bluuebunny/crossref_metadata_2025 huggingface dataset:
Enabling Within Constraints: Assessing International Aid's Impact Upon Cypriot Peacebuilding Organisations
Authors: Barrow Mark
Published: August 2023

Indigenous civil society organisations (CSOs) are receiving a larger proportion of international aid than ever before. The international community supplies them with financial support owing to the belief that they can effectively mediate between disputant communities. The impact of this situation attracts scholarly debate. Whereas scholars traditionally assert that recipients transform into service-delivery organisations tied to the interests of their donors, some allege that CSOs retain the agency to negotiate how funds are spent in accordance with their own priorities. By focusing on Cypriot peacebuilding CSOs, I add further nuance to this debate. I argue that international aid enables CSOs to carry out peacebuilding initiatives according to their underlying agenda, owing to several contextual factors, providing they adhere to donors’ expectations and restrictions. International aid cannot therefore be reduced to having a solely positive or negative impact – a more complex picture emerges, to some degree suiting both donors and CSOs.
Endovascular treatment outcomes of vertebrobasilar junction aneurysms: Systematic review and meta-analysis
Authors: Senol Yigit Can , Kobeissi Hassan , Orscelik Atakan , Bilgin Cem , Ghozy Sherief , Arul Santhosh , Kallmes David F , Kadirvel Ramanathan
Published: August 2023

Background

Vertebrobasilar junction (VBJ) aneurysms represent a relatively rare and often anatomically complex subgroup of saccular aneurysms. This systematic review and meta-analysis aimed to assess the safety and efficacy of endovascular treatment (EVT) of VBJ aneurysms.

Methods

PubMed, Web of Science, Ovid Medline, Ovid Embase, and Scopus were searched from inception to 20 December 2022. We included primary studies assessing the long-term clinical and angiographic outcomes for VBJ aneurysms treated with endovascular techniques. We excluded surgically managed studies. All data were analyzed using R software version 4.2.1. We calculated pooled prevalence rates and their corresponding 95% confidence intervals (CI).

Results

In this meta-analysis, a total of 76 VBJ aneurysms from seven studies were included for quantitative analysis. The results showed that the rate of adequate occlusion (complete + near complete occlusion) was 94.1% (95% CI = 76.71–98.71), and the rate of complete occlusion was 77.7% (95% CI = 63.07–87.65). A modified Rankin Scale (mRS) score of 0–2 was achieved in 93.9% of patients (95% CI = 67.65–99.14). The mortality rate was found to be 5.9% (95% CI = 0.97–28.55), and the retreatment rate was 4.6% (95% CI = 1.50–13.36). The overall ischemic complication rate was 4.7% (95% CI = 0.73–25.4), while the overall hemorrhagic complication rate was 4.6% (95% CI = 1.5–13.36).

Conclusions

The treatment of VBJ aneurysms with EVT is effective in achieving curative treatment and is associated with good clinical outcomes and low mortality rates. These findings provide important insights into the clinical and angiographic outcomes and the complication rates of EVT for VBJ aneurysms.
Usability of a continuous oxygen saturation device for home telemonitoring
Authors: Bonometti Francesco , Bernocchi Palmira , Vitali Andrea , Savoldelli Anna , Rizzi Caterina , Scalvini Simonetta
Published: August 2023

Background

The emergency for the COVID-19 pandemic has led to greater use of home telemonitoring devices. The aim of this study was to assess the usability of continuous home-monitoring care with an oxygen saturation device on post-COVID-19 patients.

Method

The system consists of a digital continuous pulse oximeter and a smartphone with an App, which were provided to patients. A survey composed of a standard Post-Study System Usability Questionnaire, and a satisfaction questionnaire was exploited to conduct a usability and feasibility analysis of the service.

Results

A total of 29 patients (17.2% female) with a mean age of 65 ± 11.5 years were enrolled: 20 patients were smartphone users (69%) with a mean age of 60.2 ± 9.5 years, and 9 patients (31%) did not own a smartphone (mean age 76.8 ± 5.9). The monitoring period was 1 month: a total of 444 recordings were conducted, 15 recordings per patient averagely. In total, 82% of the recordings performed did not require any intervention, while 18% led to the production of a report and subsequent intervention by a nurse who verified, together with the specialist, the need to intervene (i.e. the patient accessed the clinic for medical control and/or modification of oxygen therapy). A total of 17 patients compiled a usability questionnaire. The service was perceived as useful and well-structured, although it often required caregiver support.

Conclusions

Using continuous home-monitoring care with an oxygen saturation device seems feasible and useful for patients who could be followed at home avoiding going back to the hospital every time a trend oximetry is needed. Further improvements in connections, data flow processes, and simplifications, based on patients’ feedback, are needed to scale up the service.
A Journey Along the Frontier: My Attempts to Bring Accountability to Shadow Education in Australia and Beyond
Authors: Dhall Mohan
Published: August 2023

