Stable High Level Research Articles

Trends in Proton-Pump Inhibitor Use Among Danish Adults: A Nationwide Drug Utilization Study 2015-2023.

The global increase in proton-pump inhibitor (PPI) use has raised concerns about their appropriate use, particularly due to potential overprescription and associated adverse effects. This study examines PPI utilization patterns among Danish adults from 2015 to 2023 using the Danish nationwide health registries. We estimated the annual incidence rate (users per 100 person-years) and monthly prevalence (proportion with a filled prescription or sufficient tablets). Treatment duration was assessed using the 'proportion of patients covered' and the Kaplan-Meier method. We also calculated the proportion of adults with concomitant use of ulcerogenic drugs over time. We identified 1 729 440 adults who filled at least one PPI prescription during 2015-2023. The prevalence increased from 7.0% in 2015 to 8.2% in 2023, while incidence rate remained stable at ~3 users per 100 person years. PPI use increased with age. Three years after initiation, 17% used PPIs, while 1.5% had remained on continuous treatment. In 2023, 50% of users had concomitant ulcerogenic drug use, a 3.2% increase since 2015. The prevalence of PPI use in Denmark has risen markedly reaching a high stable level, with a clear age-dependent trend. Increased attention to appropriate PPI use is necessary to ensure rational prescribing and prevent potential overuse.

Construction and characterization of bioluminescent Salmonella Reading outbreak and non-outbreak strains.

Salmonella enterica serotype Reading has recently become a significant foodborne pathogen linked to poultry products. To enhance pathogen monitoring, this study developed bioluminescent strains of S. Reading by inserting the chloramphenicol acetyltransferase gene into a plasmid containing a bioluminescence gene cluster. These modified strains were transformed into outbreak and non-outbreak bacterial strains via electroporation. The bioluminescent strains demonstrated stable plasmid retention and high bioluminescence levels. They also showed growth comparable to their parent strains, even in the absence of antibiotics. These bioluminescent strains could potentially facilitate real-time monitoring and control of S. Reading in poultry industries.

Advancing green innovation through the establishment of data regulatory bodies: Insights from the Big Data Bureau in China

Advancing green innovation through the establishment of data regulatory bodies: Insights from the Big Data Bureau in China

MEDICAL-SOCIAL SUBSTANTIATION OF THE DIRECTIONS FOR THE DEVELOPMENT OF THE CONCEPTUAL MODEL OF THE REGIONAL CENTRE OF CARDIOLOGY ON THE PRINCIPLES OF PUBLIC-PRIVATE PARTNERSHIP (on the example of Kyiv region)

Introduction. The transformation of our country's healthcare system is impossible without quality medical reform. One of the reform's starting directions is improving the provision of cardiac care to the population. Aim. Medical and social substantiation of directions for developing a conceptual model of a regional cardiology centre based on the principles of public-private partnership (on the example of the Kyiv region). Materials and methods. Data from state and industry statistical reports of healthcare institutions of the Ministry of Health of Ukraine and data from the State Statistics Service of Ukraine, as well as materials from a sociological survey of cardiologists and patients and a survey of 31 experts (highly qualified health care organizers) conducted according to specially developed programs) were the materials in this study. The research used complex methods: systematic approach and analysis, synthesis, generalization, interpretation, medical-statistical and sociological method, expert assessment and conceptual modelling method. Results. Stable high levels of circulatory system disease prevalence among the adult population of the Kyiv region and differences depending on different age groups, increase in the mortality rate due to cardiovascular diseases (CVD) in the studied time intervals and the mortality rate of cardiac patients were established. At the same time, there was a decrease in the level of hospitalization of patients along with a decrease in the average number of beds for the treatment of cardiology patients; there were no significant changes in the staffing indicators of health centres of the Kyiv region, which provide cardiac medical care to patients with CVD in 2018-2022. However, there was an increase in the number of cardiovascular surgeon positions for the adult population of the Kyiv region in 2020 by 12.9%, and then a decrease of 7.01% in 2021. The insufficient resource provision of healthcare facilities in which cardiac medical care is provided as evidenced by a significant decrease in the coverage of echocardiography in the study, despite the reform of the network of healthcare facilities in the region. The results of the survey of patients and cardiology specialists revealed significant levels of dissatisfaction with the possibilities of providing and receiving quality cardiology care. Conclusions. A range of problems in the field of providing high-quality cardiac care to the population was determined on the example of the Kyiv region, and a strategy with phased and complex steps to solve the most acute problematic issues was proposed with the proposed project of the Strategic Plan for the development of the regional system of cardiac care for the population of the region for the period 2024-2029.

