bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPACT OF CONTRACT FARMING ON SMALLHOLDER FARMERS’ INCOME AND FOOD SECURITY IN MOZAMBIQUE. A REVIEW
Authors: Ponguane Sérgio 
Published: August 2024

Contract farming can potentially address agricultural market failures, especially in developing countries. However, the debate on how smallholder farmers benefit and the circumstances under which such benefits can be achieved seems to be far from reaching a consensus. This review aimed to analyze the impact of contract farming on smallholder farmers’ income and food security in Mozambique using a systematic literature review protocol. The results show that the literature analyzing such relationships is limited. However, contract farming has the potential to increase income, but the nature of the contract, the actors involved, and the crops under the contract appear to be the key determinants of contract farming outcomes. Furthermore, the results show positive selection trends between firms and farmers, making estimating the net effect of contract farming difficult. Concerning food security, the reviewed studies did not allow us to draw consistent conclusions regarding its relationship with contract farming. Therefore, we argue that further research on the impact of contract farming on smallholder farmers’ income and food security using consistent methodologies that consider selection bias is needed.
Keywords: out-grower schemes; inclusive business models; market failures.

Impacto da agricultura contratual na renda e na segurança alimentar dos pequenos produtores agrícolas em Moçambique. uma revisão de literatura

RESUMO: A agricultura contratual tem potencial para resolver falhas de mercados agrícolas, especialmente nos países em desenvolvimento. Contudo, o debate sobre a forma como os pequenos agricultores beneficiam e as circunstâncias em que tais benefícios podem ser alcançados parece estar longe de chegar a um consenso. Esta revisão teve como objectivo analisar o impacto da agricultura contratual no rendimento e na segurança alimentar dos pequenos agricultores em Moçambique, utilizando um protocolo de revisão sistemática da literatura. Os resultados mostram que a literatura que analisa tais relações é limitada. No entanto, a agricultura contratual tem o potencial de aumentar os rendimentos, mas a natureza do contrato, os intervenientes envolvidos e as culturas sob contrato parecem ser os principais determinantes dos resultados da agricultura contratual. Além disso, os resultados mostram que existem tendências de selecção positiva entre empresas e agricultores, tornando difícil estimar o efeito líquido da agricultura contratual. No que diz respeito à segurança alimentar, os estudos revistos não nos permitiram tirar conclusões consistentes sobre a sua relação com a agricultura contratual. Argumentamos, portanto, que é necessária mais investigação sobre o impacto da agricultura contratual no rendimento e na segurança alimentar dos pequenos agricultores, utilizando metodologias consistentes que tenham em conta o potencial viés de seleção.
Palavras-chave: esquemas de fomento; modelos de negócio inclusivos; falhas de mercado.
Improving neurological deficits secondary to transverse myelitis using epidural spinal cord stimulation: illustrative cases
Authors: Gupta Rishabh , Johnson Reid , Gil Jeong Han , Balser David , Sandozi Afsar , Cramer Samuel W , Uzma Samadani and 
Published: August 2024

BACKGROUND
Epidural spinal cord stimulation (eSCS) is canonically used for the treatment of intractable, chronic pain. Recent efforts have successfully utilized eSCS to improve neurological deficits in patients with spinal cord injury. However, there is a paucity of literature on the use of eSCS for demyelinating conditions, with no prior case reports examining eSCS among patients with transverse myelitis (TM).

OBSERVATIONS
Two patients with TM underwent eSCS and experienced improvements in motor function and bladder symptoms. The first patient exhibited enhanced motor strength in both lower extremities and no longer experienced leg spasms, increasing exercise capacity and decreasing their fall risk. The patient had reduced incontinence pad usage due to a regained ability to sense bladder fullness. The second patient also experienced improved motor scores, leading to enhanced motor functionality and independence. Furthermore, the patient observed reductions in urinary tract infections post-eSCS. Neither patient reported substantial improvement in bowel function following stimulation.

