bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-interacting scalar field in (2+1) dimensions Einstein gravity with torsion
Authors: Kaya R. , Özçelik H. T. 
Published: May 2024

AbstractWe study a massless real self-interacting scalar field $$\varphi $$
φ
non-minimally coupled to Einstein gravity with torsion in (2+1) space-time dimensions in the presence of a cosmological constant. The field equations with a self-interaction potential $$V(\varphi )$$

V
(
φ
)

including $$\varphi ^{n}$$

φ
n

terms are derived by a variational principle. By numerically solving these field equations with the 4th Runge–Kutta method, the circularly symmetric rotating solutions for (2+1) dimensions Einstein gravity with torsion are obtained. Exact analytical solutions to the field equations are derived for the proposed metric in the absence of both torsion and angular momentum. We find that the self-interacting potential only exists for $$n=6$$

n
=
6

, as requested by conformal symmetry. We also study the motion of massive and massless particles in (2+1) Einstein gravity with torsion coupled to a self-interacting scalar field. The effect of torsion on the behavior of the effective potentials of the particles is analyzed numerically.
Establishing Geriatric Opiate Use Patterns in Trauma
Authors: Hammond Emily , Zhan-Moodie Samantha , Sapkalova Viktoriya , Rivera Daniel , Agrawal Rishabh , Thomas Jason , Fox Elizabeth , Lawson Andrew 
Published: May 2024

Introduction: There is evidence that providers often overprescribe opiates in the postoperative period. Despite an ever-growing geriatric population, there is little research detailing current opiate usage in older patients after trauma. This population presents a unique set of challenges for pain management and prescription drug dependence due to sensitivity, a narrow therapeutic window, and high rates of pre-existing polypharmacy. Objective: Assess the use of narcotics in geriatric trauma patients with various injury patterns to establish a reference point for future intervention for reduction in narcotic dependence. Methods: We created a database of trauma patients’ age ≥65 years admitted to a single level 1 trauma center in the Southeastern United States during the 2019 calendar year. Information gathered included patient factors, injury patterns, operative intervention, pain medications prescribed during hospitalization and at discharge, total and average daily morphine milligram equivalents (MME) inpatient and outpatient, and requests/prescriptions for narcotics at follow-up. Results: In 2019, there were 475 patients aged ≥65 admitted to our level 1 trauma center for acute traumatic injuries. 219 of those patients required operative intervention. Average total inpatient MME for this cohort was 169.0 with average daily MME of 22.89. The average total prescribed MME upon discharge was 79.27. There were 29 patients documented to request narcotic prescription refill at time of clinic follow-up, 27 of whom were prescribed a narcotic medication at follow-up. Conclusion: This dataset establishes a reference point for opiate use in geriatric trauma patients to facilitate further research for mitigation of risk in this population.
Association Between Lifetime Interpersonal Violence and Post–COVID-19 Condition Among Women in Kentucky, 2020-2022
Authors: Güler Ayşe , Bush Heather M. , Schill Katie , Kussainov Nurlan , Coker Ann L. 
Published: May 2024

Objective: The COVID-19 pandemic increased the risk of interpersonal violence. We investigated the association between lifetime interpersonal violence experience and risk of post–COVID-19 condition (the persistence of symptoms of COVID-19 and severity of health problems associated with COVID-19 that last a few weeks, months, or years) among women with lifetime interpersonal violence experience. Methods: Women participants aged ≥18 years in Kentucky’s Wellness, Health & You—COVID-19 study completed online quantitative surveys about the impacts of the pandemic, developing COVID-19, and symptoms of post–COVID-19 condition. We conducted cross-sectional analyses estimating rate ratios of developing COVID-19 and symptoms of post–COVID-19 condition during the pandemic (October 13, 2020–February 28, 2022). Results: Of the analytic sample (N = 938), 342 (36.5%) disclosed a history of lifetime interpersonal violence. Compared with women with no lifetime interpersonal violence experience, women with lifetime interpersonal violence experience had significantly more distress because of the pandemic, defined as family financial challenges ( P = .001), symptoms of mental health challenges ( P < .001), and negative coping behaviors ( P < .001). While experiencing lifetime interpersonal violence was not significantly associated with either receiving COVID-19 vaccinations (adjusted rate ratio [aRR] = 1.10; 95% CI, 0.75-1.61) or developing COVID-19 (aRR = 1.15; 95% CI, 0.92-1.44), experiencing lifetime interpersonal violence was associated with an increased rate of developing symptoms of post–COVID-19 condition (aRR = 2.09; 95% CI, 1.19-3.65). Conclusion: Symptoms of post–COVID-19 condition may be linked to lifetime interpersonal violence experience, possibly through stress or violence-associated trauma. Future research is needed to assess the negative effects of the pandemic, prioritizing people with lifetime interpersonal violence experience.
Utility of combining multiple parameters of 123I-IMP SPECT and voxel-based morphometry MRI using a multiparametric scoring system for differentiating dementia with Lewy bodies from Alzheimer's disease
Authors: Matsusue Eiji , Inoue Chie , Shimoda Manabu , Nakamura Tomoya , Matsumoto Shota , Matsumoto Kensuke , Tanino Tomohiko , Nakamura Kazuhiko , Fujii Shinya 
Published: May 2024

