bluuebunny/crossref_metadata_2025 huggingface dataset:
71273 - Female and male general surgeons differ in personality traits - a Swedish cross-sectional study
Authors: Blohm My , McGrath Aleksandra , Mukka Sebastian , Jolbäck Per
Published: August 2024

Introduction

Evidence suggests that female surgeons achieve comparable or even more favourable outcomes than male surgeons. It is currently unclear what factors contribute to these potential differences. Possible explanations might be differences in personality traits, communication style, attitude, and risk-taking behaviour. This study aimed to examine disparities in personality traits between male and female general surgeons in Sweden.

Method

The research was conducted as a cross-sectional study of personality traits. Between August 29, 2022, and December 15, 2023, Swedish specialists in general surgery were invited to participate in an online survey. The survey, assessed with the Big Five Inventory, collected information on self-reported surgeon gender, years in practice, employment data, and differences in personality traits.

Result

The analysis encompassed responses from 223 Swedish general surgeons: 121 (54%) males and 102 (46%) females. In contrast to female surgeons, male surgeons were older and had longer surgical experience. A higher proportion of male surgeons were employed in rural hospitals. Higher mean scores were observed in all personality traits among female surgeons. The adjusted analysis showed significantly higher scores for conscientiousness (p<0.001), extraversion (p<0.001), agreeableness (p=0.006), and neuroticism (p<0.001); however, no such change was observed for openness.

Discussion

This cross-sectional study demonstrates that Swedish female and male surgeons differ in personality traits. The implications of these results could lead to a deeper understanding of the variations in surgical outcomes based on the gender of the surgeon.
72297 - Cholecystectomy through minilaparotomy
Authors: Brokstorp Malin , Redéen Stefan , Österberg Johanna , Sandblom Gabriel
Published: August 2024

Introduction

The gold standard for managing gallstone disease is nowadays laparoscopic cholecystectomy. Nevertheless, few studies have evaluated the long-term outcomes of cholecystectomy by mini-laparotomy. The aim of this study was to evaluate complications following cholecystectomy through mini-laparotomy.

Method

The study population consisted of patients undergoing cholecystectomy by mini-laparotomy 2007-2012 in Motala registered in GallRiks. Patients with registered complications were matched with a control group in a 1:2 ratio based on gender and age. Data were retrieved from GallRiks and a retrospective patient report review assembling variables related to complications, patient satisfaction and health status. A chi-2 test analyzed risk factors and co-morbidities; other results were presented descriptively.

Result

During the study period, 599 patients underwent cholecystectomy. Thirty-three patients (5.5%) were registered in GallRiks as suffering a complication, including 29 (4.8%) surgical complications. Registered complications were infection (n=12), bleeding (n=8), liver lesion (n=2), bile duct injury (n=2), leakage from cystic duct (n=2), bile duct stones (n=1), ileus (n=1) and gastritis (n=1). Risk factors such as smoking, transection of rectus muscle or incision size showed no significant correlation to complication incidence. The co-morbidities diabetes, pulmonary disease and coronary heart disease had no significant impact on outcomes regarding complications.

Discussion

The results of this study may suggest that mini-laparotomy could be a safe option for cholecystectomy when the first-hand method, laparoscopy, is unavailable or inappropriate.
72316 - Trends and Prevalence of Umbilical Hernia Repairs in Sweden; A Nationwide Population-based Register-study
Authors: Bergström Mathias , Widhe Björn , Bringman Sven , Melkemichel Maria
Published: August 2024

Introduction

Umbilical hernia repairs (UHRs) are widely performed worldwide, yet knowledge about their repairs remains underexplored. Guidelines suggest that UHR larger than 1 cm should preferably be repaired using mesh. The aim was to assess trends and prevalence over time for the use of suture versus mesh following UHR in Sweden.

Method

This observational population-based register study included prospectively collected data from the nationwide Swedish Perioperative Register (SPOR). Patients > 18 years old with a UHR between 2017-2022 in SPOR were eligible. Surgical units were categorized into six healthcare regions. Primary outcome was change in method of repair over time. Secondary outcome was regional variations in method of repairs.

Result

Out of 10,356 elective primary UHRs; mesh was used in 47.9%, whereas 14.1% of these were repaired laparoscopically. Women were less frequently repaired with mesh (38.8%) compared to men (52.1%). Suture repairs had a lower median age (49 years) and BMI (27.2 kg/m2) compared to mesh repairs (55 years, BMI 29.7 kg/m2). Lower ASA class (1-2) were predominant in suture repairs (53.8%), while higher ASA class (3-4) were predominant in mesh repairs (59.1%). Mesh repairs increased marginally, 46.1% to 49.3% during the study period (p < 0.001). Only the South healthcare region had a significant increase from 25.9% to 56.4% for mesh repairs (p < 0.001).

Discussion

Mesh repairs, despite guidelines, have still not significantly influenced UHR practices in Sweden. Mesh was more commonly used for men, obese patients, those of older age and with a greater co-morbidity.
71918 - The Swedish Breast Implant Registry (BRIMP) - experience with 50.000 Implants
Authors: Halle Martin , Stark Birgit
Published: August 2024

Introduction

The safety of breast implants has been questioned lately regarding the PIP scandal, BIA-ALCL and Breast implant illness (BII). Primary endpoints of BRIMP are to detect adverse events. Secondary endpoints may help in decision makings to choose defined implants in specific circumstances.