Public-Private Partnerships in Community Rehabilitation: A Financial Risk and Return Analysis

This research explores the effectiveness of Public-Private Partnerships (PPPs) in the delivery of Community-Based Rehabilitation (CBR) programs in India from 2018 to 2023. As India seeks to bridge the healthcare gap for persons with disabilities (PwDs), CBR models supported through PPPs offer a unique avenue for innovation, funding, and sustainability. This paper evaluates how these partnerships influence financial risk, return on investment (ROI), and stakeholder engagement. The research uses descriptive statistics, including measures such as mean, median, standard deviation, and variance, to analyze program performance across states like Maharashtra, Kerala, and Jharkhand. It includes stakeholder feedback scores, funding allocations, and ROI trends, all of which are interpreted using quantitative tools and regression analysis. Case studies further enrich the findings by providing practical insights into real-world implementation. The results indicate that well-managed PPPs yield high ROI and stable satisfaction levels across public and private stakeholders. Government funding has also shown consistent growth over the years. Overall, the study offers a data-backed policy framework for reducing risk and enhancing returns in community rehabilitation through structured PPPs, making a case for wider adoption of such models in India’s health and social infrastructure sectors.

Association between maternal lipid profiles and lipid ratios in early to middle pregnancy as well as their dynamic changes and gestational diabetes mellitus

BackgroundUnfavourable lipid and glucose levels may play a crucial role in the pathogenesis of gestational diabetes mellitus (GDM). However, there is a lack of prospective studies on the relationship between lipid profiles, lipid ratios and GDM during pregnancy.AimsTo prospectively investigate the relationship between lipid profile and lipid ratios in early and mid-pregnancy and their pattern of change from early to mid-pregnancy and the risk of GDM.MethodsThis nested case-control study was based on maternal and child healthcare hospitals from Fujian Province, China. We included pregnant women who delivered in the hospital from January 2021 to June 2023. Lipid profiles (TC, TG, ApoA1, ApoB, HDL-c, LDL-c) and fasting glucose were measured before 14 weeks of gestation and between 20 and 28 weeks of gestation, and lipid ratios (triglyceride glucose index, TG/HDL-c and TC/HDL-c) was constructed. Logistic regression was used to assess the relationship between lipid profile, lipid ratios and GDM.ResultsOf 1586 pregnant women, 741 were diagnosed with GDM. After adjusting for potential confounders, TG, ApoA1, ApoB, LDL-c, triglyceride glucose index, TG/HDL-c, and TC/HDL-c in early pregnancy were positively associated with the risk of GDM (odds ratios [95% CI] for extreme interquartile comparisons were 2.040 (1.468–2.843), 1.506 (1.091–2.082), 1.529 (1.110–2.107), 1.504 (1.086–2.086), 1.952 (1.398–2.731), 2.127 (1.526–2.971), and 2.370 (1.700-3.312), all trend P < 0.05). HDL-c was negatively associated with the risk of GDM (0.639: 0.459–0.889, trend P all less than 0.05). Similarly, in mid-pregnancy, lower levels of HDL-c, higher levels of triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio were associated with increased risk of GDM (all trends P < 0.05). Stably high levels (both ≥ median for early and mid-pregnancy) of triglyceride glucose index, TG/HDL-c and TC/HDL-c were associated with increased risk of GDM (OR [95% CI]: 2.369 (1.438–3.940), 1.588 (1.077–2.341), 1.921 (1.309–2.829), respectively). The opposite was true for HDL-c, where stable high levels were negatively associated with GDM risk (OR [95% CI]: 0.599 (0.405–0.883)).ConclusionIncreases in triglyceride glucose index, TG/HDL-c ratio, and TC/HDL-c ratio in early and mid-pregnancy, as well as their stable high levels from early to mid-pregnancy, are associated with a higher risk of GDM. In contrast, increased levels of HDL-c, both in early and mid-pregnancy, and their stable high levels from early to mid-pregnancy were associated with a lower risk of GDM. That highlighted their possible clinical relevance in identifying those at high risk of GDM.

