bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa
Authors: Seretlo-Rangata Mmakwena Linda , Sodi Tholene , Govender Saraswathie
Published: February 2025

Introduction

Water is essential for human survival and serves various purposes, including domestic, socioeconomic, and agricultural activities. However, water scarcity has emerged as a significant threat to this vital resource, posing a global challenge. While discussions surrounding the consequences of water scarcity typically emphasizes its effects on physical health and socioeconomic impacts, the mental and psychological effects on communities are often overlooked. Thus, the study aimed to explore the psychological effects of water scarcity on community members in Lephalale municipality, Limpopo province, South Africa.

Methods

A qualitative research approach was used in the study. Participants were selected using purposive sampling and twenty participants who relied mainly on communal taps to access water were included (10 males and 10 females). Semi-structured in-depth interviews were used to collect data and interviews were audio recorded and later transcribed and translated by a language expert. Data were analyzed using content thematic analysis.

Results

Three main themes emerged from the study results: (1) emotional distress; (2) interpersonal conflicts; (3) disruptions in the activities of daily living. Emotional distress included feelings of shame, embarrassment, anger, disappointment, hopelessness and helplessness. Additionally, interpersonal conflicts arose due to competition for water resources, and disruptions in daily activities were linked to water access challenges.

Conclusion

The study findings demonstrated that water scarcity has a significant psychological impact on community members. The study concludes by recommending the integration of psychological principles and involvement of mental health care practitioners when developing water management programmes, strategies, interventions, and policy. The study can provide policy makers and mental health care practitioners valuable insights into the mental health challenges faced by communities affected by water scarcity. Moreover, these study findings can assist mental health care practitioners to tailor their interventions to address the specific needs of communities experiencing water scarcity, particularly community members presenting with mental health challenges associated with this issue.
Case report: Cerebrotendinous Xanthomatosis masquerading as adult ADHD in psychiatric practice
Authors: Kim Jongtae , Hong Yun Jeong , Lee Si Baek , Kim Seong Hoon , Lee Myung Ah , Ko Eunbuel , Park Jeong Wook
Published: February 2025

Introduction

This case report details the presentation of a patient who initially sought consultation at a psychiatric outpatient clinic with symptoms suggestive of Attention-Deficit/Hyperactivity Disorder (ADHD); however, further evaluation revealed a diagnosis of Cerebrotendinous Xanthomatosis (CTX). CTX, a genetic disorder impacting lipid metabolism, is often overlooked in differential diagnoses due to its rarity. This case underscores the importance of considering alternative diagnoses in adults exhibiting ADHD-like symptoms without a childhood history of the disorder, adding to the literature on diagnostic complexities in psychiatric practice.

Case presentation

A 33-year-old man visited a psychiatric outpatient clinic with symptoms such as increasing distractibility and inattention, requesting an evaluation for adult ADHD. However, the absence of an ADHD history in childhood, coupled with progressive neurological symptoms and tendon xanthomas, led to further investigation. Comprehensive neurological assessments, including neuroimaging and genetic testing, ultimately diagnosed him with CTX. Treatment with chenodeoxycholic acid (CDCA) resulted in stabilization of cognitive function, although improvement in gait disturbances and tremors remained minimal.

Conclusion

This case demonstrates that CTX can masquerade as adult ADHD, emphasizing the necessity for thorough assessments in atypical ADHD presentations. Psychiatrists should consider rare metabolic disorders like CTX in similar cases, which may enable timely intervention and improve patient outcomes.
Can digital governance stimulate green development? Evidence from the program of “pilot cities regarding information for public well-being” in China
Authors: Zou Xuxin , Min Jiadi , Meng Shuang , Dai Wenguan , Li Xinyang
Published: February 2025

Digital governance is an important goal of government digital transformation, and the policy of “pilot cities regarding information for public well-being” in China is an important initiative to promote the reform of government governance system and realize green development. Based on the panel data of 282 cities in China from 2007 to 2020, this paper analyzes the mechanism and path of the impact of digital governance on green development using the program of “pilot cities regarding information for public well-being” as a quasi-natural experiment. The double-difference model and mediation effect model are utilized. The results show that digital governance can significantly promote green development, and the path of influence is the supererogation and the rationalization of industrial structure, i.e., digital governance can promote the green development of the cities by enhancing the supererogation and the rationalization of industrial structure. In addition, there is obvious heterogeneity in the impact of digital governance on green development. The policy exerts a stronger effect on economically developed cities than on economically backward cities, and a stronger effect on large cities than on small- and medium-sized cities. Therefore, the relevant departments should continue to optimize the pilot policy regarding information for public well-being, strive to improve the government’s digital governance, focus on economically backward cities and small-sized cities, actively cultivate the green development, promote the optimization and upgrading of industrial structure, and vigorously support cross-regional exchanges and cooperation, so as to jointly achieve green and high-quality development.
A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021)
Authors: Ramos-Rincón José-Manuel , Sánchez-Paya José , González-De-La-Aleja Pilar , Rodríguez-Díaz Juan-Carlos , Merino Esperanza
Published: February 2025

Objectives

The study aimed to analyze in-hospital mortality (IHM) among all COVID-19 patients hospitalized in Spain between March 1, 2020, and December 31, 2021, and to compare two distinct periods: the prevaccination period (March 1, 2020, to January 31, 2021) and the vaccination period (February 1, 2021, to December 31, 2021). The objective was to assess the impact of vaccination on IHM and identify associated risk factors, using data from Spain’s national hospitalization registry.