Background Brain magnetic resonance imaging voxel-based morphometry (VBM) and perfusion single-photon emission computed tomography (SPECT) are useful for differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). Purpose To determine whether combining multiple parameters of VBM and SPECT using a multiparametric scoring system (MSS) improves diagnostic accuracy in differentiating DLB from AD. Material and Methods In total, 23 patients with DLB and 57 patients with AD underwent imaging using a voxel-based specific regional analysis system for AD (VSRAD), an easy Z-score imaging system, and a Z-Graph using three-dimensional stereotactic surface projection. The cutoff values were determined using the receiver operating characteristic curve to differentiate DLB from AD for all parameters. Patients were scored 1 (DLB) or 0 (AD) for each statistically significant parameter, according to a threshold. The total score was determined for each case to obtain a cutoff value for the MSS. Results The mean Z-scores in the medial temporal lobes using the VSRAD were significantly lower in patients with DLB than in those with AD. Each Z-score of the summed Z-scores in all four segmented regions of the occipital lobes using the Z-Graph was significantly higher in patients with DLB than in those with AD. Among the five parameters, the highest accuracy was 80% for the Z-score of the summed Z-scores in the left medial occipital lobe. For the MSS, a cutoff value of four improved the diagnostic accuracy to 82%. Conclusion MSS was more accurate than any single parameter of VBM or SPECT in differentiating DLB from AD.
Polymer foam fabricated via surfactant foaming method enables high-performance solar interfacial evaporation
Authors: Li Hao , Cao Xulei , Tao Naili , Wang Yaoyao , Dong Weixiong , Meng Guihua , Wu Jianning 
Published: May 2024

Solar interfacial evaporation is considered as a low energy consumption, low cost, and sustainable desalination technology. However, its practical application is still limited by complex preparation processes and low photothermal conversion efficiency. In this work, we report novel polymer foam (Agar/SA/GO-Ag composite foam). It is prepared by simple and convenient surfactant foaming and in-situ reduction methods and consists of graphene oxide (GO) and silver nanoparticles (Ag NPs) (photothermal conversion medium) as well as Agar and sodium alginate (SA) (basic skeleton) for use in solar-powered interfacial evaporation systems. The prepared foam has excellent wettability and achieves 96.7% light absorption in the full spectrum range. A high evaporation rate of 2.55 kg·m−2·h−1 and a high evaporation efficiency of 97.3% were obtained under the conditions of simulated sunlight (1.0 kW·m−2). Moreover, the foam exhibits good reusability in a 10-cycle test without obvious attenuation in evaporation performance. Foam is used for seawater desalination and wastewater purification, and the treated water meets the water quality standards of the World Health Organization (WHO) and the United States Environmental Protection Agency (USEPA). In short, this work demonstrates a sustainable strategy for low-cost and efficient solar-powered clean water production.
Case report: Deep vein arterialization for limb salvage in a patient with subacute limb ischemia
Authors: Chim Michelle Si Min , How Guo Yuan , Hong Qian Tai , Lo Zhiwen Joseph , Pua Uei 
Published: May 2024

Background Successful revascularization of the lower extremity is key to avoiding amputation in patients with subacute limb ischemia. Percutaneous deep vein arterialization (DVA) is a novel endovascular technique which allows the shunting of blood through an arteriovenous fistula and native vein into the lower limb, typically employed in no-option chronic limb-threatening ischemia. Method We present a case illustrating the unconventional use of DVA for limb salvage in a patient presenting with subacute limb ischemia refractive to surgical treatment, endovascular revascularization, and medical therapy. Result and Conclusion The arteriovenous anastomosis allowed for the reconstitution of arterial inflow to the patient’s foot, thereby avoiding major limb amputation. Conclusion The conventional knowledge that DVA neo-conduits require maturation limiting its role in the treatment of subacute limb ischemia is challenged. However, further research is needed to establish its role and effectiveness for subacute limb ischemia.
Impact of rifaximin use in infections and mortality in patients with decompensated cirrhosis and hepatic encephalopathy
Authors: Idalsoaga Francisco , Robles Camila , Ortiz Andrea , Corsi Oscar , Fuentes-López Eduardo , Díaz Luis Antonio , Ayares Gustavo , Arrese Marco , Arab Juan Pablo 
Published: May 2024