Associations between serum albumin level trajectories and clinical outcomes in sepsis patients in ICU: insights from longitudinal group trajectory modeling.

Sepsis triggers a strong inflammatory response, often leading to organ failure and high mortality. The role of serum albumin levels in sepsis is critical but not fully understood, particularly regarding the significance of albumin level changes over time. This study utilized Group-based Trajectory Modeling (GBTM) to investigate the patterns of serum albumin changes and their impact on sepsis outcomes. We conducted a retrospective analysis on ICU patients from West China Hospital (2015-2022), employing GBTM to study serum albumin fluctuations within the first week of ICU admission. The study factored in demographics, clinical parameters, and comorbidities, handling missing data through multiple imputation. Outcomes assessed included 28-day mortality, overall hospital mortality, and secondary complications such as AKI and the need for mechanical ventilation. Data from 1,950 patients revealed four serum albumin trajectories, showing distinct patterns of consistently low, increasing, moderate, and consistently high levels. These groups differed significantly in mortality, with the consistently low level group experiencing the highest mortality. No significant difference in 28-day mortality was observed among the other groups. Subgroup analysis did not alter these findings. The study identified four albumin trajectory groups in sepsis patients, highlighting that those with persistently low levels had the worst outcomes, while those with increasing levels had the best. Stable high levels above 30 g/L did not change outcomes significantly. These findings can inform clinical decisions, helping to identify high-risk patients early and tailor treatment approaches.

Intestinal mycobiota dysbiosis associated inflammation activation in chronic schizophrenia

Intestinal mycobiota dysbiosis associated inflammation activation in chronic schizophrenia

A data‐based approach to determining the optimal water ponding scale and zone for small urban wetland restoration

This study established a planning framework for effective small‐scale urban wetland restoration by adapting an analytical template used for watershed‐scale projects. We evaluated the optimal water ponding scale and location for small urban wetland restoration. We calculated the achievable water ponding area in Oyama Wetland, Hokkaido, Japan, by the use of an artificial water supply and elevation differences without reliance on precipitation. The volume of infiltration into the sediments, a component of the water balance equation, was estimated during a temporary suspension of the artificial water supply, and the estimate was then validated by modeling the decrease of the water ponding area from 2008, before the introduction of the artificial water supply, with high reproducibility (Nash–Sutcliffe efficiency = 0.68). The estimated attainable water ponding area was 1172 m2. We identified where a water ponding location could be most efficiently established through principal component and cluster analyses of groundwater level observation data collected from 2008 to 2010. Areas with high groundwater levels (first axis) and stable groundwater levels (second axis) accounted for approximately 73% of the cumulative contribution ratio. The calculated potentially achievable ponding area was consistent with the area achieved by the actual wetland restoration. This study shows how efficient and safe restoration of urban wetlands can be achieved with a dataset that volunteers and others can obtain independently. Long‐term data analysis using the adapted template allows for clear identification of discrepancies between desired reference conditions and current conditions, facilitating the setting of objectives that promote long‐term monitoring.

A Multicenter Cohort Study on 301 Tissue-Level Implants: Cumulative Implant Survival Rate and Marginal Bone Level Change up to 4.5 Years.

To retrospectively determine the cumulative survival rate (CSR) and marginal bone level change (ΔMBL) around novel hybrid design tissue-level (TL) dental implants that support multiple-screw-retained restorations. Implant CSRs were analyzed at the implant and patient level using Kaplan-Meier estimates. ΔMBL was measured by comparing the periapical loading and follow-up visit radiographs using an improved standardized digital methodology based on image gray levels. ΔMBL outcomes were subject to linear mixed regression to identify potential risk factors. A total of 301 TL implants in 69 patients with an average age of 62.6 ± 11.7 years (range: 36 to 87 years) at the time of implant placement were considered for the analysis. All 301 implants were successfully restored and loaded. The 54-month CSRs at the implant and patient levels were 98.9% (95% CI: 96.7 to 99.6) and 95.3% (95% CI: 86.1 to 98.5), respectively. ΔMBL after a mean follow-up of 22 ± 10.7 months after loading was 0.00 ± 0.57 mm. None of the implant sites showed marginal bone loss exceeding 1.5 mm. Multivariate regression analysis revealed a significant association between ΔMBL and the loading protocol (P = .027) but not between ΔMBL and age or transgingival height. The high CSRs and stable peri-implant marginal bone levels support the use of recent TL implants, which have a hybrid design inherited from the bone-level implant-abutment connection, as a suitable treatment option for restoring partially or fully edentulous patients with a good mid-term prognosis. These results should be complemented by further prospective studies in a real-world multicenter private practice setup that represents the daily realities of implant treatment.