Methods

This retrospective analysis used data from the Spanish National Surveillance System for Hospital Data. The primary outcome was in-hospital mortality (IHM). Multivariate logistic regression identified risk factors across the overall study period, as well as during the prevaccination and vaccination periods. Risk factors included age (in 20-year intervals), sex, comorbidities (e.g., hypertension, diabetes, chronic kidney failure, obesity, neurodegenerative disorders, and others), and admission to the intensive care unit.

Results

A total of 524,314 COVID-19 hospitalizations were recorded in Spain, with 329,690 during the prevaccination period and 194,624 during the vaccination period. Hospitalization rates dropped from 697/100,000 people to 411/100,000, and in-hospital mortality (IHM) decreased from 16.2 to 11.5% (adjusted odds ratio [AOR]: 0.71, 95% CI: 0.70–0.73, p < 0.001). IHM rose with age, from 0.8% in patients aged 18–39 to 31.7% in those ≥80 years (p < 0.001), but significant decreases were observed across all age groups after vaccination, especially in those ≥80 years (AOR: 0.76, 95% CI: 0.75–0.79, p < 0.001). Risk factors for IHM remained consistent, with leukemia, neoplasm, and lymphoma posing the highest risks, while female sex (AOR: 0.75, 95% CI: 0.74–0.77, p < 0.001) and dyslipidemia (AOR: 0.85, 95% CI: 0.32–0.86, p < 0.001) were protective factors.

Conclusion

During the vaccination period, the risk of in-hospital mortality (IHM) was 29% lower than in the prevaccination period, after adjusting for sex, age, and comorbidities. This reduced risk was observed across sexes, age groups, and comorbidities. The risk factors for IHM remained consistent between the two periods, with age as the main risk factor, while female sex and dyslipidemia were identified as protective factors.
Explainable correlation-based anomaly detection for Industrial Control Systems
Authors: Birihanu Ermiyas , Lendák Imre
Published: February 2025

Anomaly detection is vital for enhancing the safety of Industrial Control Systems (ICS). However, the complicated structure of ICS creates complex temporal correlations among devices with many parameters. Current methods often ignore these correlations and poorly select parameters, missing valuable insights. Additionally, they lack interpretability, operating efficiently with limited resources, and root cause identification. This study proposes an explainable correlation-based anomaly detection method for ICS. The optimal window size of the data is determined using Long Short-Term Memory Networks—Autoencoder (LSTM-AE) and the correlation parameter set is extracted using the Pearson correlation. A Latent Correlation Matrix (LCM) is created from the correlation parameter set and a Latent Correlation Vector (LCV) is derived from LCM. Based on the LCV, the method utilizes a Multivariate Gaussian Distribution (MGD) to identify anomalies. This is achieved through an anomaly detection module that incorporates a threshold mechanism, utilizing alpha and epsilon values. The proposed method utilizes a novel set of input features extracted using the Shapley Additive explanation (SHAP) framework to train and evaluate the MGD model. The method is evaluated on the Secure Water Treatment (SWaT), Hardware-in-the-loop-based augmented ICS security (HIL-HAI), and Internet of Things Modbus dataset using precision, recall, and F-1 score metrics. Additionally, SHAP is used to gain insights into the anomalies and identify their root causes. Comparative experiments demonstrate the method's effectiveness, achieving a better 0.96% precision and 0.84% F1-score. This enhanced performance aids ICS engineers and decision-makers in identifying the root causes of anomalies. Our code is publicly available at a GitHub repository: https://github.com/Ermiyas21/Explainable-correlation-AD.
Individualism: the end of social cohesion? The effects of inequality and group identity on cooperation
Authors: Senn Sebastian , Mutzner Nico , Oberhauser Vincent , Rauhut Heiko
Published: February 2025

Introduction

Global challenges like pandemics and climate change are fundamentally cooperation problems, where individual interests often conflict with the collective good. Rising economic inequality and individualism are believed to erode social cohesion and cooperation, exacerbating these tensions. Public goods games (PGGs) are widely used to study cooperation in scenarios of unequal resource distribution, but findings on the effects of inequality remain inconsistent, partly due to varied applications of heterogeneity across studies.

Methods

This study introduces a novel research design that directly compares collectivistic and individualistic groups to examine the combined effects of individualism and inequality on cooperation. Groups were exposed to different resource distribution conditions, including both equal and unequal distributions, and their cooperation rates were measured.

Results

The findings reveal no significant differences in cooperation rates between collectivistic and individualistic groups. However, groups with higher inequality exhibited significantly higher cooperation rates than those with equal resource distributions. Notably, heterogeneous groups showed considerable variation in their success at establishing cooperation. Further analysis indicates that the willingness to reduce initial inequality served as a strong signal, enhancing group identity and fostering cooperation.