LESSONS
Improvements in motor functionality and bladder functioning are well-documented as factors that improve quality of life among paraplegic patients. Given the findings of the present case report, larger cohort studies examining the use of eSCS for demyelinating conditions, including TM, are warranted.
https://thejns.org/doi/10.3171/CASE24152
Complete removal of a cavernous malformation in the dorsal pons, in contact with the expanded transpontine vein: illustrative case
Authors: Yamamoto Daisuke , Shibahara Ichiyo , Hyakutake Yuri , Inukai Madoka , Sato Sumito , Koizumi Hiroyuki , Hide Takuichiro , Kumabe Toshihiro 
Published: August 2024

BACKGROUND
Craniotomy is required for the removal of brainstem cavernous malformations (CMs) with repeated hemorrhage, and this condition is often complicated by an accompanying developmental venous anomaly (DVA). However, a DVA of the brainstem or cerebellum with drainage penetrating the pons is an exceptional finding.

OBSERVATIONS
A 57-year-old man presented with double vision. Computed tomography revealed progressive enlargement of the hemorrhage in the dorsal pons. Contrast-enhanced magnetic resonance angiography revealed an expanded transverse vessel penetrating the center of the pons in contact with the CM. Digital subtraction angiography revealed that the DVA, comprising the expanded transpontine vein and some cerebellar medullary veins acting as normal venous drainage, coexisted with the CM. By utilizing the angioarchitecture and intraoperative neuronavigation system data, electrophysiological mapping, and indocyanine green videoangiography, complete removal of the CM was accomplished while preserving the DVA and brain function.

LESSONS
This study presents the intraoperative images of an expanded transpontine vein as a DVA, which has never been depicted in a live patient before, accompanied by a CM in the dorsal portion of the pons.
https://thejns.org/doi/10.3171/CASE24314
Assessment of gnostic and stereognostic functions in patients with liver cirrhosis: A comparative study with healthy controls
Authors: Tapajčiková Táňa , Líška Dávid , Slapšinskaitė Dackevičienė Agnė , Skladaný L’ubomír 
Published: August 2024

BACKGROUND: Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease’s progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function. OBJECTIVES: The main objective of the study is to compare the gnostic function and stereognostic function in individuals with liver cirrhosis and those in a healthy population. METHODS: The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25 women and 49 men). The control group consisted of a 63 healthy population (including 23 women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests. RESULTS: The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p< 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p< 0.05), except for the second attempt with the left upper limb (p= 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p> 0.05). CONCLUSION: Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis.
Analysis of pathogen distribution and sTREM-1 and miR-126 levels in patients with pulmonary infection after craniocerebral injury
Authors: Gu Lei , Zhen Yun , Huang Zhenlin , Chen Tianbao , Li Fuxiong , Chen Kaipeng 
Published: August 2024

BACKGROUND: sTREM-1H and miR-126 play crucial roles in inflammation and immune responses, yet their involvement in patients with pulmonary infection following cranial injury remains understudied. OBJECTIVE: The distribution of pathogens causing infection in patients with pulmonary infection after craniocerebral injury was explored, and the changes in the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and miR-126 in peripheral blood were analyzed. METHODS: In this study, 60 patients (study group) with postoperative lung infection in craniocerebral injury treated from January 2019 to December 2, 2021, and 60 patients without lung infection were selected as the control group. The study group received anti-infection treatment. The infection pathogen of the study group was tested, and the changes of sTREM-1 and miR-126 levels in the peripheral blood of the study and control groups were recorded to explore the diagnosis and predictive Value of prognostic death. RESULTS: 66 pathogens were detected, including 18 gram-positive bacteria, 42 gram-negative bacteria, and 6 fungi. The sTREM-1 level was higher than the control group, and the miR-126 level was lower than the control group. By ROC curve analysis, the diagnostic AUC values of both patients were 0.907 and 0.848, respectively ([Formula: see text] 0.05). Compared to those in the study group, patients had decreased sTREM-1 levels and increased miR-126 levels after treatment ([Formula: see text] 0.05). Compared with the survival group, patients in the death group had increased sTREM-1 levels and decreased miR-126 levels, and ROC curve analysis, the predicted AUC death values were 0.854 and 0.862, respectively. CONCLUSION: Gram-negative bacteria, with increased peripheral sTREM-1 levels and decreased miR-126 levels. The levels of sTREM-1 and miR-126 have specific diagnostic and prognostic Values for pulmonary infection after craniocerebral injury. However, the study’s conclusions are drawn from a limited sample and short-term data, which might limit their broader applicability. Future studies with larger populations and longitudinal designs are required to confirm these findings and determine these biomarkers’ robustness across different settings. Further research should also explore how these biomarkers influence patient outcomes in craniocerebral injuries.
Early decompressive surgery improves long-term prognosis in patients with intracerebral hemorrhage
Authors: Wu Weichuan , Li Chengyan , Men Donghai , Li Xiaopeng , Huang Baqi 
Published: August 2024