Evaluation of potato varieties by productivity and adaptability in the conditions of the North Caucasus region

The purpose of the study is to identify new potato genotypes for breeding work with a high stable level of yield and adaptive ability, which will be used as initial parental forms. The work was carried out within the framework of the Federal Comprehensive Scientific and Technical Project "Breeding and seed production of potatoes based on modern methods of biotechnology to create domestic varieties resistant to viral diseases and adapted to the natural conditions of the North Caucasus region". The criteria for the studied indicators of varieties include overall productivity, resistance to viral and fungal diseases, the degree of degeneration, and the potential of an early harvest. In the conditions of 2021-2022 an assessment was made of 43 varieties of potatoes, different groups of maturation, and of the adaptive ability of varieties. Experimental studies were carried out in the fields of FAT-AGRO LLC, Predgorny district, Republic of North Ossetia-Alania. Phenological observations, disease resistance, biochemical determinations were carried out according to the "Research Methods for Potato Culture". The scientific novelty lies in the fact that in the conditions of the foothill zone of North Ossetia-Alania, an agroecological assessment of promising and new varieties of potatoes was carried out. According to the results of testing potato varieties in the collection nursery, the most plastic varieties of domestic and foreign originators were identified, characterized by high productivity. The marketability of the selected varieties ranged from 77 to 96 %. Studies have shown that the largest mass of tubers under a bush had varieties of medium-early and mid-ripening groups of ripeness and averaged 852.2 and 902.2 g/bush, respectively. Plant damage by wrinkled mosaic ranged from 1.6 to 11.6 %. There were no signs of damage by speckled mosaic in 20 studied varieties (20.0 %). The least damage had varieties Gala, Krepysh, Alaska - 0.7; 1.6 and 1.6 %, respectively.

Performance measurements for indoor photovoltaic devices: Classification of a novel light source

There is an increasing interest in using indoor photovoltaic (IPV) devices to power Internet of Things applications, low power communications, and indoor environmental sensing. For the commercialization of IPV technologies, device performance measurements need to conform to the relevant standardized specifications. We present a novel IPV device measurement system that incorporates digital light processing (DLP) to deliver a spectrally invariant light source at all required illuminance levels, as specified by the indoor standard testing conditions in IEC TS 62607-7-2:2023. We evaluated the DLP system according to requirements for spectral coincidence, temporal stability, and non-uniformity at the sample plane. We demonstrate the measurements to define the classification status of the system and the unique benefits of the DLP system that allow a stable spectral profile and high levels of uniformity across all illuminance levels. This is the first reported measurement system for IPV device testing based on DLP technology, and the classification methodology of this work can be used as an example for the classification of indoor light simulators in laboratory environments based on the latest IEC TS 62607-7-2:2023.

Redefining agile supply chain practices in the disruptive era: a case study identifying vital dimensions and factors