Discussion

The results suggest that in contexts where group identity is strong, inequality can act as a coordination mechanism, enabling groups to distribute the burden of collective costs more effectively and enhancing overall cooperation. These findings challenge the assumption that inequality inherently undermines cooperation and highlight the potential for strategically leveraging inequality in contexts characterized by collectivistic norms.
Integrative hydrologic modelling of soil and water conservation strategies: a SWAT-based evaluation of environmental resilience in the Merguellil watershed, Tunisia
Authors: Hermassi Taoufik , Jarray Fathia , Tlili Waad , Achour Issam , Mechergui Mohamed
Published: February 2025

Introduction

Analyzing the hydrological dynamics and assessing the impact of Soil and Water Conservation (SWC) techniques provides crucial insights for developing region-specific conservation strategies and advancing effective watershed management.

Methods

A multi-objective calibration concept was applied to the Soil and Water Assessment Tool (SWAT) model, where simultaneous calibration across the watershed andits sub-watersheds was performed using multiple objective criteria. This study investigates the impact of SWC measures on the hydrological dynamics of the Merguellil watershed, Central Tunisia. The research includes a sensitivity analysis, as well as the calibration and validation of the SWAT model, revealing seven sensitive parameters.

Results and discussion

During calibration (2000-2012), NSE was 0.82 and R2 was 0.9, RSR was 0.19 and PBIAS was 11.62%. In validation (2013–2020), NSE was 0.81 and R2 remained 0.9, RSR was 0.22 and PBIAS was 10.96%, indicating a strong correlation. Results of multi-watershed calibration were analyzed in two representative sub-watersheds (SW 8 and SW 16) and present good agreement between simulated and observed values. Simulating the SWAT model with and without SWC techniques reveals a consistent reduction in surface runoff, notably in central subbasins with values exceeding 15%. The observed decrease is attributed to vegetation cover, indicating the effectiveness of SWC practices. In contrast, subbasins lacking SWC interventions exhibit minimal runoff changes. The study further assesses the impact of SWC techniques on soil erosion, revealing negative percentage differences that indicate a reduction in erosion of over 30% following the implementation of these techniques. The central subbasins, marked by olive trees and strategic conservation, demonstrate substantial decreases, emphasizing successful erosion control efforts. Groundwater recharge analysis shows that SWC practices, along with favorable conditions, significantly enhance percolation and groundwater recharge, highlighting their beneficial impact. Variations in recharge percentages across subbasins reflect the nuanced responses influenced by anthropogenic and natural factors. Erosion hotspots were identified using sediment yield (SY) data. Six sub-watersheds were categorized from moderate to severe sediment severity classes and pinpointed as soil erosion hotspots, requiring immediate intervention. Finally, the study underscores the vital role of SWC techniques in mitigating surface runoff, reducing soil erosion, and enhancing groundwater recharge in the semi-arid Merguellil watershed. The findings emphasize the need for tailored conservation strategies considering geographical variations for effective watershed management and sustainability.
Being Born Early Can Affect the Way We Control Our Emotions
Authors: McDonogh Abbie , O’Reilly Mescall Alexandria , Nosarti Chiara
Published: February 2025

Every year, 13 million babies are born before the usual 9 months of pregnancy. To understand what happens to these babies’ brains when they grow up, we used powerful brain scans to take detailed photos of the brain, and we compared the brains of children born early to those born at 9 months. We also studied the development of these children. We found that a part of the brain important for feelings and emotions, develops slightly differently in babies born early. These differences could explain why children born early may have more difficulty controlling their emotions. Brain differences could also explain why children born at 9 months may be less likely to develop anxiety and depression in later life. In this article, we will discuss the study findings, the impacts they might have, and how we can use this information to improve mental health in vulnerable children.
An open source code for modeling radio wave propagation in earth’s ionosphere
Authors: Green Alexander , Longley William J. , Oppenheim Meers M. , Young Matthew A.
Published: February 2025

We present FARR (Finite-difference time-domain ARRay), an open source, high-performance, finite-difference time-domain (FDTD) code. FARR is specifically designed for modeling radio wave propagation in collisional, magnetized plasmas like those found in the Earth’s ionosphere. The FDTD method directly solves Maxwell’s equations and captures all features of electromagnetic propagation, including the effects of polarization and finite-bandwidth wave packets. By solving for all vector field quantities, the code can work in regimes where geometric optics is not applicable. FARR is able to model the complex interaction of electromagnetic waves with multi-scale ionospheric irregularities, capturing the effects of scintillation caused by both refractive and diffractive processes. In this paper, we provide a thorough description of the design and features of FARR. We also highlight specific use cases for future work, including coupling to external models for ionospheric densities, quantifying HF/VHF scintillation, and simulating radar backscatter. The code is validated by comparing the simulated wave amplitudes in a slowly changing, magnetized plasma to the predicted amplitudes using the WKB approximation. This test shows good agreement between FARR and the cold plasma dispersion relations for O, X, R, and L modes, while also highlighting key differences from working in the time-domain. Finally, we conclude by comparing the propagation path of an HF pulse reflecting from the bottomside ionosphere. This path compares well to ray tracing simulations, and demonstrates the code’s ability to address realistic ionospheric propagation problems.
Links between protein-source diversity, household behavior, and protein consumption inadequacy in the Indian rural semi-arid tropics
Authors: Kumar Shalander , Pramanik Soumitra , Reardon Thomas , Revathi E.
Published: February 2025

