bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Attempts at Judicial Resolution of the Nkonya-Alavanyo Communal Conflict in Ghana
Authors: Agyei Prince Duah , Odartey-Wellington Felix 
Published: April 2024

Abstract
While the literature on the Nkonya-Alavanyo conflict references litigation and its apparent ineffectiveness in resolving the conflict, there is a paucity of detail about this litigation. This paper contributes to a more holistic comprehension of the discourses structuring resolution attempts in this conflict, with lessons for the resolution of communal conflicts generally. Drawing on archival data, media reports, and field interviews, we examine the trajectory of the Nkonya-Alavanyo conflict in the Ghanaian judicial system as an example of an intractable communal conflict that has defied legal attempts at resolution. We argue that judicial attempts at resolving the conflict have been ineffective because the resultant juridical discourse is polysemic and – to the extent that the non-negotiable value of justice is a factor in the conflict – is subject to divergent articulations. Second, we submit that the juridical discourse competes with State, civil society, and partisan articulations that do not privilege judicial decisions, with State discourse increasingly being one of militarisation.
South Sudan’s Transitional Constitution: the Making, Failure and Lessons
Authors: Deng Mark A. W. 
Published: April 2024

Abstract
The period 2005 to 2011 has a special significance for the people of Sudan. It not only saw the emergence of South Sudan as an independent country, but it also marked the beginning of formal constitution-making in South Sudan’s tumultuous political history. Two important documents – the Interim Constitution 2005 and the Transitional Constitution 2011 – were enacted during this period. I discuss both documents in this paper. I find that the Transitional Constitution unnecessarily concentrates power in the president. I argue that in failing to constrain the president, the Transitional Constitution has failed the task of a modern constitution.
A subspecies of marbled newt (Triturus marmoratus) in the Iberian Peninsula newly resolved from congruent nuclear and mitochondrial dna data
Authors: Arntzen Jan W. 
Published: April 2024

Abstract
The herpetofauna of the Iberian Peninsula is relatively well-researched, yet detailed studies, at least in part relying on molecular genetic data, continue to reveal taxa new to science, mostly species and subspecies. Newts of the genus Triturus are one such group with undiscovered yet taxonomically relevant variation, as shown by the recent description of new (sub)species of pygmy newts (T. pygmaeus, T. rudolfi). The marbled newt, Triturus marmoratus, shows an equally deep and geographically coherent spatial-genetic diversification. It is here shown that a northern and a southern group are characterized by different mitochondrial dna profiles and are also differentiated in morphometry and colouration pattern. With no firm evidence for selection against intermediate genotypes, the southern group is described at the subspecies level, as T. marmoratus harmannis ssp. nov. The subspecies’ contact zone is situated at ca. 41.5 northern latitude and stretches from the Atlantic coast near Porto, Portugal to the northeast of Madrid, Spain.
Synoptic Conditions and Lake-to-Lake Connections for Days with Lake Effect on All of the Great Lakes
Authors: Laird Neil F. , Crossett Caitlin C. , Britt Catherine J. , Metz Nicholas D. , Carmer Kelly , McBroom Braedyn D. 
Published: April 2024

Abstract
An investigation of lake effect (LE) and the associated synoptic environment is presented for days when all five lakes in the Great Lakes (GL) region had LE bands [five-lake days (5LDs)]. The study utilized an expanded database of observed LE clouds over the GL during 25 cold seasons (October–March) from 1997/98 to 2021/22. LE bands occurred on 2870 days (64% of all cold-season days). Nearly a third of all LE bands occurred during 5LDs, although 5LDs consisted of just 17.1% of LE days. A majority of 5LDs (56.5%) had lake-to-lake (L2L) bands, and these days comprised 43.5% of all L2L occurrences. 5LDs occurred with a mean of 26.1 (SD = 6.2) days per cold season until 2008/09 and then decreased to a mean of 13.8 (SD = 5.5) days during subsequent cold seasons. January and February had the largest number of consecutive LE days in the GL with a mean of 5.7 and 5.4 days, respectively. As the number of consecutive LE days increases, both the number of 5LDs and the occurrence of consecutive 5LD increase. This translates to an increased potential of heavy snowfall impacts in multiple, localized areas of the GL for extended time periods. The mean composite synoptic pattern of 5LDs exhibited characteristics consistent with lake-aggregate disturbances and showed similarity to synoptic patterns favorable for LE over one or two of the GL found by previous studies. The results demonstrate that several additional areas of the GL are often experiencing LE bands when a localized area has active LE bands occurring.
Auricular Hematomas in a High-Volume Trauma Population: A Retrospective Review
Authors: Phillips Alisa L. , Luttrell Jordan B. , Berry Joseph M. , Dedhia Raj D. , Eid Anas 
Published: April 2024