PurposeThis paper aims to uncover the key enablers of an agile supply chain in the manufacturing sector amidst disruptions such as pandemics, trade wars and cross-border challenges. The study aims to assess the applicability of existing literature to manufacturing and identify additional industry-specific enablers contributing to the field of supply chain management.Design/methodology/approachThe research methodology is comprehensively described, detailing the utilization of extent literature and semistructured interviews with mid- and top-level executives in a supply chain. The authors ensure the robustness of the data collection process and results interpretation.FindingsThe study identifies six essential dimensions of an agile supply chain: information availability, design robustness, external resource planning, quickness and speed, public policy influencing skills and cash flow management. The study provides valuable insights for industry professionals to develop agile supply chains capable of responding to disruptions in a rapidly changing world.Research limitations/implicationsThis study is limited by its focus on the manufacturing sector, and future research may explore the applicability of these findings to other industries. By focusing on these essential dimensions identified in the study, managers can develop strategies to improve the agility and responsiveness of their supply chains. In addition, further research may investigate how these enablers may vary in different regions or contexts.Practical implicationsThe COVID-19 pandemic has forced executives to reconsider their sourcing strategies and reduce dependence on suppliers from specific geographies. To ensure business continuity, companies should assess the risk associated with their suppliers and develop a business continuity plan that includes multisourcing their strategic materials. Digital transformation will revolutionize the supply chain industry, allowing for end-to-end visibility, real time insights and seamless integration of business and processes. Companies should also focus on creating a collaborative workforce ecosystem that prioritizes worker health and well-being. Maintaining trust with stakeholders is crucial, and firms must revisit their relationship management strategies. Finally, to maintain business leadership and competitiveness during volatile periods, the product portfolio needs to be diversified and marketing and sales teams must work in tandem with product teams to position new products accordingly.Social implicationsThis work contributes substantially to the literature on supply chain agility (SCA) by adding several new factors. The findings result in a more efficient and cost-effective supply chain during a stable situation and high service levels in a volatile situation. A less complex methodology for understanding SCA provides factors with a more straightforward method for identifying well-springs of related drivers. First, the study contributes to reestablish the factors such as quickness, responsiveness, competency, flexibility, proactiveness, collaboration and partnership, customer focus, velocity and speed, visibility, robustness, cost-effectiveness, alertness accessibility to information and decisiveness as applicable factors for SCA. Second, the study suggests a few more factors, such as liquidity management, Vendors’ economic assessment and economic diversity, that are the study’s unique contributions in extending the enablers of SCA. Finally, public policy influencing skills, local administration connects and maintaining capable vendors are the areas that were never considered essential for SCA. These factors have emerged as a vital operational factor during the lockdown, and academicians may consider these factors in the future to assess their applicability.Originality/valueThis study provides new insights for decision-makers looking to enhance the resilience and agility of their supply chains. The identification of unique enablers specific to the manufacturing industry contributes to the existing body of literature on agile supply chains in the face of disruptions.

Reasoning about self and others: A dynamic process

Background It can be very challenging for practitioners to talk with autistic children, especially when the conversation calls for self-regulation. Self-regulation is inextricably linked to awareness of oneself and others in social contexts. Encouraging the need for autonomy could help increase self-awareness and awareness of others in social events, which in turn could strengthen self-regulation. However, little is known about how autonomy influences competence in reasoning about self and others when regarding social events in which autistic children participate. This study explores the reasoning of self-other awareness on a microlevel timescale using ipsative, dynamic approaches to autism. The central question in this study is: to what extent can autonomy-provided scaffolding (APS) elicit high levels of reasoning about self-others in social events (RSS) over time? Method We used video-taped interaction data from three sessions between one autistic child and a practitioner, contextualized by a set of animated DSM-5-based items of social events on which the child was asked to reflect. Interaction variables were the child's level of RSS and the practitioner's level of APS. We coded the real-time interaction. Results First, when exploring the dynamics of the microdata, we found contingency over time within sessions. Second, over the sessions, the practitioner showed a stable high level of APS, whereas the child's level of RSS increased. Third, a coupling effect between the level of APS and RSS was found within and over sessions. Salient is that the child and practitioner increasingly adapted to each other over the three sessions, and over time, high-level APS of the practitioner elicited higher levels of RSS of the child. Discussion Because the child showed a significant improvement in RSS over time, our research question provides a promising perspective. Contrary to what one might expect in autism, APS supported the performance of the child in reasoning about self-others in social situations. These outcomes underline the importance of giving voice to autistic children. The results may encourage researchers to develop strategies and tools that can help give a voice to children, to gain more insight into the child's reasoning. This may further develop self-other awareness and self-regulation in the social events of autistic children.

Бобовият компонент на горски садинови ливади в условията на „детелинова година“

A study of the species composition, biological, morphological and productive characteristics of the legume component of forest Chrysopogon gryllus meadows a year with high spring moisture availability was conducted. A very high species diversity of leguminous grasses was found - 17 species from 7 genera. Until the mowing of the meadows, a distinct turnover of species and an almost equal total productivity of dry mass from the legume component per ten-day period was observed. Thus, the productivity of fresh and dry mass of the legume component and, accordingly, the nitrogen fixation levels in the orchard meadows have a stable high level until mowing. The annual clovers can be identified as the legume with the strongest response to increasing moisture availability. A high productivity of mesophytic perennial clover species has also been reported, which significantly increase the fodder value of the grasslands. The species Dorycnium herbaceum and Medicago falcata have the highest productivity of fresh and dry mass when mowing the Chrysopogon gryllus meadows and have the greatest contribution to the forage value of the harvested hay. According to the morphological analysis, the legume component is characterized by a very high variability, both in plant height and in the relative share of leaves and flowers in the formed biomass, which determines its importance for the functional and biological diversity in the studied meadow type. The results are indicative of a great self-recovery potential of the Chrysopogon gryllus meadows in the the foothills of the Central Balkan, as well as a lack of degradation processes under their current mode of use.