Our study analyzes the determinants, sources, and levels of protein consumption among 785 households across nine districts in six Indian states in the semi-arid tropics. We found that 80% of these households consumed less protein than recommended and relied on cereals for 60–75% of their protein intake. Notably, even when protein-rich foods are accessible to households, they still consume them insufficiently. We found that their protein intake deficiency is driven by a lack of diversity of protein sources (in particular, legumes, millets, and livestock), as well as by a dearth of women's education and role in household decision-making and low incomes and assets. We advocate for initiatives to raise nutrition awareness, empower women, and adopt a nutrition-centric farming approach.
Postoperative radiotherapy improves survival in completely resected non-small cell lung cancer with pathologic N2 stage IIIA and positive lymph node count greater than one: a SEER-based retrospective cohort study
Authors: Zhu Diyang , Xiao Yuanyuan , He Shancheng , Xie Baochang , Zhao Wenqi , Xu Yuhui
Published: February 2025

Objective

Non-small cell lung cancer (NSCLC) constitutes approximately 85% of lung cancer cases, with 20%–30% of patients diagnosed at stage III. While multimodal therapy is the standard for treating locally advanced NSCLC, the role of PORT remains controversial. This study seeks to evaluate the effect of postoperative radiotherapy (PORT) on overall survival (OS) and cancer-specific survival (CSS) in patients with resected pathologic N2 (pN2) stage IIIA NSCLC.

Methods

Data from the Surveillance, Epidemiology, and End Results Program (SEER) 17 registry (2010–2019) were analyzed. The cohort included 1,471 patients aged 65 years or older, diagnosed with stage IIIA pN2 NSCLC, who had undergone lobectomy or total pneumonectomy. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. Univariate and multivariate analyses were conducted to assess the association of PORT with OS and CSS. Kaplan-Meier survival curves were employed to estimate survival outcomes, while the COX proportional hazards model was utilized for comparative analysis. PLN counts were stratified into two categories: ≤1 and >1.

Results

Among the 1,471 patients included in the study, 613 (41.67%) received PORT, while 858 (58.33%) did not. PORT was associated with a significantly higher 1- and 3-year OS (89.96% and 68.49%, respectively) compared to the non-PORT group (87.44% and 61.88%, respectively, P = 0.03). However, no significant difference in CSS was observed between the groups (P = 0.15). Among patients with PLN counts >1, PORT significantly improved OS (HR = 1.32, 95% CI = 1.04–1.68, P = 0.0016) and CSS (HR = 1.32, 95% CI = 0.99–1.70, P = 0.026), whereas no significant differences were seen in patients with PLN counts ≤1.

Conclusions

This study underscores the potential of PORT in enhancing OS in patients with resectable pN2 stage IIIA NSCLC, particularly in those with PLN counts exceeding one. These findings suggest that PORT may offer improved outcomes in patients with extensive lymph node involvement, emphasizing the need for further prospective studies to validate and expand upon these observations.
Poor radiological outcomes and associated factors among tibial shaft fracture patients treated with intramedullary nail fixation at Addis Ababa Burn, Emergency and Trauma Hospital, Ethiopia
Authors: Shugie Yohannes , Kebede Samuel , Adugna Fanna , Demissie Dereje Bayissa , Desta Tilahun
Published: February 2025

Background

Tibial shaft fractures account for the majority of operatively treated long bone fractures and have the greatest prevalence of open wounds. For both open and closed injuries, intramedullary fixation has become the standard of therapy. At Addis Ababa Burn, Emergency, and Trauma (AaBET) Hospital, the rates of poor radiological outcomes for tibial shaft fractures treated with intramedullary fixation are unknown.

Methods

A retrospective health facility-based cross-sectional study design was conducted among patients with tibial shaft fractures treated with intramedullary nails at AaBET Hospital. Data were collected by reviewing medical records and x-rays. The study was conducted on a sample size of 160 using a simple random sampling technique. Descriptive statistics such as frequency and percentage were used to summarize the results. Binary logistic regression was used to describe the associations between variables. A P-value < 0.05 was considered statistically significant.

Results

This study included 122 (76.3%) men and 38 (23.8%) women with a mean age of 36.3 ± 13.9. The magnitude of poor radiological outcomes among the tibial shaft fracture patients treated with intramedullary nail fixation was 23.1%, with factors including include the presence of medical comorbidity [adjusted odd ratio (AOR) (95% confidence interval, CI): 16.5 (2.524–108.69)], having diabetes mellitus [AOR (95% CI): 3.85 (1.07–14.08)], Gustilo–Anderson type III (GA III) open fractures [AOR (95% CI): 17.4 (3.11–97.72)], and post-operative infection [AOR (95% CI): 13.9 (5.8–33.16)] identified as being significantly associated with poor radiological outcomes.

Conclusion

The magnitude of poor radiological outcomes in this study is comparable to other similar studies. The study found that factors including Gustilo–Anderson type III open fractures, diabetes mellitus, and post-operative infections increase the odds of poor radiological outcomes in patients with tibial shaft fractures after intramedullary nailing. Therefore, surgeons should improve their assessment and evaluation of patients with infection signs and use negative wound pressure for GA III fractures.
Retrospective evaluation of autotransfusion using a cell saver device versus allotransfusion in the perioperative management of acute hemoperitoneum in 43 dogs (2017–2021)
Authors: Blunschi Fabienne , Gluding Dennis , Hassdenteufel Esther , Schneider Matthias , Lehmann Hendrik
Published: February 2025

Background

Cell saver (CS) technology is an increasingly popular approach for autotransfusion in small animal veterinary medicine for the treatment of patients with abdominal hemorrhagic effusion.