Highlights

This article provides insights into stakeholders’ challenges while bringing educational accountability to private tutoring providers through a self-regulation model. There is no participant involved in this narrative inquiry study. Policymakers may be ambivalent about bringing accountability as their families may benefit from private tutoring. This account is written from the perspective of a teacher-trained tutor who has worked with policymakers to address some of the challenges. This first-person narrative describes the experience of establishing a national peak body to bring greater accountability to private tutoring providers. This peak body is unique because it positions the educational interests of students as at least equal to providers’ commercial interests. The author believes that greater accountability for tutoring businesses is required in all markets and that issues will not resolve through self-regulation alone.
Republication of “Proximal Rotational Metatarsal Osteotomy for Hallux Valgus (PROMO): Short-term Prospective Case Series With a Novel Technique and Topic Review”
Authors: Wagner Pablo , Wagner Emilio
Published: August 2023

Background:

Hallux valgus deformity consists of a lateral deviation of the great toe, metatarsus varus, and pronation of the first metatarsal. Most osteotomies only correct varus, but not the pronation of the metatarsal. Persistent postoperative pronation has been shown to increase deformity recurrence and have worse functional outcomes. The proximal rotational metatarsal osteotomy (PROMO) technique reliably corrects pronation and varus through a stable osteotomy, avoiding fusing any healthy joints. The objective of this research is to show a prospective series of the PROMO technique.

Methods:

Twenty-five patients (30 feet) were operated with the PROMO technique. The sample included 22 women and 3 men, average age 46 years (range 22-59), for a mean prospective follow-up of 1 year (range 9-14 months). Inclusion criteria included symptomatic hallux valgus deformities, absence of severe joint arthritis, or inflammatory arthropathies, with a metatarsal malrotation of 10 degrees or more, with no tarsometatarsal subluxation or arthritis on the anteroposterior or lateral foot radiograph views. The mean preoperative and postoperative Lower Extremity Functional Scale (LEFS) score, metatarsophalangeal angle, intermetatarsal angle, metatarsal malrotation, complications, satisfaction, and recurrence were recorded.

Results:

The mean preoperative and postoperative LEFS scores were 56 and 73. The median pre-/postoperative metatarsophalangeal angle was 32.5/4 degrees and the intermetatarsal angle 15.5/5 degrees. The metatarsal rotation was satisfactorily corrected in 24 of 25 patients. An Akin osteotomy was needed in 27 of 30 feet. All patients were satisfied with the surgery, and no recurrence or complications were found.

Conclusions:

PROMO is a reliable technique, with good short-term results in terms of angular correction, satisfaction, and recurrence. Long-term studies are needed to determine if a lower hallux recurrence rate occurs with the correction of metatarsal rotation in comparison with conventional osteotomies.

Level of evidence:

IV, prospective case series.
Republication of “Evidence Versus Practice: Operative Treatment Preferences in Hallux Valgus”
Authors: Noback Peter C. , Trofa David P. , Vosseller J. Turner
Published: August 2023

Background:

There is substantial variability in the operative treatment of hallux valgus despite the existence of high quality evidence to guide treatment decisions. The purpose of this study was to determine the current trends in the treatment of mild, moderate, and severe hallux valgus and if greater degrees of consensus correlate with the presence of higher-level evidence.

Methods:

Members of the American Orthopaedic Foot & Ankle Society completed a 14-item survey. A total of 131 (14%) of 922 members completed the survey. Three cases representing 3 stages of HV were presented, and respondents selected their preferred treatment. Preferred forms of proximal and distal metatarsal osteotomies, as well as mode of fixation for each, were inquired.

Results:

In the treatment of mild hallux valgus without second metatarsalgia, 80% of those surveyed chose a distal metatarsal osteotomy, while, if second metatarsalgia was present, 56% chose a distal metatarsal osteotomy with a second metatarsal-shortening osteotomy. In the treatment of moderate hallux valgus, there was generally less consensus, while, in the treatment of severe hallux valgus, a majority of those surveyed chose a Lapidus procedure, with the addition of a second metatarsal-shortening osteotomy in the presence of second metatarsalgia. The most popular distal and proximal metatarsal osteotomies, respectively, were chevron osteotomy (80%) and opening wedge osteotomy (33%). The presence of Level I evidence did not significantly correlate with higher degrees of consensus.

Conclusion:

Despite the existence of high-quality evidence supporting the use of certain procedures in the treatment of HV, there exists an apparent lack of consensus among surgeons about the choice of surgical procedures. Moreover, higher-level evidence was not correlated with greater consensus in hallux valgus.

Level of Evidence:

Level II.
Democratising Healthcare in India: Opportunities and Challenges
Authors: Singh Shalini
Published: August 2023

India is in a state of distinctive paradox. On one side, it is ranked the fifth largest economy in the world with the aim to be among the top three by 2030, while on the other hand, the country’s equally important health sector lags and is ranked 145 among 195 countries on the Healthcare Access and Quality Index (HAQ; GBD 2016 Healthcare Access and Quality Collaborators, 2018). Despite significant thrust on healthcare and reforms over the last decade that have positively impacted life expectancy, helped lower infant mortality rate and provided better health coverage due to government initiatives like Ayushman Bharat and the National Health Mission, healthcare in India still faces critical challenges and is crippled with many deficiencies around health quality, accessibility, affordability and safety. This perspective article explores the opportunities and challenges in healthcare delivery in India and why it is imperative to implement a framework for connecting all the stakeholders in the healthcare ecosystem to facilitate equitable access to quality and affordable healthcare. The article also reflects on models of collaboration, connected health and coopetition to strengthen and streamline the healthcare sector for improved outcomes.
Building an action plan to tackle palliative care inequality through multi-stakeholder platforms
Authors: Sánchez-Cárdenas Miguel Antonio , León-Delgado Marta Ximena , Rodríguez-Campos Luisa Fernanda , Correa-Morales Juan Esteban , González-Salazar Laura Vannesa , Cañón Piñeros Ángela María , Fuentes-Bermúdez Genny Paola , María Vargas-Escobar Lina
Published: August 2023