Method

Between 2014 and 2021 breast implants were registerd in BRIMP for both primary and secondary surgeries. Complications were studied at 60 days, one and six years postop. The incidence of long-term consequences such as brand related capsular contraction, rupture or deflation and rotation was studied. Explant surgery was reported with type of capsular surgery performed.

Result

In total 50.000 implants were registered for primary operations (71,9%) and reoperations (28,1%). The vast majority of primary operations were performed for benign conditions (91,8%). Peroperative antibiotic coverage was standard, where 23% of patients received intraoperative antibiotic irrigation in addition. Implants were predominantly placed in a dual plane position via inframammary incisions. Implant size below 400 cc was used in the vast majority of the cases and only 3,6% of the patients had implants above 600 cc. The risk for reoperation in aesthetic surgery within 60 days was less than 0.1%, with no difference between the brands. The risk for reoperation in aesthetic surgery for capsular contracture within 7 years was less than 2%. A linear increase was seen for permanent explantations together with increasing rates of total casulectomy performed.

Discussion

BRIMP helps to improve patient safety and is an important tool for providing objective information for patients, professional, health care and media.
72250 - Fifty years of Lithium-associated hyperparathyroidism – a complete literature review
Authors: Shahraki Reza Alidousti , Meehan Adrian D , Wallin Göran , Daskalakis Kosmas
Published: August 2024

Introduction

Lithium-associated hyperparathyroidism (LHPT) was first reported in 1973. It remains unclear if this is a specific endocrinopathy or separate simultaneous medical conditions. Definitive management for lithium-treated patients with calcium dysfunction has yet to be established (1).

Method

We conducted this systematic review of all available studies in English which provide patient material from the adult population (>18 years) illustrating lithium’s association in the development of hypercalcaemia and/or hyperparathyroidism. A predefined review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD 395676). The search used five major databases: Medline, EMBASE, Cochrane Library, PsycINFO, and Web of Science, between 1973 to January 2023, using the keywords hyperparathyroidism, lithium, hypercalcaemia, hypocalcaemia. Review articles and abstracts were excluded.

Result

Of the initial 5418 searches, 169 articles were included for final analysis. Prevalence of hypercalcaemia is reported in approximately 20-30% of lithium-treated patients. Lithium gives moderate increases in calcium levels, with or without elevations in parathyroid hormone. Paradoxically, lithium may be skeletal protective. Multiglandular disease is more common in LHPT than in pHPT, most often consisting of hyperplastic glands. In surgical cases, bilateral exploration is often preferred. Follow-up times are relatively short. No randomised surgical studies exist.

Discussion

LHPT appears to be a common endocrinopathy. Lithium patients with tendency to calcium dysfunction should be carefully monitored. More radical surgery may lead to health benefits. Randomized controlled trials should be conducted to identify optimal treatment in patients with LHPT.
Inequalities for women diagnosed with distal arch and descending thoracic aortic aneurysms: results from the Effective Treatments for Thoracic Aortic Aneurysms (ETTAA) cohort study
Authors: Pouncey Anna L , Patel Dhvni , Freeman Carol , Sastry Priya , Bicknell Colin , Large Stephen R , Sharples Linda D
Published: August 2024

Background

Women with thoracic aortic aneurysms within the arch or descending thoracic aorta have poorer survival than men. Sex differences in relative thoracic aortic aneurysm size may account for some of the discrepancy. The aim of this study was to explore whether basing clinical management on aneurysm size index (maximum aneurysm diameter/body surface area) rather than aneurysm size can restore equality of survival by sex.

Methods

The Effective Treatments for Thoracic Aortic Aneurysms (ETTAA; ISRCTN04044627) study was a prospective, observational cohort study. Adults referred to National Health Service hospitals in England with new/existing arch or descending thoracic aorta aneurysms greater than or equal to 4 cm in diameter were followed from March 2014 to March 2022. Baseline characteristics and survival to intervention and overall were compared for men and women. Survival models were used to assess the association between all-cause survival and sex, with and without adjustment for aneurysm diameter or aneurysm size index.

Results

A total of 886 thoracic aortic aneurysm patients were recruited: 321 (36.2%) women and 565 (63.8%) men. The mean(s.d.) aneurysm diameter was the same for women and men (5.7(1.1) versus 5.7(1.2) cm respectively; P = 0.751), but the mean(s.d.) aneurysm size index was greater for women than for men (3.32(0.80) versus 2.83(0.63) respectively; P < 0.001). Women had significantly worse survival without intervention: 110 (34.3%) women and 135 (23.9%) men (log rank test, P < 0.001). All-cause mortality remained greater for women after adjustment for diameter (HR 1.65 (95% c.i. 1.35 to 2.02); P < 0.001), but was attenuated after adjustment for aneurysm size index (HR 1.11 (95% c.i. 0.89 to 1.38); P = 0.359). Similar results were found for all follow-up, with or without intervention, and findings were consistent for descending thoracic aorta aneurysms alone.