Objective

To evaluate the utility, effectiveness, and safety of autotransfusions collected with a CS device and to assess whether the use of the CS device reduces the demand for allogenic blood transfusions.

Materials and methods

Retrospective study of dogs with acute hemoperitoneum of splenic origin treated surgically. Dogs were grouped by the type of transfusion received: allo- and autotransfusion (AA), allotransfusion only (AO), autotransfusion only (CS), and no transfusion (NT). Differences in changes of laboratory parameters (hematocrit and lactate), transfusion volume, and outcomes were analyzed across groups.

Results

Forty-three dogs were included. Twenty-seven (62.8%) suffered from hemangiosarcoma, and 16 (37.2%) had a benign cause of hemoperitoneum. The classification into blood transfusion groups was as follows: 7/43 (16.3%) in the AA-group, 11/43 (25.6%) in the AO-group, 11/43 (25.6%) in the CS-group and 14/43 (32.6%) in the NT-group. Increase in hematocrit over time was similar in all subgroups that received any form of blood transfusion (AA-, AO-, CS-group). Total volume of transfused blood (autologous and allogenic) was significantly higher in the AA-group (median 54.0mL/kg, range 24.7–126.5mL/kg) than in the AO-group (median 7.6mL/kg, range 4.6–13.5mL/kg, p = 0.01) but not the CS-group (median 23.8mL/kg, range 14.1–50.0mL/kg, p = 0.22). No difference was found for the volume of allogenic blood transfused between the AA-group (median 9.4mL/kg, range 5.0–16.2mL/kg) and AO-group (median 7.6mL/kg, range 4.6–13.5mL/kg) (p = 0.68). The use of the CS device did not adversely affect the time from presentation to surgery, the duration of surgery, or the outcomes.

Discussion

The use of autologous blood transfusions obtained by CS device in dogs suffering from acute hemoperitoneum caused by a benign or malignant splenic disorder appeared safe and effective in the cases described. And therefore may emphasize its further application as an addition or alternative to traditional allogenic blood transfusions.
Effect of ectoparasite Ichthyophthirius multifiliis on the histopathology and gill and gut microbiota of goldfish (Carassius auratus)
Authors: Bu Xialian , Peng Xianqi , Huang Lei , Zhao Yu , Jiao Jinbiao , Zhu Jian , Chen Jing , Huang Xiaohong , Zheng Aqin , Qu Huantao , Yao Jiayun
Published: February 2025

Introduction

The ectoparasite Ichthyophthirius multifiliis, is the pathogen of white spot disease in freshwater fish, which parasitizes on gills, fins, and skins of fish, causing tissue damage and death of host. However, whether it influences gill and gut microbiota is still unknow.

Methods

In this study, H&E staining was used to show the gill and gut histopathological characteristics of I. multifiliis-infected and uninfected goldfish (Carassius auratus). Meanwhile, 16S rRNA gene amplicon sequencing was conducted to analyze the difference of gill and gut microbiota between I. multifiliis-infected and uninfected goldfish.

Results

Histopathological examination revealed that I. multifiliis has induced significant damage to the gills of goldfish, characterized by lamellae fusion, cell hyperplasia, cell hyperaemia, inflammatory infiltration, necrosis and desquamation. 16S rRNA gene sequencing result showed that alpha and beta diversity of gill microbiota was significantly reduced in the I. multifiliis-infected group, while no significant changes were observed in gut microbiota. Genus Candidatus Megaira exhibited the highest relative abundance in the I. multifiliis-infected group. Meanwhile, the abundance of opportunistic pathogens Aeromonas and Achromobacter were increased in the intestines of I. multifiliis-infected goldfish.

Discussion

The increased presence of Candidatus Megaira may originate from within the cells of I. multifiliis. The increase of opportunistic pathogens Aeromonas and Achromobacter may pose a threat to the health of goldfish. In summary, this study laid a foundation for further research on the interaction between I. multifiliis and host microbiota.
Acceptance of Open Preperitoneal Repair in Inguinal Hernia Surgery Delphi-Consensus After an Anonymous International Survey Among European Hernia Society Members
Authors: Lorenz Ralph , Akkersdijk Willem , Paiva De Oliveira Gabriel , Warren Tim , Soler Marc
Published: February 2025

Introduction

For years, the Lichtenstein technique was the gold standard for open repair, but several open pre-peritoneal techniques have developed since the fifties of the 20th century that offer some benefits over the Lichtenstein technique in terms of post-surgical incidence of pain. Since the 2023 update of the International HerniaSurge Guidelines, open preperitoneal mesh techniques have been an acceptable alternative, providing available expertise and competence with at least equal results as Lichtenstein repair.

Aim

The aim of this project is to understand the views of surgeons regarding the approach to inguinal hernia repair and determine best practice principles for optimal surgical outcomes.