BACKGROUND: Multiple studies have shown that early decompressive surgery in patients with intracerebral hemorrhage can effectively limit hematoma expansion, reduce perihematomal edema, and improve prognosis. However, these studies are limited by small sample sizes and short follow-up times. OBJECTIVE: To analyze the effect of early decompressive surgery on the long-term prognosis of patients with cerebral hemorrhage and identify the influencing factors for poor prognosis. METHODS: A retrospective analysis of 78 patients with cerebral hemorrhage admitted between January 2020 and December 2022 was conducted. Patients were divided into early and delayed surgery groups for comparison of outcomes such as mortality rate, modified Rankin Scale score, and Short Form-36 scores. Additionally, factors influencing long-term prognosis were analyzed through logistic regression based on significant differences observed between groups. RESULTS: The early decompressive surgery group showed superior outcomes with lower mortality rates, modified Rankin Scale (mRS) scores, hematoma expansion rates, and perihematomal edema volumes compared to the delayed surgery group ([Formula: see text] 0.05). Additionally, age, preoperative Glasgow Coma Scale (GCS) score, preoperative hematoma volume, and a history of hypertension or diabetes were identified as independent prognostic factors for patients with cerebral hemorrhage, with odds ratios (ORs) greater than 1. CONCLUSIONS: Early decompressive surgery can improve the long-term prognosis and quality of life of patients with cerebral hemorrhage, reduce mortality rates, and decrease hematoma expansion and perihematomal edema. Older patients, those with higher preoperative hematoma volume and GCS score, and those with coexisting hypertension and diabetes should be given special attention to decrease the occurrence of adverse prognosis.
The impact of combined aerobic and resistance exercise on the prognosis of early Parkinson’s disease patients
Authors: Chen Yumei , Chen Yanbin 
Published: August 2024

BACKGROUND: Although literature suggests that exercise can improve symptoms in Parkinson’s Disease (PD) patients, research on the effects of aerobic exercise and resistance training (AE&RT) in early-stage PD remains limited. Understanding the synergistic effects of these exercise modalities can provide valuable insights for optimizing exercise interventions for PD patients, particularly in the early stages of the disease, where interventions may have the greatest impact on long-term functional outcomes. OBJECTIVE: This study aimed to investigate the effects of a combined AE&RT program on motor function, postural stability, and cognitive processing speed in early stage PD patients. METHODS: A total of 236 participants with early-stage PD were assigned to either the Aerobic Exercise Group (AE group) ([Formula: see text] 112) or the AE&RT Group ([Formula: see text] 124) inthis controlled randomized trial. The study employed a one-year supervised exercise program, with the AE Group participating in aerobic activities and the AE&RT Group engaging in combined AE&RT. Outcome measures included symptom improvement, motor function, postural stability, cognitive processing speed, peak oxygen consumption, quality of life evaluation, and the incidence of adverse events. RESULTS: The AE&RT Group demonstrated greater improvements in tremor, muscle rigidity, gait instability, sleep problems, and hyposmia compared to the AE Group. Additionally, the combined exercise group exhibited better cognitive processing speed, as well as enhanced motor function and postural stability. Peak oxygen consumption was significantly higher in the AE&RT Group. However, the quality of life evaluation indicated a statistically higher quality of life in the AE Group. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION: The findings suggest that the integration of AE&RT in early-stage PD patients leads to more comprehensive improvements in motor symptoms, cognitive function, postural stability, and cardiovascular fitness compared to aerobic exercise alone. These results have important implications for developing tailored exercise interventions to enhance the physical and cognitive well-being of individuals with early-stage PD.
The role of depth of general anesthesia in serum CGRP and SP level in diabetes patients
Authors: Li Pengxin , Peng Sheng , Song Zhenghuan , Tan Jing , Gu Lianbing 
Published: August 2024