Conclusion

Guidelines for referral to specialist services should consider including aneurysm size index rather than diameter to reduce inequity due to patient sex.
Freezing of gait in Parkinson's disease is related to imbalanced stopping–related cortical activity
Authors: Cockx Helena M , Oostenveld Robert , Flórez R Yuli A , Bloem Bastiaan R , Cameron Ian G M , van Wezel Richard J A
Published: August 2024

Freezing of gait, characterized by involuntary interruptions of walking, is a debilitating motor symptom of Parkinson's disease that restricts people's autonomy. Previous brain imaging studies investigating the mechanisms underlying freezing were restricted to scan people in supine positions and yielded conflicting theories regarding the role of the supplementary motor area and other cortical regions. We used functional near-infrared spectroscopy to investigate cortical haemodynamics related to freezing in freely moving people. We measured functional near-infrared spectroscopy activity over multiple motor-related cortical areas in 23 persons with Parkinson's disease who experienced daily freezing (‘freezers’) and 22 age-matched controls during freezing-provoking tasks including turning and doorway passing, voluntary stops and actual freezing. Crucially, we corrected the measured signals for confounds of walking. We first compared cortical activity between freezers and controls during freezing-provoking tasks without freezing (i.e. turning and doorway passing) and during stops. Secondly, within the freezers, we compared cortical activity between freezing, stopping and freezing-provoking tasks without freezing. First, we show that turning and doorway passing (without freezing) resemble cortical activity during stopping in both groups involving activation of the supplementary motor area and prefrontal cortex, areas known for their role in inhibiting actions. During these freezing-provoking tasks, the freezers displayed higher activity in the premotor areas than controls. Secondly, we show that, during actual freezing events, activity in the prefrontal cortex was lower than during voluntary stopping. The cortical relation between the freezing-provoking tasks (turning and doorway passing) and stopping may explain their susceptibility to trigger freezing by activating a stopping mechanism. Besides, the stopping-related activity of the supplementary motor area and prefrontal cortex seems to be out of balance in freezers. In this paper, we postulate that freezing results from a paroxysmal imbalance between the supplementary motor area and prefrontal cortex, thereby extending upon the current role of the supplementary motor area in freezing pathophysiology.
Exploring yeast biodiversity and process conditions for optimizing ethylene glycol conversion into glycolic acid
Authors: Senatore Vittorio Giorgio , Milanesi Riccardo , Masotti Fiorella , Maestroni Letizia , Pagliari Stefania , Cannavacciuolo Ciro , Campone Luca , Serra Immacolata , Branduardi Paola
Published: August 2024

Plastics have become an indispensable material in many fields of human activities, with production increasing every year; however, most of the plastic waste is still incinerated or landfilled, and only 10% of the new plastic is recycled even once. Among all plastics, polyethylene terephthalate (PET) is the most produced polyester worldwide; ethylene glycol (EG) is one of the two monomers released by the biorecycling of PET. While most research focuses on bacterial EG metabolism, this work reports the ability of Saccharomyces cerevisiae and nine other common laboratory yeast species not only to consume EG, but also to produce glycolic acid (GA) as the main by-product. A two-step bioconversion of EG to GA by S. cerevisiae was optimized by a design of experiment approach, obtaining 4.51 ± 0.12 g l−1 of GA with a conversion of 94.25 ± 1.74% from 6.21 ± 0.04 g l−1 EG. To improve the titer, screening of yeast biodiversity identified Scheffersomyces stipitis as the best GA producer, obtaining 23.79 ± 1.19 g l−1 of GA (yield 76.68%) in bioreactor fermentation, with a single-step bioprocess. Our findings contribute in laying the ground for EG upcycling strategies with yeasts.
Mobilising Transnational Labour Law in Search of Transformation in Europe
Authors: Meakin Jack
Published: August 2024

This paper provides a critical map of trade unions’ strategic engagements with transnational legal mechanisms in Europe. Despite high profile defeats and challenges faced by workers and trade unions before supranational courts, they have continued to mobilise complaint and supervisory mechanisms at the transnational level. This raises questions about the reasons why and how law is mobilised in the industrial relations context and over the transformative potential of transnational labour law. Legal argumentation has been mobilised to defend and redetermine legislative rights to protect vulnerable workers and provide the conditions for democracy at work. The experience of legal mobilisation detailed in this paper encourages a sceptical and pragmatic approach to social transformation via legal mobilisation. It will set out the legal opportunities that shape the effectiveness of transnational labour law mobilisation, as well as the structural limitations and competing normative interests that delimit the interpretive trajectory, recognition, and enjoyment of collective labour rights in contemporary Europe.
Evaluating the cost-effectiveness of Cy-Tb for LTBI in India: a comprehensive economic modelling analysis
Authors: Muniyandi Malaisamy , Nagarajan Karikalan , Mathiyazhagan Kavi , Tyagi Kirti , Rajsekar Kavitha , Padmapriyadarsini Chandrasekaran
Published: August 2024

Background

Latent tuberculosis infection (LTBI) remains a significant challenge, as there is no gold standard diagnostic test. Current methods used for identifying LTBI are the interferon-γ release assay (IGRA), which is based on a blood test, and the tuberculin skin test (TST), which has low sensitivity. Both these tests are inadequate, primarily because they have limitations with the low bacterial burden characteristic of LTBI. This highlights the need for the development and adoption of more specific and accurate diagnostic tests to effectively identify LTBI. Herein we estimate the cost-effectiveness of the Cy-Tb test as compared with the TST for LTBI diagnosis.

