bluuebunny/crossref_metadata_2025 huggingface dataset:
The Origins of Futures Trading in the Liverpool Cotton Market
Authors: Simpson A W B
Published: November 2023

I first became interested in the origins of futures trading through investigating the historical background to the contract case, Raffles v. Wichelhaus and Busch (1864). This case was first seriously discussed by an American exile to the English bar, Judah P. Benjamin, in his treatise on the law of sale. The story of the two ships forms the basis for arguments about the principles of contract formation. The form of contract, known as a contract ‘to arrive’, or an ‘arrival’ contract, out of which the litigation arose, evolved, somehow, into the form used for futures trading in cotton; Liverpool was one of the places where a large, organized futures market developed in the nineteenth century.
Enforcement of Intellectual Property Rights Through Border Measures
Authors: Vrins Olivier , Schneider Marius
Published: November 2023

This book is a practical guide on anti-counterfeiting and anti-piracy measures at the borders of the enlarged European Community. It deals with all aspects of ‘border measures’ under Regulation (EC) 1383/2003. As well as providing a thorough description of the implementation of the new regime, the publication also fills in the gaps by including areas of national law, thus providing a coherent overview of the application of the current regime of border measures in place within the European Union. The main topics addressed are: (i) the general background behind the phenomena of counterfeiting and piracy in Europe (by Prof. Michael Blakeney); (ii) the international legal framework for border measures (Paris Convention, Berne Convention, TRIPS, WIPO Model Provisions, etc.) (by Prof. Daniel Gervais), as well as (EC) Regulation 1383/2003, Implementing Regulation 1891/2004 and the case law of the European Court of Justice (by Mr Schneider and Mr Vrins); (iii) the main part of the book is devoted to national reports on the application of border measures in all 25 Member Countries of the European Community; (iv) the last Chapter of the book highlights the similarities and differences in the approaches adopted by the Member States when faced with infringements of intellectual property rights at the borders, and attempts to emphasize how these are relevant to right-holders when defining their strategies in the fight against such infringements. This manual is the very first English language publication dealing with the practical application of Regulation 1383/2003 in all 25 Member Countries of the European Community.
The Phenomenon Of Counterfeiting And Piracy In The European Union: Factual Overview And Legal And Institutional Framework
Authors: Blakeney Michael
Published: November 2023

In developed countries, there is good evidence that intellectual property is, and has been, important for the promotion of invention in some industrial sectors, particularly the pharmaceutical, chemical, and petroleum industries as well as biotechnology and some components of information technology. Copyright has also proven essential for the music, film, and publishing industries. For developing countries, the nurturing of indigenous technological capacity through the intellectual property system has also proved to be a key determinant of economic growth and poverty reduction.
Cyprus
Authors: Markides Alecos , Markides Hermione A
Published: November 2023

The Control of Free Circulation of Counterfeit and Pirated Goods Law 2002 (‘Law 31(I) of 2002’),was adopted in 2002 in order to honour an obligation undertaken by the Republic of Cyprus during negotiations to prepare for its accession to the European Union. The object of this Law was the proper incorporation into the legal order of Cyprus of the following Community Acts:Commission Regulation (EC) 1367/95, as amended.
Estonia
Authors: Koitel Raivo
Published: November 2023

Prior to the entry into force of EC Regulation 1383/2003(‘the Regulation’), the Customs Codeand the Act on the Prevention of Import and Export of Goods Infringing Intellectual Property Rightswere in force in Estonia. The Customs Code was limited solely to pirated and counterfeit goods, whilst the Act on the Prevention of Import and Export of Goods Infringing Intellectual Property Rights, which came into force on 1 September 2001, also covered patents, utility models, and layout topographies of integrated circuits.
Finland
Authors: Juthström Bernt , Harsu Johanna
Published: November 2023

Finland plays a special role in the fight against counterfeiting and pirated goods due to its geographic location at the Russian border. The territory of Finland is increasingly used for transit to infiltrate both the European and Russian markets with illegal products. The approach of the national customs authorities to anti-counterfeiting measures has been very effective and Finnish Customs is internationally recognized as an authority that is highly motivated to reduce trade in infringing goods.
Latvia
Authors: Uzulena Mara , Merzvinskis Gatis
Published: November 2023

Since 1991, Latvia has undergone profound political, social, and economical changes, including the transition from a centrally planned to a market economy. Having started from scratch, Latvia has established an efficient legislative system in all fields of social life, including intellectual property. Shortly after regaining independence in 1991, appropriate legislation governing intellectual property rights as well as their protection was adopted in Latvia.
Malta
Authors: Tonna David , Camilleri Antoine
Published: November 2023