Methods

Using a modified Delphi method, a panel of experts developed 43 Likert scale statements across six key domains. These statements were used to develop an online survey distributed to surgeons in Europe involved in inguinal hernia repair. The threshold for consensus was set a priori at 75%.

Results

A total of 202 responses were received from surgeons involved in inguinal hernia repair over three rounds of survey. After the initial survey round, seven statements were revised and reissued for a further round. At the conclusion of the survey phase, 31 of the 38 remaining statements achieved consensus (of which 13 achieved ≥90% agreement). From these results, the panellists developed a set of 3 recommendations to help define principles for optimal approach to inguinal hernia repair. Accordingly Open preperitoneal techniques seems to be an alternative to Lichtenstein technique if expertise is available and should be included in a tailored concept. Knowledge of anatomy, Education and Training in open preperitoneal techniques is crucial for the acceptance of these techniques.

Conclusion

The proposed set of recommendations provides some principles for surgeons to consider when selecting an approach to inguinal hernia repair, ensuring good patient outcomes in a practical and cost-effective manner.
Process Discovery for Event Logs with Multi-Occurrence Event Types
Authors: Kovács László , Jlidi Ali
Published: February 2025

One of the most actively researched areas in the field of process mining is process discovery, which aims to construct a schema that aligns with existing event trace sequences. Current standard industrial workflow schema induction methods impose certain limitations on the system being examined. To address the shortcomings, this article proposes a novel solution that employs graph neural networks and convolutional neural networks to perform schema discovery. In the first phase of schema generation, we perform equivalence prediction, implemented as an edge prediction task. From the obtained equivalence network, we identify the target schema nodes, which correspond to the maximal quasi-cliques of this network. The results of the performed efficiency tests demonstrate that the proposed method can manage such complex cases that are not covered by standard process discovery methods, and it provides more compact and more precise schema graphs.
Mapping Soil Organic Matter in Black Soil Cropland Areas Using Remote Sensing and Environmental Covariates
Authors: Zhang Yu , Luo Chong , Zhang Wenqi , Wu Zexin , Zang Deqiang
Published: February 2025

The accurate prediction of soil organic matter (SOM) content is important for sustainable agriculture and effective soil management. This task is particularly challenging due to the variability in factors influencing SOM distribution across different cultivated land types, as well as the site-specific responses of SOM to remote sensing data and environmental covariates, especially in the black soil region of northeastern China, where SOM exhibits significant spatial variability. This study evaluated the variations on the importance of different remote sensing imagery and environmental covariates in different cultivated land zones. A total of 180 soil samples (0–20 cm) were collected from Youyi County, Heilongjiang Province, China, and multi-year synthetic bare soil images from 2014 to 2022 (focusing on April and May) were acquired using Google Earth Engine. Combining three types of environmental covariates such as drainage, climate and topography, the study area was categorized into dry field and paddy field. Then, the SOM prediction model was constructed using random forest regression method and the accuracy of different strategies was evaluated by 10-fold cross-validation. The findings indicated that, (1) in the overall regression analysis, combining drainage and climate variables and multi-year synthetic remote sensing images of May could attain the highest prediction accuracy, and the importance of environmental covariates was ranked as follows: remote sensing (RS) > climate (CLI) > drainage (DN) > Topography (TP). (2) Zonal regression analysis was conducted with a high degree of precision, as evidenced by an R2 of 0.72 and an impressively low RMSE of 0.73%. The time window for remote monitoring of SOM was different for dry field and paddy field. More specifically, the optimal time frames for SOM prediction in dryland were identified as April and May, while those for paddy fields were concentrated in May. (3) In addition, the importance of diverse environmental covariates was observed to vary with the cultivated land types. In regions characterized by intricate topography, such as dry fields, the contributions of remote sensing images and climate variables assumed a heightened importance. Conversely, in paddy fields featuring flat terrain, the roles of climate and drainage variables played a more substantial role in influencing the outcomes. These findings underscore the importance of selecting appropriate environmental inputs for improving SOM prediction accuracy.
Determining Spatial Responses of Fishers (Pekania Pennanti) to Mechanical Treatments of Forest Stands for Fuel Reduction
Authors: Smith Tessa R. , Gese Eric M. , Clayton R. David , Terletzky Patricia A. , Purcell Kathryn L. , Thompson Craig M.
Published: February 2025