Background:

To achieve universal care and overcome existing barriers, the most effective strategy is to devise an action plan that incorporates palliative care into primary health care (PHC), as recommended by the World Health Organization’s (WHO) Astana Declaration. In Colombia, a country with an upper-middle-income status, about 128,000 individuals experience severe health-related suffering (SHS) that necessitates palliative care. Although the country’s healthcare system has made steady strides in the integration and development of palliative care, there is still no national plan in place for palliative care.

Objective:

Build up Colombia’s palliative care plan through stakeholder consensus.

Method:

Based on the participatory action research method and the multi-stakeholder platforms model, this study convened 142 stakeholders from different levels of the health system (patient representatives, journalists, health professionals, government entities, insurance companies, universities, and drug regulatory authorities)

Results:

The national plan aims to achieve its objectives through a series of strategic actions. These include integrating and diversifying palliative care services, improving access to opioids, increasing palliative care education, promoting community-based palliative care programs, securing funding, and implementing a regulatory framework for palliative care by public policymakers.

Conclusions:

The national palliative care is an alliance that aims to reduce palliative care inequity in Colombia by 2026 by empowering stakeholders nationwide to collaborate around specific goals and objectives.
Comparison of selected prooxidant-antioxidant balance and bone metabolism indicators and BDNF levels between older women with different levels of physical activity
Authors: Sadowska-Krępa Ewa , Rzetecki Adam , Zając-Gawlak Izabela , Nawrat-Szołtysik Agnieszka , Rozpara Michał , Mikuľáková Wioletta , Stanek Agata , Pałka Tomasz
Published: August 2023

Background

Given a lack of studies precisely indicating how many steps elderly people should take daily for their antioxidant defence, bone metabolism, and cognitive abilities to improve, our study set out to compare the selected antioxidant, prooxidant, bone turnover, and BDNF indicators between elderly women differing in physical activity (PA) measured by the daily number of steps.

Methods

The PA levels of 62 women aged 72.1 ± 5.4 years were assessed based on their daily number of steps and then were used to allocate the participants to three groups: group I (n = 18; <5,000 steps a day); group II (n = 22; from 5,000 to 9,999 steps a day); and group III (n = 22; ≥10,000 steps a day). Blood samples were collected from the participants in early morning hours and subjected to biochemical analysis for prooxidant-antioxidant balance indicators (SOD, CAT, GPx, GR, GSH, UA, MDA and TOS/TOC), bone metabolism indicators (Ca, 25-OH vitamin D, osteocalcin, CTX-I, and PTH), and BDNF levels.

Results

The groups were not statistically significantly different in the activity of SOD, CAT, GPx, and GR, but their concentrations of GSH (H = 22.10, p < 0.001) and UA (H = 12.20, p = 0.002) proved to be significantly associated with the groups’ daily PA. The between-group differences in the concentrations of MDA and TOS/TOC were not significant, with both these indicators tending to take higher values in group I than in groups II and III. Significant differences between the groups were established for the concentrations of 25-OH vitamin D (H = 24.21, p < 0.001), osteocalcin (H = 7.88, p = 0.019), CTX-I (H = 12.91, p = 0.002), and BDNF (H = 14.47, p = 0.001), but not for Ca and PTH.

Conclusions

Significantly higher concentrations of GSH, slightly lower oxidative stress indicators, significantly higher BDNF levels, and moderately better bone turnover indicators and resorption markers in the group taking more than 5,000 steps a day suggest that this level of PA can promote successful aging. More research is, however, needed to confirm this finding.
Genotype diversity of brucellosis agents isolated from humans and animals in Greece based on whole-genome sequencing
Authors: Brangsch Hanka , Sandalakis Vassilios , Babetsa Maria , Boukouvala Evridiki , Ntoula Artemisia , Makridaki Eirini , Christidou Athanasia , Psaroulaki Anna , Akar Kadir , Gürbilek Sevil Erdenlig , Jamil Tariq , Melzer Falk , Neubauer Heinrich , Wareth Gamal
Published: August 2023

Background

Brucellosis is a zoonotic disease whose causative agent,Brucellaspp., is endemic in many countries of the Mediterranean basin, including Greece. Although the occurrence of brucellosis must be reported to the authorities, it is believed that the disease is under-reported in Greece, and knowledge about the genomic diversity of brucellae is lacking.

Methods

Thus, 44Brucellaisolates, primarilyB. melitensis, collected between 1999 and 2009 from humans and small ruminants in Greece were subjected to whole genome sequencing using short-read technology. The raw reads and assembled genomes were used forin silicogenotyping based on single nucleotide substitutions and alleles. Further, specific genomic regions encoding putative virulence genes were screened for characteristic nucleotide changes, which arose in different genotype lineages.

