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Item A Multicenter Randomized Controlled Trial of Microbiome-Based Artificial Intelligence-Assisted Personalized Diet vs Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet: A Novel Approach for the Management of Irritable Bowel Syndrome(Wolters Kluwer Health, 2024) Tunali V.; Çidem Arslan N.; Ermiş B.H.; Hakim G.D.; Gündoğdu A.; Hora M.; Nalbantoğlu Ö.U.INTRODUCTION: Personalized management strategies are pivotal in addressing irritable bowel syndrome (IBS). This multicenter randomized controlled trial focuses on comparing the efficacy of a microbiome-based artificial intelligence-assisted personalized diet (PD) with a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (FODMAP) for IBS management. METHODS: One hundred twenty-one patients participated, with 70 assigned to the PD group and 51 to the FODMAP diet group. IBS subtypes, demographics, symptom severity (IBS-SSS), anxiety, depression, and quality of life (IBS-QOL) were evaluated. Both interventions spanned 6 weeks. The trial’s primary outcome was the within-individual difference in IBS-SSS compared between intervention groups. RESULTS: For the primary outcome, there was a change in IBS-SSS of 2112.7 for those in the PD group vs 299.9 for those in the FODMAP diet group (P 5 0.29). Significant improvement occurred in IBS-SSS scores (P < 0.001), frequency (P < 0.001), abdominal distension (P < 0.001), and life interference (P < 0.001) in both groups. In addition, there were significant improvements in anxiety levels and IBS-QOL scores for both groups (P < 0.001). Importantly, PD was effective in reducing IBS SSS scores across all IBS subtypes IBS-Constipation (IBS-C; P < 0.001), IBS-Diarrhea (IBS-D; P 5 0.01), and IBS-Mixed (IBS-M; P < 0.001) while FODMAP diet exhibited comparable improvements in IBS-C (P 5 0.004) and IBS-M (P < 0.001). PD intervention significantly improved IBS-QOL scores for all subtypes (IBS-C [P < 0.001], IBS-D [P < 0.001], and IBS-M [P 5 0.008]) while the FODMAP diet did so for the IBS-C (P 5 0.004) and IBS-D (P 5 0.022). Notably, PD intervention led to significant microbiome diversity shifts (P < 0.05) and taxa alterations compared with FODMAP diet. DISCUSSION: The artificial intelligence-assisted PD emerges as a promising approach for comprehensive IBS management. With its ability to address individual variation, the PD approach demonstrates significant symptom relief, enhanced QOL, and notable diversity shifts in the gut microbiome, making it a valuable strategy in the evolving landscape of IBS care. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.Item Leadership development training for orthopaedic trauma surgeons: an international survey(Wolters Kluwer Health, 2024) MacKechnie M.C.; Miclau E.; MacKechnie M.A.; Miclau T.; Abalo A.G.; Adem E.G.; Aguilar D.; Ahmed S.O.M.; Akue A.H.-M.; Alhadhoud M.; Al-Saadan W.A.; AlSaifi M.; Anicet L.F.; Apivatthakakul T.; Areu M.M.M.; Babhulkar S.; Babikir E.; Barquet A.; Bataga T.; Begue T.; Brink O.; Burda R.; Buteera A.M.; Chesser T.J.S.; Chokotho L.; Cimerman M.; De Ridder V.A.; Dieme C.B.; Dogjani A.; Dragon K.; Ebrahimpour A.; Ekure J.; Escalante Elguezabal I.A.; Enghelmayer R.A.; Farouk O.; Garnavos C.; Garuz M.; Gebhard F.; Gelink A.; Gerich T.G.; Glinkowski M.W.; Grecu D.-C.; Gudushauri P.; Guerado E.; Haonga B.T.; Hattar Y.; Herrera A.C.; Hussein K.; Isiklar Z.U.; Jagdeo R.; Kagda F.H.Y.; Kojima K.E.; Lamichhane A.; Laubscher M.; Leandre N.L.; Leung J.P.; Makelov B.; Michail K.; Miller A.N.; Mkochi V.L.; Mukalamusi D.M.; Muñoz-Vives J.M.; Munthali J.; Narayan R.C.; Nau T.; Navarre P.; Neyra H.T.; Ngissah R.K.S.; Noda T.; Oberli H.; Okcu G.; Orujov E.; Padilla L.; Pesantez R.; Radko K.; Salce I.; Schemitsch E.H.; Schmidt U.; Schuetz M.A.; Sciuto D.; Segovia J.; Selmani E.; Siniki F.; Sitnik A.; Smirnov A.; Taha W.S.; Talevski D.; Terjajevs I.; Ullman M.; Venerand B.; Weill Y.A.; Woolley P.M.; Younes E.M.Purpose:This study examined the leadership development themes that global orthopaedic surgeons in differently resourced countries perceive as essential components and evaluated barriers to attending leadership development programs.Methods:This multinational, 45-question survey engaged orthopaedic surgeons (one expert per country). The questionnaire collected participants' demographics, perception of effective leadership traits, and valuation of various leadership themes based on importance and interest.Results:The survey was completed by 110 orthopaedic surgeons worldwide. Respondents most commonly reported holding a leadership position (87%) in hospital settings (62%), clinical settings (47%), and national orthopaedic societies (46%). The greatest proportion of participants reported having never attended a leadership course (42%). Participants regarded "high performing team-building," "professional ethics," and "organizational structure and ability to lead" as the most important leadership themes. No significant (P ≤ 0.05) differences were identified among perceived importance or interest in leadership themes between income levels; however, statistically significant differences were identified in the questionnaire; respondents in low- and middle-income countries (LICs/LMICs) demonstrated a stronger interest in attending a leadership course than those in high-income countries (HICs) (98% vs. 79%, P = 0.013), and fewer surgeons in LICs/LMICs had taken personality assessment tests than those in HICs (22% vs. 49%, P = 0.019). The most common barriers to attending leadership courses were lack of opportunities and invitations (57%), difficulty missing work (22%), and cost of course attendance (22%).Conclusions:These findings can better inform the development of effective curricula and provide a framework for a successful model for the future. © 2024 Wolters Kluwer Health. All rights reserved.Item Response to Dahly and Morris(Wolters Kluwer Health, 2025) Tunali V.; Ermiş B.H.; Nalbantoǧlu O.U.[No abstract available]Item Response to Melton et al(Wolters Kluwer Health, 2025) Tunali V.; Ermiş B.H.; Nalbantoğlu Ö.U.[No abstract available]