Study Design Retrospective review. Objective Auricular hematomas are generally associated with sports-related injuries, with studies predominantly in white populations and high neighborhood socioeconomic status (NSES) compared to our county. A previous population-based study of trauma patients in our county, Shelby County, Tennessee, shows that those who live in high vs low NSES experienced socioeconomic variation in injury. We aim to determine if differences exist in clinical management and outcomes in this population. Methods Patients from two hospital systems diagnosed with auricular hematomas from 2008–2023 were reviewed retrospectively. Inclusion criteria included adequate follow-up, clinical description of the hematoma, and comment on any complications or recurrence. Results 48 patients, with a median age of 28 (range: 0–83), with the most common etiology being assault/non-accidental trauma (NAT) at 41.7%, equally distributed across all NSES ( P = .30), with one sports-related injury. Facial trauma consults were associated with lower recurrence rates, 25% vs 62.5% ( P = .003) and were less likely to be placed for self-pay patients ( P = .019). Bolster placement resulted in lower recurrence rates, 23.3% compared to 58.3% ( P = .030). Conclusions Higher rates of assault/NAT etiologies existed in our population, independent of NSES. Our study reiterates the importance of facial trauma consultation and bolster usage to reduce recurrence.
Ecological risk assessment and source tracing of heavy metals in surface sediments of a hilly riverine reservoir in Chongqing, China
Authors: Ao Liang , Chang Ruiting , Tang Yanqiu , Zhang Sheng 
Published: April 2024

Abstract
Background
This work conducted quantitative and qualitative analyses on the heavy metals in 32 surface sediment samples collected from eight sampling sites across four seasons in the Yutan reservoir, a typical mountainous hilly riverine reservoir in Southwest China.

Results
Nine heavy metals were identified: (Cr, Cd, Pb, Cu, Zn, Hg, As, Ni, and Co). The concentrations varied within the ranges of 23.16 ~ 34.62, 0.53 ~ 1.09, 31.88 ~ 59.04, 51.94 ~ 85.84, 106.76 ~ 227.69, 0.08 ~ 0.15, 12.57 ~ 25.60, 12.06 ~ 27.64 and 11.04 ~ 14.56 mg/kg, respectively, following a decreased concentration order of Zn > Cu > Pb > Cr > Ni > As > Co > Cd > Hg. Except for Cd, which accumulated in winter, and Hg, which reduced in spring. The concentration of heavy metals showed no significant seasonal variation and generally had higher contents at the river mouth and lower concentrations in open water areas and branches. The geoaccumulation index (Igeo) assessment also indicated that the reservoir was uncontaminated by Cr and Ni (Igeo < 0), slightly polluted by Pb, Cu, Zn, and Co (0 < Igeo < 1), moderately polluted by Hg and As (1 < Igeo < 2), and heavily polluted by Cd (1.44 < Igeo < 2.48). Notably, the most polluted sites were at the river mouth, followed by the sediments in branches with slight pollution. Source tracing analysis revealed that Cr, Ni, Cd, Pb, Hg, As, organic matter, total nitrogen, and total phosphorus were primarily attributed to non-point sources. In contrast, Fe was linked to the hardware industry. Moreover, Al originated from sewage and drinking water treatment processes. Cu and Zn were discharged from three components, indicating complex sources.

Conclusions
The findings underscored that non-point sources were the primary contributors to the increased risk of heavy metal contamination in the reservior’s sediment. In addition, to effectively manage the risk and enhance the aquatic environment, greater focus should be placed on the inner load of heavy metals in the sediment of the mountainous hilly riverine reservoirs, particularly after controlling external pollution sources.
Acute coronary syndrome patterns in the Young: risk factor profile and in-hospital outcomes in a tertiary referral hospital in Kenya
Authors: Kassam Nadeem , Ngunga Mzee , Varwani Mohamed , Msunza Miriam , Jeilan Mohamed 
Published: April 2024

Abstract
Introduction
Acute coronary syndrome (ACS) accounts for coronary artery disease (CAD) –related morbidity and mortality. There has been growing concern about the rising incidence of ACS among young individuals globally both in developed and developing countries, including Sub-Saharan Africa. This group’s phenotypic characteristics; risk factors and clinical outcomes are not well described. contextual and regional studies are necessary to understand the magnitude of ACS among young Individuals and help highlight challenges and opportunities for improved ACS outcomes in the region. The study aimed to describe the demographic and clinical characteristics of young individuals hospitalized with ACS and report on in-hospital outcomes.