Historical forestry practices (e.g., fire suppression, heavy timber logging) have contributed to a discernable change in stand composition of western forests in the U.S., which now comprise a tinderbox mixture of increased surface and ladder fuels, dense stands, and fire-intolerant species. Forest managers are mitigating this concern by implementing silviculture practices (e.g., selective logging, thinning, prescribed burning) to reduce fuel loads and improve stand resiliency. Concern for habitat specialists, such as the fisher (Pekania pennanti), have arisen as they may be negatively influenced in the short-term by modifications to their environment that are needed to ensure long-term habitat persistence. To address this issue, we initiated an 8-year study in 2010 in Ashland, Oregon, to determine the behavioral response of fishers to fuel reduction treatments applied in forested stands. We measured the distance of each location from eight GPS-collared fishers to all treatments before and after they were treated within each home range, and performed three statistical tests for robustness, including a multi-response permutation procedure, chi-squared test of independence, and a Kolmogorov–Smirnov assessment. We found high variation among individuals to the tolerance of habitat manipulation. Using effect size to interpret the magnitude of fisher response to pre- and post-treatment effects, 1 fisher showed a moderate negative relationship to fuel reduction treatments, 5 exhibited a weak negative response, and 2 had a weak positive association with treatments. We used analysis of variance on the three fishers exhibiting the largest effect sizes to treatment disturbance, and used treatment, temporal, and habitat covariates to explore whether these factors influenced behavioral differences. Treatment season and vegetation class were important factors influencing response distance in the pre-treatment period. Post-treatment variables eliciting a negative treatment response were treatment season and treatment size, and results were slightly different when parsing out individual effects compared to a pooled sample set. Our findings suggested that seasonal timing and the location of management activities could influence fisher movement throughout their home range, but it was largely context-dependent based on the perceived risks or benefits to individuals.
National-Level Consumption of Antimicrobials in the Veterinary Sector in Uganda: A Report on Analysis of Import Data for 2021
Authors: Murungi Marion , Vudriko Patrick , Ndagije Helen Byomire , Kesi Diana Nakitto , Serwanga Allan , Rajab Kalidi , Manirakiza Leonard , Waswa John Paul , Kasujja Hassan , Barigye Mark , Kaweesi Ddembe , Akello Harriet , Namugambe Juliet , Kiggundu Reuben , Konduri Niranjan
Published: February 2025

Background: Antimicrobials are crucial for animal health and food security. However, their overuse in animals can lead to the emergence of resistant microorganisms. Antimicrobial resistance (AMR) poses a global public health threat that impacts both animal and human health. The objective of this study was to estimate the antimicrobial consumption (AMC) of veterinary antimicrobials at the national level using import data from January to December 2021, available from the Uganda National Drug Authority (NDA). Methods: The World Organization for Animal Health (WOAH) methodology was applied using the Anatomical Therapeutic Chemical classification codes for veterinary medicines. Results: Approximately 88,387.37 kg (88.39 tonnes) of veterinary antimicrobials were consumed in 2021. Parenteral veterinary antimicrobials accounted for 63.8% (56,375.65 kg) and oral veterinary antibacterials accounted for 36.2% (32,011.71 kg). Tetracyclines were the single most consumed veterinary antimicrobial class, accounting for 62.7% of total consumption. Oxytetracycline was the most consumed antibacterial (58.4%), followed by sulphadiazine + trimethoprim (11.1%), penicillin g/dihydrostreptomycin (7.4%), penicillin G procaine + dihydrostreptomycin (6.8%), and tetracycline (3.5%), respectively. Out of all imported veterinary antimicrobials, 76% belonged to the World Health Organization (WHO)’s Highly Important Antimicrobials (HIA) category, 16% to the Critically Important (CIA), and 9% to the Highest Priority Critically Important (HPCIA) categories. Imported colistin accounted for 0.1% of total veterinary consumption. Conclusions: This study contributes to understanding antimicrobial consumption in Uganda’s livestock sector and, for the NDA, leaves in place a system for routine surveillance at a national level. We recommend strict regulatory oversight on the importation and use of colistin and macrolides to address AMR.
Dynamic Spread of Antibiotic Resistance Determinants by Conjugation to a Human-Derived Gut Microbiota in a Transplanted Mouse Model
Authors: Sher Azam A. , Whitehead-Tillery Charles E. , Peer Ashley M. , Bell Julia A. , Vocelle Daniel B. , Dippel Joshua T. , Zhang Lixin , Mansfield Linda S.
Published: February 2025

Background. Antibiotic-resistant (AR) bacteria pose an increasing threat to public health, but the dynamics of antibiotic resistance gene (ARG) spread in complex microbial communities are poorly understood. Conjugation is a predominant direct cell-to-cell mechanism for the horizontal gene transfer (HGT) of ARGs. We hypothesized that commensal Escherichia coli donor strains would mediate the conjugative transfer of ARGs to phylogenetically distinct bacteria without antibiotic selection pressure in gastrointestinal tracts of mice carrying a human-derived microbiota with undetectable levels of E. coli. Our objective was to identify a mouse model to study the factors regulating AR transfer by conjugation in the gut. Methods. Two donor E. coli strains were engineered to carry chromosomally encoded red fluorescent protein, and an ARG- and green fluorescent protein (GFP)-encoding broad host range RP4 conjugative plasmid. Mice were orally gavaged with two donor strains (1) E. coli MG1655 or (2) human-derived mouse-adapted E. coli LM715-1 and their colonization assessed by culture over time. Fluorescence-activated cell sorting (FACS) and 16S rDNA sequencing were performed to trace plasmid spread to the microbiota. Results. E. coli LM715-1 colonized mice for ten days, while E. coli MG1655 was not recovered after 72 h. Bacterial cells from fecal samples on days 1 and 3 post inoculation were sorted by FACS. Samples from mice given donor E. coli LM715-1 showed an increase in cells expressing green but not red fluorescence compared to pre-inoculation samples. 16S rRNA gene sequencing analysis of FACS GFP positive cells showed that bacterial families Lachnospiraceae, Clostridiaceae, Pseudomonadaceae, Rhodanobacteraceae, Erysipelotrichaceae, Oscillospiraceae, and Butyricicoccaceae were the primary recipients of the RP4 plasmid. Conclusions. Results show this ARG-bearing conjugative RP4 plasmid spread to diverse human gut bacterial taxa within a live animal where they persisted. These fluorescent marker strategies and human-derived microbiota transplanted mice provided a tractable model for investigating the dynamic spread of ARGs within gut microbiota and could be applied rigorously to varied microbiotas to understand conditions facilitating their spread.
The Effects of Fisetin on Gene Expression Profile and Cellular Metabolism in IFN-γ-Stimulated Macrophage Inflammation
Authors: He Ziyu , Pan Xuchi , Xie Kun , Sakao Kozue , Chen Jihua , Komatsu Masaharu , Hou De-Xing
Published: February 2025