Methods

An economic modelling study was conducted from a health system perspective using decision tree analysis, which is most widely used for cost-effectiveness analysis using transition probabilities. Our goal was to estimate the incremental cost and number of TB cases prevented from LTBI using the Cy-Tb diagnostic test along with TB preventive therapy (TPT). Secondary data such as demographic characteristics, treatment outcome, diagnostic test results and cost data for the TST and Cy-Tb tests were collected from the published literature. The incremental cost-effectiveness ratio was calculated for the Cy-Tb test as compared with the TST. The uncertainty in the model was evaluated using one-way sensitivity analysis and probability sensitivity analysis.

Results

The study findings indicate that for diagnosing an additional LTBI case with the Cy-Tb test and to prevent a TB case by providing TPT prophylaxis, an additional cost of 18 658 Indian rupees (US${\$}$223.5) is required. The probabilistic sensitivity analysis indicated that using the Cy-Tb test for diagnosing LTBI was cost-effective as compared with TST testing. If the cost of the Cy-Tb test is reduced, it becomes a cost-saving strategy.

Conclusions

The Cy-Tb test for diagnosing LTBI is cost-effective at the current price, and price negotiations could further change it into a cost-saving strategy. This finding emphasizes the need for healthcare providers and policymakers to consider implementing the Cy-Tb test to maximize economic benefits. Bulk procurements can also be considered to further reduce costs and increase savings.
Strengthening Military Medical Provider Readiness: A Comprehensive Examination of VHA-MHS Partnerships
Authors: Brown Shaun
Published: August 2024

Military medical readiness, particularly in surgical specialties, remains a significant concern within the Military Health System (MHS). While initiatives like the U.S. Army Military-Civilian Trauma Team (AMCT3) Program have addressed some readiness gaps, they primarily focus on trauma care, leaving other crucial medical specialties underserved. Leveraging partnerships between the Department of Veterans Affairs (VA) and the Defense Health Agency (DHA) emerges as a strategic approach to address these challenges comprehensively. Further collaboration between the VA and MHS is an opportunity to enhance military medical provider readiness, covering expanded medical specialties and health care personnel. By utilizing resource-sharing agreements (RSAs) and the Joint Incentive Fund (JIF), opportunities for increased collaboration and interoperability between the VA and MHS are explored. Challenges such as maintaining partnerships, addressing billing issues, and navigating local-level politics are identified, with proposed solutions, including establishing a centralized interagency office to monitor and manage specialty care partnerships. A comprehensive approach to enhancing military medical provider readiness through VA-MHS partnerships is crucial. By addressing readiness gaps and optimizing resource utilization, such collaboration would likely improve the overall readiness of the medical force, benefiting both military and veteran patient populations.
The effects of surface fossil magnetic fields on massive star evolution: V. Models at low metallicity
Authors: Keszthelyi Z , Puls J , Chiaki G , Nagakura H , ud-Doula A , Takiwaki T , Tominaga N
Published: August 2024

At metallicities lower than that of the Small Magellanic Cloud, it remains essentially unexplored how fossil magnetic fields, forming large-scale magnetospheres, could affect the evolution of massive stars, thereby impacting the fundamental building blocks of the early Universe. We extend our stellar evolution model grid with representative calculations of main-sequence, single-star models with initial masses of 20 and 60 M$_\odot$, including appropriate changes for low-metallicity environments ($Z = 10^{-3}$–$10^{-6}$). We scrutinize the magnetic, rotational, and chemical properties of the models. When lowering the metallicity, the rotational velocities can become higher and the tendency towards quasi-chemically homogeneous evolution increases. While magnetic fields aim to prevent the development of this evolutionary channel, the weakening stellar winds lead to less efficient magnetic braking in our models. Since the stellar radius is almost constant during a blueward evolution caused by efficient chemical mixing, the surface magnetic field strength remains unchanged in some models. We find core masses at the terminal-age main sequence between 22 and 52 M$_\odot$ for initially 60 M$_\odot$ models. This large difference is due to the vastly different chemical and rotational evolution. We conclude that in order to explain chemical species and, in particular, high nitrogen abundances in the early Universe, the adopted stellar models need to be under scrutiny. The assumptions regarding wind physics, chemical mixing, and magnetic fields will strongly impact the model predictions.
The star-forming and ionizing properties of dwarf z ~ 6–9 galaxies in JADES: insights on bursty star formation and ionized bubble growth
Authors: Endsley Ryan , Stark Daniel P , Whitler Lily , Topping Michael W , Johnson Benjamin D , Robertson Brant , Tacchella Sandro , Alberts Stacey , Baker William M , Bhatawdekar Rachana , Boyett Kristan , Bunker Andrew J , Cameron Alex J , Carniani Stefano , Charlot Stephane , Chen Zuyi , Chevallard Jacopo , Curtis-Lake Emma , Danhaive A Lola , Egami Eiichi , Eisenstein Daniel J , Hainline Kevin , Helton Jakob M , Ji Zhiyuan , Looser Tobias J , Maiolino Roberto , Nelson Erica , Puskás Dávid , Rieke George , Rieke Marcia , Rix Hans-Walter , Sandles Lester , Saxena Aayush , Simmonds Charlotte , Smit Renske , Sun Fengwu , Williams Christina C , Willmer Christopher N A , Willott Chris , Witstok Joris
Published: August 2024