Methodology
This single-center retrospective study was conducted at the Aga Khan University Hospital, Nairobi. Medical records of all young individuals hospitalized with ACS from 30th June 2020 to 1st May 2023 were reviewed. We defined young individuals as 50 years or below. Categorical variables were reported as frequencies and proportions, and compared with Pearson chi- square or Fisher’s exact tests. Continuous variables were reported as means or medians and compared with independent t-tests or Mann-Whitney U tests. P- value < 0.05 was considered statistically significant.

Results
Among 506 patients hospitalized with ACS, (n = 138,27.2%) were aged 50 years and below. The study population was male (n = 107, 79.9%) and African(n = 82,61.2%) predominant with a median age of 46.5 years (IQR 41.0–50.0). Hypertension (n = 101,75.4%) was noted in most study participants. More than half of the cohort were smokers (n = 69,51.5%) having a family history of premature ASCVD(n = 70,52.2%) and were on lipid-lowering therapy(n = 68,50.7%) prior to presentation. ST-segment–elevation myocardial infarction (STEMI) was the most common clinical manifestation of ACS (n = 77, 57.5%). Of the significant coronary artery disease (n = 75,56.0%), the majority of the individuals had single vessel disease (n = 60, 80%) with a predilection of left anterior deciding artery(n = 47,62.6%). The Main cause of ACS was atherosclerosis (n = 41,54.6%). The mean left ventricular ejection fraction was 46.0 (± 12.4). The in-hospital mortality was (n = 2, 1.5%).

Conclusion
This study highlights that young individuals contribute to a relatively large proportion of patients presenting with ACS at our center. The most common presentation was STEMI. The principal cause was atherosclerosis. The findings of this study highlight the importance of developing systems of care that enable the early detection of CAD. Traditional cardiovascular risk factors were prevalent and modifiable, thus targets of intervention.
Influential factors on disease activity in Crohn’s disease and their Roc curve evaluation: a cross-sectional study
Authors: Wang Jing , Tong Shuping , Lu Bingqing 
Published: April 2024

Abstract
Objective
This study aims to investigate the factors influencing disease activity in patients with Crohn’s disease (CD) and provide insights and references for the management and prevention of CD.

Methods
We recruited CD patients who met the inclusion and exclusion criteria and were treated at the First Affiliated Hospital of Soochow University from November 2022 to June 2023. Generalized linear mixed models were used to analyze the factors affecting disease activity in CD patients. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive value of these factors for disease activity.

Results
A total of 268 CD participants aged 18 to 65 were included in the study, with over 68% of them in remission or experiencing mild disease activity, indicating relatively good disease control. The results of the generalized linear mixed models showed that older age, absence of diabetes, high levels of physical activity, and a low dietary inflammatory index (DII) were protective factors for lower disease activity in CD patients (p < 0.05). ROC curve analysis demonstrated that physical activity level, age, and DII all had ROC areas greater than 0.6 in predicting disease activity in CD patients (p < 0.05).

Conclusion
The factors influencing the disease activity of CD patients are numerous and should be given attention. CD patients who are younger, have low levels of physical activity, high DII, and have diabetes are at a higher risk of increased disease activity. By reducing or avoiding the mentioned risk factors and leveraging protective factors, it is possible to mitigate the disease activity of CD to some extent.
Profiling chronic diseases and hospitalizations in older home care recipients: a nationwide cohort study in Sweden
Authors: Schmidt-Mende Katharina , Arvinge Cecilia , Cioffi Giovanni , Gustafsson Lars Lennart , Modig Karin , Meyer Anna Carina 
Published: April 2024

Abstract
Background
Older adults with home care (HC) often have complex disease patterns and use healthcare extensively. Increased understanding is necessary to tailor their care. To our knowledge, this is the first study to describe patterns of morbidity and hospitalizations among community-dwelling older HC recipients nationwide and in subgroups defined by age, sex, and amount of HC, and to compare patterns to community-dwelling older adults without HC.