N-terminal pro-B-type natriuretic peptide concentrations, testing and associations with worsening heart failure events.

In patients with heart failure (HF), we aimed to assess (i) the time trends in N-terminal pro-B-type natriuretic peptide (NT-proBNP) testing; (ii) patient characteristics associated with NT-proBNP testing; (iii) distribution of NT-proBNP levels, focusing on the subgroups with (WHFE) vs. without (NWHFE) a worsening HF event, defined as an HF hospitalization; and (iv) changes of NT-proBNP levels over time. NT-proBNP testing and levels were investigated in HF patients enrolled in the Swedish Heart Failure Registry (SwedeHF) linked with the Stockholm CREAtinine Measurements project from January 2011 to December 2018. Index date was the first registration in SwedeHF. Patterns of change in NT-proBNP levels before (in the previous 6±3months) and after (in the following 6±3months) the index date were categorized as follows: (i) <3000ng/L at both measurements=stable low; (ii) <3000ng/L at the first measurement and ≥3000ng/L at the second measurement=increased; (iii) ≥3000ng/L at the first measurement and <3000ng/L at the second measurement=decreased; and (iv) ≥3000ng/L at both measurements=stable high. Univariable and multivariable logistic regression models, expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs), were performed to assess the associations between (i) clinical characteristics and NT-proBNP testing and (ii) changes in NT-proBNP from 6months prior to the index date and the index date and a WHFE. Consistency analyses were performed in HF with reduced ejection fraction (HFrEF) alone. A total of 4424 HF patients were included (median age 74years, women 34%, HFrEF 53%), 33% with a WHFE. NT-proBNP testing increased over time, up to 55% in 2018, and was almost two-fold as frequent, and time to testing was less than half, in patients with WHFE vs. NWHFE. Independent predictors of testing were WHFE, higher heart rate, diuretic use, and preserved ejection fraction. Median NT-proBNP was 3070ng/L (Q1-Q3: 1220-7395), approximately three-fold higher in WHFE vs. NWHFE. Compared with stable low NT-proBNP levels, increased (OR 4.27, 95% CI 2.47-7.37) and stable high levels (OR 2.48, 95% CI 1.58-3.88) were independently associated with a higher risk of WHFE. Results were consistent in the HFrEF population. NT-proBNP testing increased over time but still was only performed in half of the patients. Testing was associated with a WHFE, with features of more severe HF and for differential diagnosis purposes. Increased and stable high levels were associated with a WHFE. Overall, our data highlight the potential benefits of carrying further implementation of NT-proBNP testing in clinical practice.

Change of the vaginal microbiome with oral contraceptive therapy in women with polycystic ovary syndrome: a 6-month longitudinal cohort study

BackgroundThe association between the vaginal microbiome and polycystic ovary syndrome (PCOS) is reported, but the longitudinal changes in the vaginal microbiome that accompany oral contraceptive therapy have not been described.MethodsThis cohort study included 50 PCOS patients who wanted to make their menstrual periods more regular and accepted only oral contraceptive therapy and lifestyle coaching, then they were successfully followed up for 6 months. Venous blood was collected, and follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (T), anti-Müllerian hormone (AMH), and estradiol (E2) were assayed at baseline and at months 3 and 6. Vaginal swabs were collected at baseline and at months 3 and 6. 16S rRNA genes were sequenced to identify the microbiota structure. Latent class trajectory models were used to explore the trajectory of the changes in Lactobacillus abundance.ResultsAt 3 months, all patients reported regular periods, and the improvement lasted until 6 months. The body mass index and waist-to-hip ratio decreased with treatment (P < 0.01), and the AMH and T levels showed downward trends. We did not find a statistically significant relationship between hormone levels at the previous time point and the vaginal microbiota at subsequent time points (P > 0.05). The relative abundance of Lactobacillus increased with treatment, and trajectory analysis revealed five classes of Lactobacillus changes. Class 1, stable high level, accounted for 26%; class 2, decrease followed by increase, accounted for 18%; class 3, stable low level, accounted for 10%; class 4, increase, accounted for 20%; class 5, increase followed by decrease, accounted for 26%. Logistic models showed that compared to class 1, a higher baseline T level was associated with a reduced risk of class 2 change (odds ratio (OR) = 0.03, 95% confidence interval (CI):0.01–0.52) and class 4 change (OR = 0.10, 95% CI:0.01–0.93).ConclusionsThe abundance of Lactobacilli increased with PCOS treatment; however, the trajectory was inconsistent for each individual. Evidence of the effects of female hormone levels on the vaginal microbiome is insufficient.