Reionization is thought to be driven by faint star-forming galaxies, but characterizing this population has long remained very challenging. Here, we utilize deep nine-band JADES (JWST Advanced Deep Extragalactic Survey)/NIRCam (Near-Infrared Camera) imaging to study the star-forming and ionizing properties of 756 $z\sim 6-9$ galaxies, including hundreds of very ultraviolet (UV)-faint objects ($M_\mathrm{UV}\gt -18$). The faintest ($m\sim 30$) galaxies in our sample typically have stellar masses of $M_\ast \sim (1-3)\times 10^7\ \mathrm{ M}_\odot$ and young light-weighted ages ($\sim$50 Myr), though some show strong Balmer breaks implying much older ages ($\sim$500 Myr). We find no evidence for extremely massive galaxies ($\gt 3\times 10^{10}\ \mathrm{ M}_\odot$) in our sample. We infer a strong (factor $\gt $2) decline in the typical [O iii]$+$H $\beta$ equivalent widths (EWs) towards very faint $z\sim 6-9$ galaxies, yet a weak UV luminosity dependence on the H $\alpha$ EWs at $z\sim 6$. We demonstrate that these EW trends can be explained if fainter galaxies have systematically lower metallicities as well as more recently declining star formation histories relative to the most UV-luminous galaxies. Our data provide evidence that the brightest galaxies are frequently experiencing a recent strong upturn in star formation rate. We also discuss how the EW trends may be influenced by a strong correlation between $M_\mathrm{UV}$ and Lyman continuum escape fraction. This alternative explanation has dramatically different implications for the contribution of galaxies along the luminosity function to cosmic reionization. Finally, we quantify the photometric overdensities around two $z\,\gt\,7$ strong Ly $\alpha$ emitters. One Ly $\alpha$ emitter lies close to a strong photometric overdensity, while the other shows no significant nearby overdensity, perhaps implying that not all strong $z\,\gt\, 7$ Ly $\alpha$ emitters reside in large ionized bubbles.
Jupiter's Hotspots as observed by JIRAM-Juno: limb darkening in thermal infrared
Authors: Grassi D , Mura A , Adriani A , Sindoni G , Atreya S K , Fletcher L N , Orton G S , Plainaki C , Tosi F , Biagiotti F , Olivieri A , Castagnoli C , D'Aversa E , Migliorini A , Moirano A , Noschese R , Piccioni G , Sordini R , Bolton S
Published: August 2024

The Jupiter InfraRed Auroral Mapper (JIRAM) instrument onboard the Juno spacecraft performed repeated observations of Jupiter's North Equatorial Belt (NEB) around the time of 12th Juno pericenter passage on 2018 April 1. The data consist of thermal infrared images and show, among other atmospheric features, two bright Hotspots on the boundary between the NEB and the Equatorial Zone. Night-time images of the same areas at different emission angles were used to constrain the trend of the limb-darkening function. Comparison with simulated observations, computed for different emission angles, total opacities, single scattering albedo ω0, and asymmetry parameter g suggests that ω0 ∼ 0.90 ± 0.05 and g ∼ 0.37 ± 0.15 provide best match with data. Subsequently, we computed the ω0 and g resulting from different size distributions, taking into account the complex refractive indices of ammonium hydrosulfide (NH4SH) by Howett et al. [2007] and Ferraro et al. [1980]. Only the former data set is marginally consistent with JIRAM observations. Similarly, ammonia and hydrazine barely reproduce the experimental data. Tholin, although not usually considered a realistic component for Jupiter's aerosols, provides a better match for particle radii between 0.7 and 1 μm, both as a pure material as well as a thick coating over NH4SH cores. Notably, this radius range is consistent with the mean radius of aerosols as estimated by Ragent et al. [1998] on the basis of Galileo entry probe data. Comparison with literature suggests that similar results can be achieved by a large variety of contaminants bearing C–N bounds.
Pro-environmental behavior: the relationship with information literacy self-efficacy, climate knowledge and climate anxiety among students in Ghana
Authors: Akakpo Martin Gameli , Bokpin Hayford Alufar , Hagan Sylvia
Published: August 2024

As environmental concerns escalate globally, understanding pro-environmental behavior is important. Using a cross-sectional survey of 265 university students from Accra, Ghana, the study hypothesized that pro-environmental behavior is related to climate change knowledge, information literacy self-efficacy and climate change anxiety. Pearson product-moment correlation coefficient and simple linear regression were used to test the hypothesis. Findings suggest that climate change knowledge was positively related to information literacy self-efficacy and climate change anxiety. Climate change knowledge and information literacy self-efficacy also positively predicted pro-environmental behavior. Findings imply that students should be trained to improve their climate change knowledge and acquire information literacy skills. Training these skills can contribute to the development of responsible environmental behavior in society.
French Imperial Statecraft, Capital, Corporate Taxation, and the Tax Haven that Wasn’t, 1920s–1950s
Authors: Woker Madeline
Published: August 2024