Results

In silicogenotyping revealed that the isolates belonged to three of the known sublineages of the East Mediterranean genotype. In addition, a novel subgenotype was identified that was basal to the other East Mediterranean sublineages, comprising two Greek strains. The majority of the isolates can be assumed to be of endemic origin, as they were clustered with strains from the Western Balkans or Turkey, whereas one strain of human origin could be associated with travel to another endemic region, e.g. Portugal. Further, nucleotide substitutions in the housekeeping generpoBand virulence-associated genes were detected, which were characteristic of the different subgenotypes. One of the isolates originating from an aborted bovine foetus was identified asB. abortusvaccine strain RB51.

Conclusion

The results demonstrate the existence of several distinct persistentBrucellasp. foci in Greece. To detect these and for tracing infection chains, extensive sampling initiatives are required.
Identifying patient perceived values during outpatient encounters: an empirical study from Chinese public hospitals
Authors: Liu Sha , Hu Yinhuan , Lu Chuntao , Li Dehe , Zhang Zemiao
Published: August 2023

Background

Focusing on patients’ perceived values is essential for patient-centered health care. Only by identifying the patient’s preferred values can we better meet their needs and provide them with valuable medical services. This study aimed to construct and validate a research model to obtain an overall quantification of patient value during outpatient encounters.

Methods

The development of the research model was based on the reviewed literature, and an initial theoretical framework was formed by an expert panel discussion. A scale questionnaire for all the items was adapted from previous research related to patient value, verified using a presurvey, and thus used for data collection for this study. The structural equation model was used to determine and evaluate the research model of the values patients perceived during outpatient encounters.

Results

572 eligible respondents who completed outpatient visits from a typical public hospital in China participated in this study from November 2020 to February 2021. We constructed the patient perceived value (PPV) model to identify core values, which includes eight dimensions and 29 items in terms of functional value (installation, efficiency, price, service quality), emotional value (interactive, control), and social value (accessibility, image) from two subgroups of patient value outside and in the outpatient visit process. Cronbach’s alpha for the whole model was 0.950. The confirmatory factor analysis showed that the PPV model fits well, with a correlation of 0.83 between the two subgroups.

Conclusion

It is essential to recognize the values based on patients’ perceptions and experiences throughout the entire visit process. Our findings offer targeted insights for healthcare administrators, enabling them to holistically optimize outpatient service processes and continually enhance the quality of outpatient medical services from the patient’s perspective.
Characterization and application of a lactate and branched chain amino acid metabolism related gene signature in a prognosis risk model for multiple myeloma
Authors: Yu Zhengyu , Qiu Bingquan , Zhou Hui , Li Linfeng , Niu Ting
Published: August 2023

Background

About 10% of hematologic malignancies are multiple myeloma (MM), an untreatable cancer. Although lactate and branched-chain amino acids (BCAA) are involved in supporting various tumor growth, it is unknown whether they have any bearing on MM prognosis.

Methods

MM-related datasets (GSE4581, GSE136337, and TCGA-MM) were acquired from the Gene Expression Omnibus (GEO) database and the Cancer Genome Atlas (TCGA) database. Lactate and BCAA metabolism-related subtypes were acquired separately via the R package “ConsensusClusterPlus” in the GSE4281 dataset. The R package “limma” and Venn diagram were both employed to identify lactate-BCAA metabolism-related genes. Subsequently, a lactate-BCAA metabolism-related prognostic risk model for MM patients was constructed by univariate Cox, Least Absolute Shrinkage and Selection Operator (LASSO), and multivariate Cox regression analyses. The gene set enrichment analysis (GSEA) and R package “clusterProfiler"were applied to explore the biological variations between two groups. Moreover, single-sample gene set enrichment analysis (ssGSEA), Microenvironment Cell Populations-counter (MCPcounte), and xCell techniques were applied to assess tumor microenvironment (TME) scores in MM. Finally, the drug’s IC50 for treating MM was calculated using the “oncoPredict” package, and further drug identification was performed by molecular docking.

Results

Cluster 1 demonstrated a worse prognosis than cluster 2 in both lactate metabolism-related subtypes and BCAA metabolism-related subtypes. 244 genes were determined to be involved in lactate-BCAA metabolism in MM. The prognostic risk model was constructed by CKS2 and LYZ selected from this group of genes for MM, then the prognostic risk model was also stable in external datasets. For the high-risk group, a total of 13 entries were enriched. 16 entries were enriched to the low-risk group. Immune scores, stromal scores, immune infiltrating cells (except Type 17 T helper cells in ssGSEA algorithm), and 168 drugs’IC50 were statistically different between two groups. Alkylating potentially serves as a new agent for MM treatment.

Conclusions

CKS2 and LYZ were identified as lactate-BCAA metabolism-related genes in MM, then a novel prognostic risk model was built by using them. In summary, this research may uncover novel characteristic genes signature for the treatment and prognostic of MM.
Looking at maternal health of Asháninka communities from the conceptual framework of the accessibility of care
Authors: Lazo-Gonzales Angel Oswaldo , Sarmiento-Casavilca Tania , Espinosa-Henao Olga Elena , Ruelas-González Maria Guadalupe , Alcalde-Rabanal Jacqueline Elizabeth
Published: August 2023

Background

Peru is one of the 20 countries that has significantly reduced maternal mortality before the pandemic due to implementing policies to strengthen maternal health care, mainly in rural areas with greater poverty. However, the implementation of these policies has been different across the territory; such is the case of the indigenous communities of the Peruvian Amazon that are characterized by the inaccessibility of their territory and continue to face severe problems in accessing maternity care in health services.