BACKGROUND: Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2–4 times compared with that in patients without diabetes. OBJECTIVE: This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus METHODS: This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA) RESULTS: This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CONCLUSIONS: CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study’s findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery.
A predictive model for 28-day mortality after discharge in patients with sepsis associated with cerebrovascular disease
Authors: Hua Defeng , Chen Yan 
Published: August 2024

BACKGROUND: The present study investigated the association between cerebrovascular diseases and sepsis, including its occurrence, progression, and impact on mortality. However, there is currently a lack of predictive models for 28-day mortality in patients with cerebrovascular disease associated with sepsis. OBJECTIVE: The objective of this study is to examine the mortality rate within 28 days after discharge in this population, while concurrently developing a corresponding predictive model. METHODS: The data for this retrospective cohort study were obtained from the MIMIC-IV database. Patients with sepsis and cerebrovascular disease in the ICU were included. Laboratory indicators, vital signs, and demographic data were collected within 24 hours of ICU admission. Mortality rates within 28 days after discharge were calculated based on patient death times. Logistic regression analysis was used to identify potential variables for a predictive model. A nomogram visualized the prediction model. The performance of the model was evaluated using ROC curves, Calibration plots, and DCA. RESULTS: The study enrolled a total of 2660 patients diagnosed with cerebrovascular disease complicated by sepsis, consisting of 1434 males (53.91%) with a median age of 70.97 (59.60, 80.73). Among this cohort of patients, a total of 751 fatalities occurred within 28 days following discharge. The multivariate regression analysis revealed that age, creatinine, arterial oxygen partial pressure (Pa O2), arterial carbon dioxide partial pressure (Pa CO2), respiratory rate, white blood cell (WBC) count, Body Mass Index (BMI), and race demonstrated potential predictive variables. The aforementioned model yielded an area under the ROC curve of 0.744, accompanied by a sensitivity of 66.2% and specificity of 71.2%. Furthermore, both calibration plots and DCA demonstrated robust performance in practical applications. CONCLUSION: The proposed prediction model allows clinicians to promptly assess the mortality risk in patients with cerebrovascular disease complicated by sepsis within 28 days after discharge, facilitating early intervention strategies. Consequently, clinicians can implement additional advantageous medical interventions for individuals with cerebrovascular disease and sepsis.
Gaya Kepemimpinan Perguruan Tinggi Kesehatan: Authentic, Tansformational, Authoritarian atau Transactional
Authors: Purwanto Agus , Asbari Masduki , Hadi Agus Hari 
Published: August 2024

Background: The purpose of this study was to analyze the influence of transformational, transactional, authentic and authoritarian leadership styles on the performance of lecturers at a health college in Pati, Central Java. Â Objective: The purpose of this study was to analyze the influence of transformational, transactional, authentic and authoritarian leadership styles on the performance of lecturers at a health college in Pati, Central Java. Â Methods: The respondents of this study were 56 lecturers and the method of data collection was by distributing electronic questionnaires to the lecturers of Health College in Pati. Data analysis in this study used SEM (Structural Equation Model) LISREL program version 8.70.Â Results: The results of the analysis and processing of research data indicated that the leadership of transactional and authoritarian styles of health colleges in Pati showed positive and significant effect on lecturer performance while the transformational and authentic leadership styles do not significantly influence lecturer performance.Â Conclusion: Transactional and authoritarian leadership style has a positive and significant effect on lecturer performance while the transformational and authentic leadership styles do not significantly influence lecturer performance.Â Keywords: Authentic; Tansformational; Authoritarian atau Transactional