Towards the mid-1920s, a growing number of colonial firms began to transfer their headquarters from the metropole to French colonies to evade taxation on investment capital income. These transfers threatened to transform French colonies into tax havens. Why was this averted? This article explores the politics of corporate tax planning in the French colonial empire and shows that French colonial tax havens could have materialized on a large scale at two critical junctures: first in the inter-war period and then in the aftermath of the Second World War. It argues that they eventually did not come into being because successive administrations within the French Ministry of Finance did not let it happen. Broader structural determinants — the relative weakness of the French metropolitan fiscal state in the inter-war period and the unwillingness to let international capital dictate French development strategies in the late colonial period — crucially influenced the positions taken by the Ministry of Finance. Post-war dreams of restored grandeur made French authorities much more reluctant to outsource development and let go of state prerogatives. This unrealized possibility sheds light on the role of state power in the making and unmaking of tax havens and contributes to a fast-expanding historiography.
Lipid nanoparticle-based mRNA vaccines: a new frontier in precision oncology
Authors: Jacob Eden M , Huang Jiaoti , Chen Ming
Published: August 2024

The delivery of lipid nanoparticle (LNP)-based mRNA therapeutics has captured the attention of the vaccine research community as an innovative and versatile tool for treating a variety of human malignancies. mRNA vaccines are now in the limelight as an alternative to conventional vaccines owing to their high precision, low-cost, rapid manufacture, and superior safety profile. Multiple mRNA vaccine platforms have been developed to target several types of cancer, and many have demonstrated encouraging results in animal models and human trials. The effectiveness of these new mRNA vaccines depends on the efficacy and stability of the antigen(s) of interest generated and the reliability of their delivery to antigen-presenting cells (APCs), especially dendritic cells (DCs). In this review, we provide a detailed overview of mRNA vaccines and their delivery strategies and consider future directions and challenges in advancing and expanding this promising vaccine platform to widespread therapeutic use against cancer.
Effect of radiofrequency ablation of genicular nerves on the isokinetic muscle strength of knee joint in patients with osteoarthritis knee: a randomized double-blind sham controlled clinical trial
Authors: Makkar Jeetinder K , Warrier Gayathri , Ghai Babita , Chhabra Monica , Sarkar Pradip K , Goni Vijay G , Khurana Bisman J K
Published: August 2024

Background

This randomized controlled trial evaluated the effect of radiofrequency ablation (RFA) of genicular nerve on muscle strength in osteoarthritis (OA) knee patients with chronic pain.

Methodology

Fifty-four patients with chronic knee OA, experiencing significant pain (visual numeric rating scale [VNRS] >50) and moderate to severe disease (Kellgren Lewis grade ≥2) were enrolled. Group 1 received RFA of genicular nerves of the affected knee while Group 2 received a sham procedure. The primary outcome was change in knee muscle strength evaluated using isokinetic peak torque (IPT) using IsoforceTM isokinetic dynamometer at 3 months. Secondary outcomes included changes in pain scores, function, perceived effect of the treatment and compliance to physiotherapy.

Results

At 3 months, significant difference was observed between IPT of flexor muscle at 60° and 180° between the treatment and the Sham control (P-value = .01). No significant difference was observed in the extensor muscle strength. Within-group analysis revealed a significant increase in the IPT values for both extension and flexion at 60°/sec and 180°/sec evident across various time intervals. Group1 consistently reported lower VNRS scores at all time points. Western Ontario and McMaster Universities Osteoarthritis Index scores of both groups were significantly different at all timepoints, with higher scores indicating reduced functionality in Group2. The Global Perceived Effect and compliance to physiotherapy were higher in Group1 patients at all times of follow up albeit decreasing trend in later periods.

Conclusion

Application of RFA to genicular nerves in chronic OA knee patients resulted in better pain relief, improved functionality, and increased muscle strength at extension and flexion at 3 months follow-up.

Clinical Trial Registry of India — CTRI registration number

CTRI/2020/05/025363.
Imaging of Cerebrovascular Disease in Young Adults: What the Radiologist Needs to Know
Authors: Wang Huijuan , Medvedev Serguei , Zaki-Metias Kaitlin M. , Deptula Lisa , Pearce Eboni , Satei Alexander M. , Mills Nicholas , Pappas George
Published: August 2024

Cerebrovascular disease (CVD) can result from blood vessel narrowing, rupture, or a hypercoagulable state, which may present on imaging as vascular stenosis, hemorrhage, or occlusion, respectively. As an emerging public health issue with debilitating effects on young adults, recognizing the similarities and differences between CVD in young adults and elderly patients is imperative for optimizing management and patient outcomes. In addition to recognizing key imaging findings for the various causes of CVD, radiologists should be familiar with the clinical presentation, differential diagnoses, and management options for each of these diverse pathologies. For the purposes of this manuscript, young adults are defined as those age 18 to 50 years old.
The Needs Assessment: An Educator’s First Step
Authors: Alroumi Fahad , Belcher Anne
Published: August 2024