Objective

Analyze the main dimensions of accessibility for maternal care in public health services for women of the Asháninka community of Peru between 2016 and 2018.

Methods

Qualitative research was carried out in the Asháninka community of the Tambo River. Key informants involved in maternal health care were selected, and 60 in-depth interviews were conducted that explored geographical, financial, cultural, and organizational accessibility. The interviews were recorded and transcribed into a word processor; then, a content analysis was performed to classify the texts according to the dimensions of specified accessibility.

Results

Geographical accessibility: health units in the territory do not have the resolution capacity to attend maternal health problems. Financial accessibility: the programs implemented by the government have not been able to finance the indirect costs of care, such as transportation, which has high costs that a family cannot afford, given their subsistence economy. Cultural: there are efforts for cultural adaptation of maternal care, but its implementation needs to be improved, and the community cannot recognize it due to the lack of continuity of the model and the high personnel turnover. Organizational: health units are characterized by insufficient human resources, supplies, and medicines that fail to offer continuous and quality care.

Conclusions

The poor geographical, financial, cultural, and organizational accessibility that women from the Asháninka community face for maternal care in public health services are evident. So, the Peruvian government must review the implementation processes of its models of care and maternal health programs in these communities and propose strategies to improve the coverage, quality and continuity of maternal care.
Temporal trends of sepsis-related mortality in China, 2006–2020: a population-based study
Authors: Dong Run , Liu Wei , Weng Li , Yin Peng , Peng Jinmin , Chen Yan , Li Shan , Wang Chunyao , Jiang Wei , Hu Xiaoyun , Du Bin , Zhou Maigeng ,   for the China Critical Care Clinical Trials Group (CCCCTG)
Published: August 2023

Background

The scarcity of sepsis epidemiologic data from most low- and middle-income countries (LMICs) hampered estimation of regional and global burden of the disease, and provided limited guidance for policy makers. We aimed to characterize and analyze the temporal trends of sepsis-related mortality in China, by population groups, underlying causes of death, geographic regions, and sociodemographic index (SDI) levels.

Methods

Sepsis-related deaths were identified from the National Mortality Surveillance System (NMSS) of China from 2006 to 2020. Trends of sepsis-related mortality and years of life lost (YLLs), stratified by age, sex, underlying diseases, and regions were analyzed using the Jointpoint regression analysis. We investigated the association of SDI with trends of sepsis-related mortality.

Results

In 2020, sepsis was estimated to be responsible for 986,929 deaths and 17.1 million YLLs in China. Age-standardized sepsis-related mortality significantly declined from 130.2 (95%CI, 129.4–131) per 100,000 population in 2006 to 76.6 (76.3–76.9) in 2020. Age-standardized YLLs decreased from 2172.7 (2169.4–2176) per 100,000 population in 2006 to 1271 (1269.8–1272.2) in 2020. Substantial variations of sepsis-related mortality and YLLs were observed between population groups and regions, with higher burden in males, the elderly, and western China. An inverse relation was noted between SDI and sepsis-related mortality or YLLs.

Conclusions

Despite declining trends of age-standardized mortality and YLLs of sepsis in China, significant disparities between population groups and regions highlight a need for targeted policies and measures to close the gaps and improve the outcome of sepsis.
Enterotypes of the human gut mycobiome
Authors: Lai Senying , Yan Yan , Pu Yanni , Lin Shuchun , Qiu Jian-Ge , Jiang Bing-Hua , Keller Marisa Isabell , Wang Mingyu , Bork Peer , Chen Wei-Hua , Zheng Yan , Zhao Xing-Ming
Published: August 2023

Background

The fungal component of the human gut microbiome, also known as the mycobiome, plays a vital role in intestinal ecology and human health. However, the overall structure of the gut mycobiome as well as the inter-individual variations in fungal composition remains largely unknown. In this study, we collected a total of 3363 fungal sequencing samples from 16 cohorts across three continents, including 572 newly profiled samples from China.

Results

We identify and characterize four mycobiome enterotypes using ITS profiling of 3363 samples from 16 cohorts. These enterotypes exhibit stability across populations and geographical locations and significant correlation with bacterial enterotypes. Particularly, we notice that fungal enterotypes have a strong age preference, where the enterotype dominated by Candida (i.e., Can_type enterotype) is enriched in the elderly population and confers an increased risk of multiple diseases associated with a compromised intestinal barrier. In addition, bidirectional mediation analysis reveals that the fungi-contributed aerobic respiration pathway associated with the Can_type enterotype might mediate the association between the compromised intestinal barrier and aging.

Conclusions

We show that the human gut mycobiome has stable compositional patterns across individuals and significantly correlates with multiple host factors, such as diseases and host age.
Recovery from (treatment-resistant) depression after lifestyle changes and micronutrient precision supplementation: a preliminary field study in patients
Authors: Mader Isabella M.
Published: August 2023

Background and purpose

The incidence of depression is increasing, despite continued advances in psychological and pharmacological interventions. New treatment approaches are urgently needed. Here we assess the effects on depression of individualized micronutrient supplementation, in concert with a standard set of lifestyle changes.