Introduction: Infections in patients with cirrhosis are associated with high morbidity and mortality. Rifaximin is an antibiotic used to treat and prevent hepatic encephalopathy (HE); however, it has been suggested that it may play a crucial role in reducing infections in these populations. Aim: To evaluate the role of rifaximin in preventing frequent cirrhosis-related infections [spontaneous bacterial peritonitis, pneumonia, urinary tract infection (UTI), and bacteremia], Clostridioides difficile infection, and all-cause mortality, as well as determining adverse effects and adherence to the drug. Methods: A retrospective cohort study was conducted on decompensated cirrhotic patients with history of HE between January 2017 and November 2022 at a university center. Patients with cirrhosis, regardless of their etiology and severity, were included in the study, encompassing both hospitalized and outpatient cases. The statistical analysis included adjusted general linear models, Poisson regressions, and propensity score matching. Results: We included 153 patients. The mean age in the cohort was 60.2 ± 12.3 years and 67 (43.8%) were women. The main cause of cirrhosis was metabolic dysfunction-associated steatotic liver disease 52 (38%), and the median Model of End-Stage Liver Disease sodium was 16.5 (7–32). In the cohort, 65 (45%) patients used rifaximin. The mean follow-up was 32 months. Eighty-five patients with infectious events were recorded, and a total of 164 infectious events were registered. The main infectious events were UTIs (62, 37.8%) and pneumonia (38, 23.2%). The use of rifaximin was associated with lower infection rates, displaying an incidence rate ratio (IRR) of 0.64 [95% confidence interval (CI) (0.47–0.89); p = 0.008]. However, no discernible impact on mortality outcome was observed [IRR 1.9, 95% CI (0.9–4.0); p = 0.09]. There were no reported adverse effects, and no patient discontinued the therapy due to adverse effects. Conclusion: The use of rifaximin significantly reduces infections in patients with cirrhosis and HE. Despite rifaximin was associated with a decreased all-cause mortality, this impact was not statistically significant in the adjusted analysis.
Phenotypic characterization of nonautoimmune diabetes in adult Ugandans with low body mass index
Authors: Kibirige Davis , Sekitoleko Isaac , Lumu William , Thomas Nihal , Hawkins Meredith , Jones Angus G. , Hattersley Andrew T. , Smeeth Liam , Nyirenda Moffat J. 
Published: May 2024

Background: Type 2 diabetes is common in relatively lean individuals in sub-Saharan Africa. It is unclear whether phenotypic differences exist between underweight and normal-weight African patients with type 2 diabetes. This study compared specific characteristics between underweight (body mass index <18.5 kg/m2) and normal-weight (body mass index of 18.5–24.9 kg/m2) adult Ugandans with new-onset nonautoimmune diabetes. Methods: We collected the demographic, clinical, anthropometric, and metabolic characteristics of 160 participants with nonobese new-onset type 2 diabetes (defined as diabetes diagnosed <3 months, body mass index <25 kg/m2, and absence of islet-cell autoimmunity). These participants were categorized as underweight and normal weight, and their phenotypic characteristics were compared. Results: Of the 160 participants with nonobese new-onset type 2 diabetes, 18 participants (11.3%) were underweight. Compared with those with normal weight, underweight participants presented with less co-existing hypertension (5.6% versus 28.2%, p = 0.04) and lower median visceral fat levels [2 (1–3) versus 6 (4–7), p < 0.001], as assessed by bioimpedance analysis. Pathophysiologically, they presented with a lower median 120-min post-glucose load C-peptide level [0.29 (0.13–0.58) versus 0.82 (0.39–1.50) nmol/l, p = 0.04] and a higher prevalence of insulin deficiency (66.7% versus 31.4%, p = 0.003). Conclusion: This study demonstrates that nonautoimmune diabetes occurs in underweight individuals in sub-Saharan Africa and is characterized by the absence of visceral adiposity, reduced late-phase insulin secretion, and greater insulin deficiency. These findings necessitate further studies to inform how the prevention, identification, and management of diabetes in such individuals can be individualized.
The gamification and development of a chatbot to promote oral self-care by adopting behavior change wheel for Taiwanese children
Authors: Chang Wen-Jen , Chang Pei-Ching , Chang Yen-Hsiang 
Published: May 2024