Every novel curriculum begins with a needs assessment. A general needs assessment identifies the problem that a curriculum seeks to address, and it clearly delineates the gap between the current and ideal state of affairs.1 Building on the general needs assessment, a targeted needs assessment refines those needs to the specific learners and their environment.1-3 The two are a continuum and constitute the first step in curriculum design.
Pre-existing Diabetes and Stillbirth or Perinatal Mortality
Authors: Blankstein Anna R. , Sigurdson Sarah M. , Frehlich Levi , Raizman Zach , Donovan Lois E. , Lemieux Patricia , Pylypjuk Christy , Benham Jamie L. , Yamamoto Jennifer M.
Published: August 2024

OBJECTIVE:

Despite the well-recognized association between pre-existing diabetes mellitus and stillbirth or perinatal mortality, there remain knowledge gaps about the strength of association across different populations. The primary objective of this systematic review and meta-analysis was to quantify the association between pre-existing diabetes and stillbirth or perinatal mortality, and secondarily, to identify risk factors predictive of stillbirth or perinatal mortality among those with pre-existing diabetes.

DATA SOURCES:

MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception to April 2022.

METHODS OF STUDY SELECTION:

Cohort studies and randomized controlled trials in English or French that examined the association between pre-existing diabetes and stillbirth or perinatal mortality (as defined by the original authors) or identified risk factors for stillbirth and perinatal mortality in individuals with pre-existing diabetes were included. Data extraction was performed independently and in duplicate with the use of prespecified inclusion and exclusion criteria. Assessment for heterogeneity and risk of bias was performed. Meta-analyses were completed with a random-effects model.

TABULATION, INTEGRATION, AND RESULTS:

From 7,777 citations, 91 studies met the inclusion criteria. Pre-existing diabetes was associated with higher odds of stillbirth (37 studies; pooled odds ratio [OR] 3.74, 95% CI, 3.17–4.41, I

2
=82.5%) and perinatal mortality (14 studies; pooled OR 3.22, 95% CI, 2.54–4.07, I

2
=82.7%). Individuals with type 1 diabetes had lower odds of stillbirth (pooled OR 0.81, 95% CI, 0.68–0.95, I

2
=0%) and perinatal mortality (pooled OR 0.73, 95% CI, 0.61–0.87, I

2
=0%) compared with those with type 2 diabetes. Prenatal care and prepregnancy diabetes care were significantly associated with lower odds of stillbirth (OR 0.26, 95% CI, 0.11–0.62, I

2
=87.0%) and perinatal mortality (OR 0.41, 95% CI, 0.29–0.59, I

2
=0%).

CONCLUSION:

Pre-existing diabetes confers a more than threefold increased odds of both stillbirth and perinatal mortality. Maternal type 2 diabetes was associated with a higher risk of stillbirth and perinatal mortality compared with maternal type 1 diabetes.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42022303112.
Evaluation of Statewide Program to Reduce Cesarean Deliveries Among Nulliparous Individuals With Singleton Pregnancies at Term Gestation in Vertex Presentation
Authors: Rosenstein Melissa G. , Chang Shen-Chih , Tucker Curisa M. , Sakowski Christa , Leonard Stephanie A. , Main Elliott K.
Published: August 2024

OBJECTIVE:

To evaluate the effect of statewide efforts to reduce nulliparous, term, singleton, vertex (NTSV) cesarean delivery rates in California.

METHODS:

This was a population-based study of all NTSV births in California from 2015 to 2019. In 2015, all California hospitals with NTSV cesarean delivery rates above the 23.9% Healthy People 2020 target were invited to join a CMQCC (California Maternal Quality Care Collaborative)–sponsored, 3-year, multifaceted collaborative or a system-level quality collaborative to safely support vaginal birth. We examined the cesarean delivery rate overall and by participation or nonparticipation in a collaborative program. Secondarily, for hospitals that started with an NTSV cesarean delivery rate above 23.9%, we compared patient-level, hospital-level, and obstetric management characteristics between hospitals that met the Healthy People 2020 target (cesarean delivery rate below 23.9%) in 2019 and those that did not.

RESULTS:

There were 758,268 NTSV births at 238 hospitals. Annual mean NTSV cesarean delivery rates decreased among all racial and ethnic groups statewide and among all patients, regardless of payer, maternal age, or body mass index (BMI). The decrease in cesarean delivery was driven largely by a decrease in the frequency of cesarean delivery performed for labor dystocia (14.9% in 2015 to 12.8% in 2019) and from cesarean delivery before the onset of labor (4.2% in 2015 to 3.3% in 2019). For hospitals that started with an NTSV cesarean delivery rate above 23.9%, NTSV cesarean delivery rates among 80 hospitals participating in the CMQCC had a mean±SD decline of 6.9±5.9%, 13 hospitals participating in the system-level collaborative had a 5.0±4.5% decline, and those not participating in any collaborative had a 2.1±6.0% decline. In multivariable analysis, there was no association between meeting the Healthy People target and any of the hospital-level factors or aggregated patient-level characteristics. Rates of induction of labor increased in both groups and were not associated with a change in cesarean delivery rates.