Methods

We conducted a small field-study with 17 participants in Austria. Patients with depression (n = 11) and healthy volunteers (n = 6) underwent laboratory serum analysis and filled out the DASS-21 and a questionnaire about their medical history and condition. The list of parameters to be tested in the serum analysis was derived from an expert heuristic compilation of factors known to influence depression, narrowed down to a workable list to be tested in this initial study. On the basis of the results, the participants (n = 17) received individualized recommendations for micronutrient supplementation, in collaboration with their treating physician. Participants followed the individual supplementation regime for two months, along with a standard set of lifestyle changes. After two months the laboratory serum analyses, the DASS-21, and the questionnaire were repeated.

Results

All patients with micronutrient deficiencies were in the patient group; none of the healthy volunteers showed any micronutrient deficiencies. After two months of precision supplementation and lifestyle changes, all but one patient had recovered from their depression or had considerably improved. The one patient who didn’t recover was the only one with a known trigger of their depression (trauma). Of 11 patients with depression, the trigger was unknown for the other ten.

Conclusions

These results have promising implications for further research, treatment, drug development, and public health. We propose that systematic screening of patients with symptoms of depression be developed for future research, medical care, and practice. Psychiatry and psychotherapy may see improved results once they no longer have to push against the underlying constraints of existing micronutrient deficiencies.
Comparison of dislocation rates of Teflon and Titanium stapes prostheses: A retrospective survival analysis on 855 patients
Authors: Gargula Stéphane , Daval Mary , Lecoeuvre Adrien , Ayache Denis
Published: August 2023

Background

Stapes prosthesis dislocation is the first cause of revision stapes surgery. To our knowledge, there is no data about stability of the incus attachment of manual crimped prosthesis of different materials. This study aimed to compare the dislocation incidence between titanium and fluoroplastic stapes prostheses.

Method

A monocentric retrospective cohort study was conducted between January 2013 and June 2022 in a tertiary-care center. All patients that underwent a primary stapes surgery with manually crimped fluoroplastic or titanium prostheses were included. Prosthesis dislocation from the incus was identified intraoperatively or with CT scan. The incidence of stapedial prosthesis dislocation over time was estimated using the Kalbfleisch and Prentice survival analysis method. Other indications for revision surgery prior to prosthesis dislocation were considered as competing events. Differences in the cumulative incidence functions between the fluoroplastic group and the titanium group was assessed using the Gray's test.

Results

Eight hundred and fifty-five patients underwent primary stapes surgery during the study period. Fluoroplastic prosthesis was used in 758 (88.7%) cases and titanium prosthesis in 97 (11.3%) cases. Median follow-up was 51.7 months (28.4–80.1). Dislocation was observed in 23 (3.0%) patients with fluoroplastic prosthesis and none (0.0%) in the titanium group. The probability of prosthesis dislocation at two years after surgery was 3.5% in the Teflon group and 0.0% in the Titanium group. No significant difference was found in the cumulative incidence of prosthesis dislocation between the fluoroplastic group and the titanium group (p = 0.12).

Conclusions

Despite lack of statistical power, our results suggest a trend in a more stable incus attachment of manually crimped titanium stapes prosthesis compared to fluoroplastic over time. Further prospective randomized studies could be valuable to assess our findings.

Graphical Abstract
Deriving mineral moduli of the noncarbonate fraction in a marly chalk reservoir using petrophysical logging data and an isoframe model
Authors: Meireles Leonardo T. P. , Fabricius Ida L.
Published: August 2023

Knowledge of the elastic properties of clays and clay-rich sediments is essential when performing quantitative seismic interpretation and geomechanical modeling of reservoirs where they are present. Such is the case for the marly chalk reservoirs of Lower Cretaceous age in the Danish North Sea. We develop a new method to derive the elastic properties of the clay-rich insoluble residue (IR) fraction in marly chalks, using petrophysical logs and rock physical modeling. We calculate compressional ( M), shear ( G), and bulk ( K) moduli of the formation along the borehole using the density and sonic (shear and compressional) logs and model the elastic properties of minerals using the isoframe (IF) rock-physics model. In our model, the marly chalk is composed of two materials: calcite, with well-known elastic properties, and the IR fraction, whose elastic properties are the sought variable. We systematically vary the assumed elastic properties of the IR fraction, each time achieving equality between the measured and modeled elastic moduli solving for the IF values of calcite ([Formula: see text]) and IR fraction ([Formula: see text]) for each of the three elastic parameters one at a time, deriving the modeled values for the other two. We add up the error between the modeled and logged values for each set of assumed elastic properties of the IR fraction. We adopt the values of [Formula: see text] and [Formula: see text] that minimize the compound error as the actual elastic properties of the IR fraction. We run the algorithm in the Boje-2C and Valdemar-2H wells in different stratigraphic units of the Lower Cretaceous: the Fanø Formation and the marly chalk of the Tuxen and Sola formations. Elastic properties derived for the IR fraction compare well to data for wet clays from ultrasonic velocity laboratory tests. In a clean chalk section (almost 100% calcite), the model outputs values similar to calcite.
Practical aspects of multiaxial classification: a clinically useful biopsychosocial framework for child and adolescent psychiatry
Authors: Mayall Mark , McDermott Brett , Sadhu Raja , Teoh Yvonne , Bosanquet Margot , Nundeekasen Sunaina
Published: August 2023

