bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competencies for Public Health Professionals and Epidemiologists Who Detect and Investigate Enteric Disease Outbreaks
Authors: White Alice E. , Torok Michelle R. , Smith Kirk E. , Booth Hillary , Scallan Walter Elaine 
Published: August 2023

Objective: Food safety progress depends on the ability of public health agencies to detect and investigate foodborne disease outbreaks. The Integrated Food Safety Centers of Excellence identify and implement best practices and serve as resources for public health professionals who investigate enteric disease outbreaks. To target the needs of this diverse workforce, the Integrated Food Safety Centers of Excellence developed and assessed a professional tier framework and competencies. Methods: We described the characteristics of public health professionals who investigate enteric disease outbreaks in the epidemiology role in a conceptual tiered framework. We mapped core competencies to each tier and disseminated a survey to practitioners at local (June 2019) and state (August 2018) US public health agencies to evaluate the importance and frequency of each competency. Results: We developed 15 competencies on surveillance, outbreak detection, interview skills, investigation team, specimen testing, data analysis, hypothesis generation, study design, communication, enteric disease biology, control measures, legal authority, quality improvement, environmental health, and reporting to surveillance. The 286 survey respondents selected interview skills, surveillance, control measures, and hypothesis generation as the competencies most important to their work and most frequently performed. Conclusion: The Integrated Food Safety Centers of Excellence created the first published workforce framework and competencies for public health professionals who detect and investigate enteric disease outbreaks in the epidemiology role, in collaboration with local, state, and federal public health agencies and national organizations. These tools have been integrated into existing programs and can be used to develop training curricula, assess workforce competency over time, and identify priorities for continuing education and training.
Effect of Exercise Training on Some Anti-Inflammatory Adipokines, High Sensitivity C-Reactive Protein, and Clinical Outcomes in Sedentary Adults With Metabolic Syndrome
Authors: Gao Kelian , Su Zhanguo , Meng Junyan , Yao Yuzhong , Li LiGuang , Su Yiping , Mohammad Rahimi Gholam Rasul 
Published: August 2023

Objective This study aimed to investigate the effects of aerobic interval training and resistance training on anti-inflammatory adipokines, high sensitivity C-reactive protein, and clinical outcomes in sedentary men with metabolic syndrome. Methods A total of 33 sedentary men with metabolic syndrome (age: 46.2 ± 4.6 years; body mass index: 35.4 ± 1.9 kg.m2) were randomly assigned to one of 3 groups: aerobic interval training (n = 12), resistance training (n = 10), or control (n = 11). Participants in the exercise groups completed a 12-week training program, 3 sessions per week, while those in the control group maintained their sedentary lifestyle. The levels of high sensitivity C-reactive protein (hs-CRP), omentin-1, adiponectin, lipid profiles, blood pressure, glucose metabolism, body composition, and peak oxygen uptake (VO2peak) were measured at baseline and after the intervention. Results Both aerobic interval training and resistance training significantly improved the levels of omentin-1 and adiponectin, as well as reduced inflammation, as indicated by a decrease in hs-CRP levels. Exercise training also led to significant improvements in lipid profiles, blood pressure, glucose metabolism, and body composition. Specifically, the aerobic interval training group had significantly greater increases in high-density lipoprotein cholesterol and VO2peak, as well as greater reductions in low-density lipoprotein cholesterol, triglycerides, and total cholesterol compared to the resistance training group. Conclusion Exercise training, particularly aerobic interval training and resistance training, can be an effective non-pharmacological intervention for managing inflammation and improving cardiovascular health in metabolic syndrome patients.
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.
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

Abstract
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

AbstractBackgroundBrucellosis 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.MethodsThus, 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.ResultsIn 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.ConclusionThe 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

Abstract
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.