bluuebunny/crossref_metadata_2025_split 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

IntroductionWater 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.MethodsA 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.ResultsThree 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.ConclusionThe 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

IntroductionThis 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 presentationA 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.ConclusionThis 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.
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

ObjectivesThe 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.MethodsThis 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.ResultsA 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 &lt; 0.001). IHM rose with age, from 0.8% in patients aged 18–39 to 31.7% in those ≥80 years (p &lt; 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 &lt; 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 &lt; 0.001) and dyslipidemia (AOR: 0.85, 95% CI: 0.32–0.86, p &lt; 0.001) were protective factors.ConclusionDuring 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.
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

IntroductionGlobal 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.MethodsThis 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.ResultsThe 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.DiscussionThe 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

IntroductionAnalyzing 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.MethodsA 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 discussionDuring 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.
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

ObjectiveNon-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.MethodsData 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 &gt;1.ResultsAmong 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 &gt;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.ConclusionsThis 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

BackgroundTibial 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.MethodsA 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 &lt; 0.05 was considered statistically significant.ResultsThis 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.ConclusionThe 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

BackgroundCell saver (CS) technology is an increasingly popular approach for autotransfusion in small animal veterinary medicine for the treatment of patients with abdominal hemorrhagic effusion.ObjectiveTo 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 methodsRetrospective 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.ResultsForty-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.DiscussionThe 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

IntroductionThe 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.MethodsIn this study, H&amp;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.ResultsHistopathological 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.DiscussionThe 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

IntroductionFor 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.AimThe 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.MethodsUsing 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%.ResultsA 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.ConclusionThe 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.