MARKETING INVASION FOR MSME GROUPS AT BANTARJAYA-BOGOR

Business continuity is a non-static phenomenon due to several reasons such as global climate conditions, scarce resources, insecure and competitive global scenario, impending population increase, political instability, economic crisis, and new innovative technologies in the world. The main problem of a small industry is not just achieving a stable high level of performance but also maintaining its position in the market while competing with all the unexpected challenges that will come. situation in Bantarjaya Village, there are several problems that can be formulated as obstacles. These problems include how to create innovations related to product distribution patterns that are experiencing production difficulties and increasing sales volumes. Efforts to create innovations related to product distribution patterns that are experiencing production difficulties and increase sales volume. This needs to be done by providing knowledge and skills in implementing pilot-based marketing management methods to increase revenue. And supports coaching motivation and managerial and entrepreneurial skills. MSMEs spread across Bantarjaya Village are a reference in producing processed snacks. Such as dodol, rangginang, and other dry cakes, in the household food products industry. Trade services are of course very important so that society continues to develop in a better direction. However, until now, his party together with all human resources of the Bantarjaya Village government continue to struggle to achieve the work program that has not been completed.

PRODUCT INNOVATION EXPANSION FOR MSME GROUPS IN BANTARJAYA VILLAGE RANCABUNGUR - BOGOR

Currently, MSMEs spread across Bantarjaya Village are a reference in producing processed snacks. Like, dodol, rangginang, and other pastries, in the home food product industry. Trading services are of course very important so that society continues to develop in a better direction. However, until now his team together with all the human resources of the Bantarjaya village government have continued to struggle to achieve unfinished work programs. Business continuity is a non-static phenomenon due to several reasons such as global climate conditions, scarce resources, insecure and competitive global scenarios, imminent population increase, political instability, economic crises, and innovative new technologies in the world. The main problem of a small industry is not only to achieve a stable high level of performance but also to maintain a position in the market while competing with all the unexpected challenges that will come. the situation in Bantarjaya Village, several problems can be formulated as obstacles. These problems include how to create innovations related to product distribution patterns that experience difficulties in production and increase sales volume. Efforts to create innovations related to product distribution patterns that experience difficulties in production and increase sales volume. this needs to be done by providing knowledge and skills in applying pilot-based marketing management methods to increase revenue. And support coaching motivation and managerial and entrepreneurial skills.

INCREASE THE POTENTIAL OF QUALITY MANAGEMENT TO EXPAND THE RELATIONSHIP WITH THE PARTIES

The main problem of a small industry is not only to achieve a stable high level of performance but also to maintain a position in the market while competing with all the unexpected challenges that will come. In the situation in Bantarjaya Village, several problems can be formulated as obstacles. These problems include how to create innovations related to product distribution patterns that experience difficulties in production and increase sales volume. Efforts to create innovations related to product distribution patterns that experience difficulties in production and increase sales volume. this needs to be done by providing knowledge and skills in applying pilot-based marketing management methods to increase revenue. And support coaching motivation and managerial and entrepreneurial skills. Currently, MSMEs spread across Bantarjaya Village are a reference in producing processed snacks. Like, dodol, rangginang, and other pastries, in the home food product industry. Trading services are of course very important so that society continues to develop in a better direction. However, until now his team together with all the human resources of the Bantarjaya village government have continued to struggle to achieve unfinished work programs. Business continuity is a non-static phenomenon due to several reasons such as global climate conditions, scarce resources, insecure and competitive global scenarios, imminent population increase, political instability, economic crises, and innovative new technologies in the world.