CONCLUSION:

Hospitals in California between 2015 and 2019 with a wide variation in institutional and patient characteristics successfully reduced their NTSV cesarean delivery rates. Reduction in the NTSV cesarean delivery rate at hospitals that started above the Healthy People target was not associated with differences in patient characteristics but rather a reduction in cesarean deliveries for labor dystocia and cesarean deliveries performed before the onset of labor.
Associations of the EAT-Lancet reference diet with metabolic dysfunction–associated steatotic liver disease and its severity: A multicohort study
Authors: Zhang Shunming , Yan Yan , Zeng Xu-Fen , Gu Yeqing , Wu Hongmei , Zhang Qing , Liu Li , Huo Zhenyu , Luo Xiaoqin , Zhang Rui , Sonestedt Emily , Borné Yan , Qi Lu , Huang Tao , Zheng Ming-Hua , Chen Yu-Ming , Niu Kaijun , Ma Le
Published: August 2024

Background and Aims:

The EAT-Lancet Commission devised a globally sustainable dietary pattern to jointly promote human health and sustainability. However, the extent to which this diet supports metabolic dysfunction–associated steatotic liver disease (MASLD) has not yet been assessed. This study aimed to investigate the association between the EAT-Lancet diet and the risk of MASLD and its severity.

Approach and Results:

This prospective multicohort study included 15,263 adults from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort, 1137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort, and 175,078 adults from the UK Biobank. In addition, 228 Chinese adults from the Prospective Epidemic Research Specifically of Non-alcoholic Steatohepatitis (PERSONS) with biopsy-proven MASLD were included. An EAT-Lancet diet index was created to reflect adherence to the EAT-Lancet reference diet. The TCLSIH cohort recorded 3010 MASLD cases during 53,575 person-years of follow-up, the GNHS cohort documented 624 MASLD cases during 6454 person-years of follow-up, and the UK Biobank developed 1350 MASLD cases during 1,745,432 person-years of follow-up. In multivariable models, participants in the highest tertiles of the EAT-Lancet diet index had a lower risk of MASLD compared with those in the lowest tertiles (TCLSIH: HR = 0.87, 95% CI: 0.78, 0.96; GNHS: HR = 0.79, 95% CI: 0.64, 0.98; UK Biobank: HR = 0.73, 95% CI: 0.63, 0.85). Moreover, liver-controlled attenuation parameter decreased with increasing the diet index in individuals with biopsy-proven MASLD (β = −5.895; 95% CI: −10.014, −1.775).

Conclusions:

Adherence to the EAT-Lancet reference diet was inversely associated with the risk of MASLD as well as its severity.
Aerobic exercise effects on systolic blood pressure and endothelial inflammation in obese and non-obese elderly women with isolated systolic hypertension
Authors: Koh Suhan , Kim Doyeon , Kim Minkyo , Kim Taekyu
Published: August 2024

Objectives:

This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension.

Methods:

Elderly women aged 70–85 years were recruited and grouped into the normal isolated systolic hypertension (n = 12) and obese isolated systolic hypertension groups (n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences.

Results:

An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 (P < 0.05) and a main time effect for oxidized low-density lipoprotein (P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 (P < 0.05) with a 42.8% influence (P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 (P < 0.05) with a 21.6% influence (P < 0.05) was observed.

Conclusions:

These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.
INTRAOCULAR PRESSURE AND SAFETY OF VITRECTOMY WITH VITREOUS GAS REPLACEMENT USING LOW-CONCENTRATION NITROUS OXIDE GAS ANESTHESIA
Authors: Noguchi Santaro , Nakakura Shunsuke , Noguchi Asuka , Tabuchi Hitoshi
Published: August 2024

Purpose:

The aim of this study is to evaluate the efficacy and safety of vitrectomy with vitreous gas replacement using low-concentration nitrous oxide (N2O) gas anesthesia, focusing on intraocular pressure (IOP) changes, pain, anxiety, and safety outcomes.

Methods:

This retrospective study analyzed 133 patients undergoing fluid-air exchange without use of SF6 or C3F8, at Saneikai Tsukazaki Hospital, Japan, from April 2019 to March 2022. Participants were divided into two groups: those receiving low-concentration nitrous oxide gas anesthesia (N2O group) and those receiving local anesthesia with room air inhalation (air group). IOP, pain, anxiety levels, and intraoperative complications were assessed.

Results:

No significant differences were found in IOP changes postoperatively between the N2O and air groups. The N2O group reported significantly lower pain scores and had lower intraoperative systolic blood pressure and heart rate changes compared with the air group. No significant intraoperative or postoperative complications were observed in either group.

Conclusion:

Vitrectomy with fluid-air exchange using low-concentration nitrous oxide gas anesthesia is safe, does not increase IOP, and may offer benefits in reducing intraoperative pain and stabilizing vital signs compared with traditional local anesthesia methods. This approach could be considered a viable option for vitreous surgery requiring fluid-air exchange.