Multiaxial classification system development (organising important and relevant clinical factors under multiple headings or ‘axes’) has a long history stretching back to the 1940s. The World Health Organization supported the development of a multiaxial system of classification for children from the 1960s and in the 1990s produced a comprehensive multiaxial system which could be used with ICD-10. Using the multiaxial approach provides for an atheoretical framework that can integrate factors from within the child and the environmental influences on the child. This article presents a variety of ways in which the ICD-10 multiaxial framework can be extended from its classic usage to provide clinicians with valuable tools to assist in a biopsychosocial clinical assessment. Using the multiaxial system in an extended format allows a more comprehensive diagnosis and planning of treatments and is helpful in the training and teaching of juniors. It is also useful in evaluating responses to medication when it is combined with a chronological analysis and can provide other useful ways of integrating information relevant to understanding clinical cases.
Evolution of Breast Cancer Recurrence Risk Prediction: A Systematic Review of Statistical and Machine Learning–Based Models
Authors: El Haji Hasna , Souadka Amine , Patel Bhavik N. , Sbihi Nada , Ramasamy Gokul , Patel Bhavika K. , Ghogho Mounir , Banerjee Imon
Published: August 2023

PURPOSE

Selection of appropriate adjuvant therapy to ultimately reduce the risk of breast cancer (BC) recurrence is a challenge for medical oncologists. Several automated risk prediction models have been developed using retrospective clinical data and have evolved significantly over the years in terms of predictors of recurrence, data usage, and predictive techniques (statistical/machine learning [ML]).

METHODS

Following PRISMA guidelines, we performed a systematic literature review of the aforementioned statistical and ML models published between January 2008 and December 2022 through searching five digital databases—PubMed, ScienceDirect, Scopus, Cochrane, and Web of Science. The comprehensive search yielded a total of 163 papers and after a screening process focusing on papers that dealt exclusively with statistical/ML methods, only 23 papers were deemed appropriate for further analysis. We benchmarked the studies on the basis of development, evaluation metrics, and validation strategy with an added emphasis on racial diversity of patients included in the studies.

RESULTS

In total, 30.4% of the included studies use statistical techniques, while 69.6% are ML-based. Among these, traditional ML models (support vector machines, decision tree, logistic regression, and naïve Bayes) are the most frequently used (26.1%) along with deep learning (26.1%). Deep learning and ensemble learning provide the most accurate predictions (AUC = 0.94 each).

CONCLUSION

ML-based prediction models exhibit outstanding performance, yet their practical applicability might be hindered by limited interpretability and reduced generalization. Moreover, predictive models for BC recurrence often focus on limited variables related to tumor, treatment, molecular, and clinical features. Imbalanced classes and the lack of open-source data sets impede model development and validation. Furthermore, existing models predominantly overlook African and Middle Eastern populations, as they are trained and validated mainly on Caucasian and Asian patients.
Predictors of mortality for major trauma patients in intensive care: A retrospective cohort study
Authors: Jennings Michael , Booker James , Addison Amy , Egglestone Rebecca , Dushianthan Ahilanandan
Published: August 2023

Background: Major trauma places substantial demand on critical care services, is a leading cause of death in under 40-year-olds and causes significant morbidity and mortality across all age groups. Various factors influence patient outcome and predefining these could allow prognostication.  The aim of this study was to identify predictors of mortality from major trauma in intensive care.

Methods: This was a retrospective study of adult trauma patients admitted to general intensive care between January 2018 and December 2019. We assessed the impact on mortality of patient demographics, patterns of injury, injury scores (Glasgow Coma Score (GCS), Charlson’s comorbidity index (CCI), Acute Physiology and Health Evaluation II (APACHE II), Injury Severity Score (ISS) and Probability of Survival Score (Ps19)), number of surgeries and mechanism of injury using logistic regression.

Results: A total of 414 patients were included with a median age of 54 years (IQR 34–72). Overall mortality was 18.6%. The most common mechanism of injury was traffic collision (46%). Non-survivors were older, had higher ISS scores with lower GCS on admission and probability of survival scores. Factors independently predictive of mortality were increasing age (OR 1.06, p <0.001) and GCS <15 on admission (OR 7.21, p <0.001). Ps19 was the best predictor of mortality (p <0.001 for each score category), with an AUROC of 0.90.

Conclusions: The significant mortality predictors were age, fall from <2 metres, injury of head or limbs, GCS <15 and Ps19. Contrary to previous studies CCI and APACHE II did not significantly predict mortality. Although Ps19 was found to be the best current prognostic score, trauma prognostication would benefit from a single validated scoring system incorporating both physiological variables and injury patterns.
Code and Data Repository for Distributionally Robust Chance-Constrained p-Hub Center Problem
Authors: Zhao Yue , Chen Zhi , Zhang Zhenzhen
Published: August 2023

This archive is distributed in association with the INFORMS Journal on Computing under the MIT License. This repository contains supporting material for the paper Distributionally Robust Chance Constrained p-Hub Center Problem by Y. Zhao, Z. Chen and Z.Z. Zhang.
Code and Data Repository for PaPILO: A Parallel Presolving Library for Integer and Linear Optimization with Multiprecision Support
Authors: Gleixner Ambros , Gottwald Leona , Hoen Alexander
Published: August 2023