Although interferon-gamma (IFN-γ) is known as a critical factor in polarizing macrophages into the pro-inflammatory state for immune response, how dietary flavonoids regulate IFN-γ response for anti-inflammation is incompletely elucidated. This study aims to investigate the effect of fisetin, a typical flavonol, on the inhibition of IFN-γ-induced inflammation by RNA sequencing (RNA-Seq) and cellular metabolism analysis. RAW264 macrophages pretreated with fisetin following IFN-γ stimulation were subjected to RNA-Seq to analyze alterations in gene expression. Cellular signaling and transcription were investigated using enrichment analysis, motif analysis, and transcription factor prediction. Cellular metabolic state was assessed by measuring the oxygen consumption rate (OCR) and lactate level to reflect mitochondrial respiration and glycolysis. Alterations in signaling proteins were confirmed by Western blot. The results revealed that fisetin downregulated the IFN-γ-induced expression of pro-inflammatory genes and M1 marker genes such as Cxcl9, Il6, Cd80, Cd86, and Nos2. In cellular metabolism, fisetin upregulated the oxidative phosphorylation (OXPHOS) pathway, restored impaired OCR, and reduced lactate production induced by IFN-γ. Motif analysis suggested that fisetin suppressed the activation of IFN-regulatory factor 1 (IRF1). Western blot data further confirmed that fisetin inhibited the phosphorylation of Jak1, Jak2, and STAT1, and decreased the nuclear accumulation of phosphorylated STAT1 and IRF1 induced by IFN-γ. Taken together, our data revealed that fisetin is a potent flavonoid that attenuates IFN-γ-stimulated murine macrophage inflammation and ameliorates disrupted cellular metabolism with a possible Jak1/2-STAT1-IRF1 pathway.
Seeking a Definition of Digital Twins for Construction and Infrastructure Management
Authors: Aragón Aitor , Arquier Mathieu , Tokdemir Onur Behzat , Enfedaque Alejandro , Alberti Marcos García , Lieval Fabien , Loscos Eduard , Pavón Rubén Muñoz , Novischi Dan Marius , Legazpi Pablo Vicente , Yagüe Ángel
Published: February 2025

The integration of digital twins (DTs) in construction is still in its infancy compared to other sectors. However, the potential for optimising project lifecycle management is significant, promising transformative impacts on safety and operational performance. In this study, the evolution of technologies preceding DTs is explored. A detailed description of the various platforms where DTs can be implemented is discussed and parallels are established with other sectors, such as manufacturing and healthcare, highlighting the successful application of DTs in these fields. The key benefits of integrating DTs in the construction industry and complex infrastructure management are assessed, emphasising that the accuracy of asset representation is crucial for their effective utilisation. Moreover, the challenges associated with recording, storing, and accessing both static and dynamic data are discussed, providing insights into the pros and cons of managing data through back-end versus front-end processes. Case studies of a transport railway station and an educational centre illustrate the practical applications and advantages of DTs, such as enhanced visual representation, improved understanding of construction and management dynamics, real-time information integration, and collaborative management processes. This paper advocates for the first steps toward establishing a European definition of DTs and standardising the relevant processes.
Assessing Construction Near-Miss Detection Proficiency for Workers Under Stressor Conditions Using Psychophysiological Measures: An Eye-Tracking Investigation
Authors: Muley Shashank , Wang Chao , Aghazadeh Fereydoun , Bangaru Srikanth Sagar
Published: February 2025

Despite the introduction of preventive safety measures, such as near-miss reporting, to mitigate accidents and minimize fatalities, construction workers are constantly exposed to stressful situations that negatively affect their safety behavior and reporting efficiency. Occupational stress is induced by various factors, with mental stress and auditory stress being common workplace stressors that impact workers on the job site. While previous studies have demonstrated the effect of stressor conditions on workers’ hazard recognition and safety performance, research gaps persist regarding the direct impact of workplace stressors on workers’ stress levels and near-miss recognition performance. This study investigates workers’ near-miss recognition ability through an eye-tracking experiment conducted in a controlled environment under mental and auditory stress conditions. The findings from this study reveal that workplace stressors triggered by mental and auditory stress can adversely affect worker stress levels, safety behavior, and cognitive processing toward near-miss recognition. Visual attention towards near-miss scenarios was reduced by 26% for mental stress conditions and by 46% for auditory stress conditions compared to baseline. The results may potentially open avenues for developing wearable stress prediction and safety intervention models using bio-sensing technology and personalized safety training programs tailored to individuals with low identification abilities.