnosis and management of this condition. The findings contribute valuable insights into the complex nature of pemphigus and underline the necessity for further research to understand the underlying mechanisms driving these differences.