Methods
Nationwide register-based cohort study in community-dwelling adults aged 70 and older receiving publicly funded HC in Sweden on January 1st 2019 and an age-and-sex matched comparison group (“non-HC recipients”). Using register data from inpatient and specialized outpatient care, we assessed the prevalence of sixty chronic diseases, frailty, multimorbidity and hospitalizations, calculated incidence rates and explored reasons for hospitalizations during two years of follow-up.

Results
We identified 138,113 HC recipients (mean age 85, 66% women, 57% ≥5 chronic diseases). The most prevalent diseases were hypertension (55%) and eye conditions (48%). Compared to non-HC recipients, HC recipients had a higher prevalence of almost all diseases, with an overrepresentation of neurological (26.1 vs. 9.5%) disease and dementia (9.3 vs. 1.5%). 61% of HC recipients were hospitalized at least once during two years, which was 1.6 times as often as non-HC recipients. One third of HC recipients´ hospitalizations (37.4%) were due to injuries, infections, and heart failure. Hospitalizations for chronic obstructive pulmonary disease, confusion, infections, and breathing difficulties were 3–5 times higher among HC recipients compared to non-HC recipients.

Conclusion
Compared to non-HC recipients, HC recipients more often live alone, have higher degrees of frailty, suffer from more chronic diseases, especially neurological disease, and are hospitalized almost twice as often. The results provide a thorough description of HC recipients, which might be useful for targeted healthcare interventions including closer collaboration between primary care, neurologists, and rehabilitation.
Determinants of household decision making autonomy among rural married women based on Ethiopian demography health survey: a multilevel analysis
Authors: Bitew Desalegn Anmut , Getahun Amare Belete , Gedef Getachew Muluye , Andualem Fantahun , Getnet Mihret 
Published: April 2024

AbstractIntroductionDecisions made at the household level have great impact on the welfare of the individual, the local community, as well as the welfare of the nation. Women’s independent decision on reproductive health increases women’s access to health information and utilization of reproductive services. This has great impact on maternal and child health outcomes. However, women in developing or low-income countries often have limited autonomy and control over their household decisions. Therefore the main purpose of this research project is to investigate the potential determinants of rural women’s household decision making autonomy.MethodsA multi level analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 8,565 married rural women was included in the final analysis. Women were considered to be autonomous if they made decisions alone or jointly with their husband in all three household decision components. It was dichotomized as yes = 1 and no = 0. Multico linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p-value ≤ 0.25 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The Adjusted Odds Ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a P-value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors.ResultA total of 8,565 weighted participants involved. From the total respondents, 68.55%(CI: 67.5%, 69.5%) of women had decision making autonomy. wealth index (poor: AOR: 0.84; 95% CI: 0.72, 0.97 and middle: AOR: 0.85; 95% CI 0.73, 0.98), literacy (illiterate: AOR: 0.75; 95% CI: 0.66, 0.86), respondents working status (Not working; AOR 0.68; 95% CI; 0.60, 0.76) ,who decides on marriage (parents: AOR 0.76; 95% CI; 0.67, 0.87), and proportion of early marriage in the community (high proportion of early marriage AOR: 1.35; 95% CI; 1.10, 1.72).ConclusionWomen decision making autonomy was significantly determined by women economic participation (their wealth and their working status), women’s literacy, proportion of early marriage in the community and women’s involvement in decision of their marriage. Improving women’s economic participation and enhancing women’s participation to decide on their marriage will enhance women’s decision making autonomy.
A cross-sectional study on turnover intention of nurses in eastern China
Authors: Huang Haolian , Wang Liping , Qian Ruilian , Zhang Yanhong 
Published: April 2024

Abstract
Background
This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors.

Methods
A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021.

Results
The turnover intention score of in-service nurses was 15 (12–17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons.

Conclusion
Nurses’ intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses’ willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.
Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon)
Authors: Takougang Innocent , Lekeumo Cheuyem Fabrice Zobel , Ze Billy Ralph Sanding , Tsamoh Forlemu Fabiola , Moneboulou Hortense Mengong 
Published: April 2024

AbstractBackgroundHealthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital.MethodsThe present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. Ap-value < 0.05 was considered significant.ResultsOut of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19;p = 0.277) and HCWs aged 35 and over (aOR = 4.11;p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9;p-value = 0.0005) and cleaners (aOR = 14.7;p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B.ConclusionsMost HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.