PaPILO, a C++14-based software package, provides parallel presolve routines for (mixed integer) linear programming problems. The routines are implemented using templates which allows switching to higher precision or rational arithmetic using the boost multiprecision package. Additionally to the distribution here under the LGPLv3, PaPILO is also distributed as part of the SCIP Optimization Suite which is available under https://scipopt.org/. PaPILO can be used as a header-based library and also provides an executable. Using the executable it is possible to presolve and postsolve MILP instances based on files. Additionally, PaPILO can be linked to SCIP, SoPlex, and HiGHS (https://github.com/ERGO-Code/HiGHS) solvers and act as a frontend. In this setting PaPILO passes the presolved problem to those solvers and applies the postsolve step to the optimal solution. When PaPILO is compiled as part of the SCIP Optimization Suite linking of SoPlex and SCIP solvers is performed automatically. Note: The original instance of this repository is hosted at git.zib.de and a read-only mirror is available at github.com/scipopt/papilo.
Pembuatan Media Penyuluhan Berbasis Kasus Data Penyebab Diare pada Balita di Daerah Keputih yang Berobat di Medical Center ITS
Authors: Permatasari Erma Oktania , Budiantara I Nyoman , Rumiati Agnes Tuti , Zain Ismaini , Ratnasari Vita , Ratna Madu
Published: August 2023

Salah satu permasalahan kependudukan di Indonesia adalah kesehatan balita. Penyakit yang dianggap ganas dan menjadi peringkat ketiga pada kasus kematian balita adalah diare. Diare merupakan peningkatan pengeluaran tinja dengan konsistensi lebih cair dan terjadi minimal 3 kali dalam 24 jam. Diare pada balita mengeluarkan tinja > 10 g/kg/24 jam, sedangkan rata-rata pengeluaran tinja sebesar 5-10 g/kg/24 jam. Diare terdiri dari dua macam, yaitu diare akut yang berlangsung kurang dari 14 hari dan diare kronik yang berlangsung lebih dari 15 hari. Medical Center mencatat terdapat peningkatan kasus diare pada balita setiap bulan dari tahun 2019 sampai 2020. Medical Center ITS merupakan pelayanan kesehatan yang terdapat di ITS dan mitra karena sasaran pengabdian masyarakat ini adalah masyarakat di Kelurahan Keputih, Sukolilo, Surabaya. Diare diduga dipengaruhi oleh tempat pembuangan tinja keluarga, sumber air minum yang digunakan sehari-hari, pendidikan orang tua, pekerjaan orang tua, usia anak, pemberian ASI eksklusif oleh ibu kepada balita, kebiasaan mencuci tangan orang tua, dan kebiasaan mencuci bahan makanan. Perlu adanya diskusi dengan narasumber (dokter dari Medical Center ITS) dan analisis lebih lanjut untuk mengetahui faktor signifikan penyebab kasus diare pada balita. Hasil tersebut dilakukan pembuatan media penyuluhan kepada masyarakat dengan harapan kasus diare pada balita dapat diminimalkan.
Perancangan Proses Bisnis Marketing Communication Produk Stroberi dan Olahan Stroberi pada Kelompok Wanita Tani dengan Metode Model-Based and Integrated Process Improvement (MIPI) di Desa Pandanrejo, Kota Batu Malang
Authors: Rahmawati Deti , Soedarso Soedarso , Hanoraga Tony , Setyaningsih Yuni , Nisa Khairun
Published: August 2023

Akselerasi keseimbangan pembangunan desa dan kota dapat diwujudkan dengan menciptakan pariwisata di desa. Desa wisata merupakan salah satu cara untuk membangkitkan pariwisata desa. Pengabdian masyarakat ini dilakukan di Desa Wisata Pandanrejo yang memiliki wisata petik stroberi. Dalam upaya pengembangannya terdapat hambatan dan tantangan. Sehingga untuk mendukung terwujudnya desa wisata yang berkelanjutan dan dapat meningkatkan kesejahteraan masyarakat sekitarnya, dibutuhkan kerjasama antar elemen. Kelompok Wanita Tani (KWT) merupakan kelompok rentan yang perlu mendapatkan pendampingan. Metode yang digunakan dalam pemberdayaan KWT ini adalah Model-based and Integrated Process Improvement (MIPI). Peningkatan pasar penjualan produk stroberi dari sisi perbaikan proses bisnis marketing communication dengan Metode MIPI menjadikan proses bisnis menjadi lebih detail dan mudah diaplikasikan. MIPI memberi solusi dengan langkah-langkah yang komprehensif bagi peningkatan pemasaran. Melalui metode MIPI, keterlibatan Kelompok Wanita Tani (KWT) dapat terlaksana lebih baik dikarenakan adanya aspek komunikasi yang terintegrasi terhadap konsumen melalui media massa guna penyampaian informasi yang efisien sehingga tujuan bisnis dapat tercapai. Hal ini dapat membawa manfaat dalam kesejahteraan KWT sehingga potensi lumbung stroberi ini nantinya dapat menjadikan Desa Pandanrejo sebagai desa wisata yang maju dan mandiri.