Background Oral health is closely related to general health and quality of life. School-aged children are at a critical stage for developing their self-care ability in oral health. Digital interventions can encourage and facilitate oral self-care in children. Objective This study aims to present the development of an educational chatbot for school-aged children to address their oral self-care and evaluate its usability. Methods The development and evaluation of the chatbot for oral self-care consisted of four stages: target behavior analysis, intervention design, system development, and the chatbot evaluation. The target behavior analysis identified barriers to children's engagement in oral self-care based on dentists’ clinical observations; hence, the requirements for achieving the desired behavior were categorized according to the capability-opportunity-motivation behavior model. Interventional functions were created following the behavior change wheel. A menu-driven chatbot was created and evaluated for usability as well as likeability. Results The barriers and requirements for achieving good behavior in school-aged children's oral self-care were identified by the dental professionals. Intervention strategy incorporated specific functions enriched with gamification features to support school-aged children in developing their abilities for engaging in oral self-care. The intervention functions consist of capability establishment, motivation enhancement, and opportunity creation, which were designed to support children in their oral self-care practices. The designed chatbot was piloted with a convenient sample of 30 school-aged children and their accompanying parents at the pediatric dental clinic. The results indicated good usability, with a mean usability score of 79.91, and high likeability with a mean score of 4.32 out of 5 for the designed chatbot. Conclusions The educational chatbot incorporated a combination of clinical dentistry practice and guidelines, aiming to promote oral self-care behavior in school-aged children. The designed chatbot achieved high scores for its usability and user likability.
‘Not a panacea’ – Expert perspectives on the concept of resilience and its potential for palliative care
Authors: Maus Katja , Peusquens Frank , Kriegsmann-Rabe Milena , Matthias Julia-Katharina , Ateş Gülay , Jaspers Birgit , Geiser Franziska , Radbruch Lukas 
Published: May 2024

Background: Resilience is an increasingly used term in medicine and subject to various definitions, often not easy to grasp. There are established core concepts for patients receiving palliative care, for example, meaning in life, that have already been researched a lot. Resilience, relative to these concepts, is a new object of research in palliative care, where it has so far been used predominantly with regard to the well-being of teams. Aim: To explore how experts in palliative care define the concept of resilience and its suitability for patients, significant others, and professionals. Design: Qualitative study using summarizing content analysis according to Mayring. Setting/participants: Twenty-one health and social care professionals with expertise caring for persons with life-threatening/limiting illnesses and their relatives were interviewed in three individual interviews and four focus groups. All conversations were recorded, transcribed, coded via MAXQDA, and validated by another researcher. Results: Resilience has been described as something procedural, dynamic, individual, and flexible. In connection with well-known concepts such as posttraumatic growth or terms from the field of mindfulness, social environment or personal factors have also been linked to resilience. Resources such as spirituality can contribute to resilience, and resilience itself can function as a resource, for example, by contributing to quality of life. An active use of the term in practical work with patients or relatives is rare, but it is used in education or team measures. Limited lifespan can pose a challenge to an active use of the concept of resilience. Conclusion: Resilience as a very individual approach provides added value to other core concepts of palliative care. Within the palliative context, the normative dimension of resilience must be well reflected. A broader definition of resilience is recommended, leaving room for everyone to find their own form of resilience. The concept of resilience in palliative care includes opportunities as well as risks and should, therefore, be implemented carefully, requiring specific training.
Efficacy of the Gulu University Reproductive Health Simulation Training for final year medical students and interns: a before-and-after study
Authors: Pebolo Pebalo Francis , Okot Jerom , Bongomin Felix , Awor Silvia , Arwinyo Baifa , Ojara Sande , Opee Jimmyy , Jackline Ayikoru , Ssennuni Eric , Ouma Simple 
Published: May 2024

Background: Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives: The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design: A before-and-after study. Methods: A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t-tests was used to test the difference in pre- and post-test scores. Independent sample t-tests compared median post-test results between interns and students, with a p-value <0.05 considered significant. Results: A total of 153 participants were enrolled, the majority being males (78.4%, n = 120) and medical students (73.9%, n = 113). Among the 40 interns, 55% ( n = 22) were doctors, 30% ( n = 12) were midwives, and 15% ( n = 6) were nurses. The study participants showed an increase in knowledge, with median post-test scores higher than pre-test scores for all participants [63% (interquartile ranges, IQR: 57–71%) versus 49% (42–54%), with a median difference of 14% (8–23%), p < 0.001]. Conclusion: The SBT effectively imparts key knowledge competencies to the interns and fifth-year medical students. We recommend that SBT be included as part of the course units that students should take and for continuous medical education for qualified healthcare workers in resource-limited settings.