The regulation of border measures under Maltese law, in the fight against counterfeiting, commenced back in the year 2000 with the promulgation by the Maltese Parliament of a law entitled Intellectual Property Rights (Cross-Border Measures) Law.The scope behind this Law was that of establishing measures relating to the importation into Malta, and exportation and re-exportation from Malta, of goods in contravention of intellectual property rights.
Portugal
Authors: Rato Gonçalo Moreira , Cruz Nuno
Published: November 2023

Portugal traditionally follows the legislative system of codification. It is therefore no surprise that Portuguese national legislation in the field of intellectual property is included in only two codes, as well as a few other individual laws governing specific aspects of copyright. This is the case particularly of the industrial property legislation, which is totally compiled into a single law, known as the Código da Propriedade Industrial (‘Industrial Property Code’).
Intellectual Property: Borders And Crossroads An overview of the issues
Authors: Phillips Jeremy
Published: November 2023

The authors of the substantive chapters of this book have prepared a thorough and detailed analysis of the legal provisions governing the interception of infringing products at the borders of the European Union. This chapter will not duplicate any of that material. Instead it will attempt, by saying a little about the subject, to explain why those chapters are so very important.
Middle-Late Miocene to Pleistocene Post-Collisional Magmatism in the Arabia-Eurasia Collision Zone, an Example from Northwest Iran
Authors: Moghadam Hadi Shafaii , Hoernle Kaj A , Hauff Folkmar , Chiaradia Massimo , Garbe-Schönberg Dieter , Orozco-Esquivel Teresa , Bindeman Ilya N , Karsli Orhan , Ghorbani Ghasem , Mousavi Naeim , Lucci Federico
Published: November 2023

Post-collisional volcanism contains important clues for understanding the processes that prevail in orogenic belts, including those in the mantle and the uplift and collapse of continents. Here we report new geochronological and geochemical data for a suite of post-collisional Miocene to Pleistocene volcanic rocks from northwest Iran. Four groups of volcanic rocks can be distinguished according to their geochemical and isotopic signatures, including: (1) Miocene depleted lavas with high Nd and Hf but low Pb and Sr isotopic ratios, (2) less depleted lavas with quite variable Pb isotopic composition, (3) lavas with non-radiogenic Nd and Hf isotopic values, but highly radiogenic Sr and Pb isotopic composition, and (4) Pleistocene adakitic rocks with depleted isotopic signatures. The isotopic data reveal that the Miocene rocks are derived from asthenospheric and highly heterogeneous sub-continental lithospheric mantle sources. Evidence suggests that the lithospheric mantle contains recycled upper continental material and is isotopically similar to the enriched mantle two (EMII) end-member. Analysis of Sr-Nd-Pb-Hf-O isotopes in both mineral and rock groundmass, in conjunction with energy-constrained assimilation and fractional crystallization (EC-AFC) numerical modeling, demonstrates that the incorporation of continental crust during magma fractionation via AFC had an insignificant impact on the isotopic composition of the Miocene lavas. Moreover, adakites are the youngest rocks and show a geochemical signature consistent with the partial melting of a young and mafic continental lower crust. Both seismological data and geochemical signatures on these Miocene to Pleistocene volcanic rocks indicate the initiation of asthenospheric upwelling and orogen uplift in the Arabia-Eurasia collision zone, which occurred after slab break-off, following the Neotethyan closure.
Just How Much of History Is Countable?
Authors: Carpenter Daniel
Published: November 2023

How can historical perspective be brought to the quantitative social sciences? The question has proven immensely popular, but answers that deal squarely with historical context and narrative remain elusive. An important recent book by Gregory Wawro and Ira Katznelson—Time Counts—provides an important new direction and a kit of useable tools. Using Wawro and Katznelson's approach and methods puts social scientists in a better position to appreciate the historicity of their data and to avoid common errors in statistical execution and inference. Time Counts also raises questions every bit as vital as those it answers, especially when it comes to the boundaries between narrative and quantitative work. An important concern is that inference from a particular historical setting (or what I call a “regime”) cannot be reduced to a special case of inference from large-sample statistics. Historical judgment is at least partially incommensurable with the idea of probability, cases are often important precisely because they are not countable, and scientific rigor may demand avoiding quantification for part of the social scientist's approach.
Structural Equation Modeling: Effects of Master Adaptive Learner and Clinical Learning Environment Attributes on Career Satisfaction and Intention to Stay
Authors: Osborne Raine , Bailey Chloe , Dinsmore Daniel , Lyter Emily , Burnfield Judy , Medearis Holly , Roura Amanda
Published: November 2023

Objective

The objective of this observational study was to test a proposed conceptual model depicting the influence of personal and environmental attributes of clinical learning environments on rehabilitation professionals’ career satisfaction and intention to stay with their current organization. The mediating effects of 2 loci of engagement were also assessed.

Methods

Rehabilitation professionals (physical therapists, occupational therapists, speech-language pathologists, and registered nurses; n = 436) from 4 health care organizations in the Northeast, Southeast, and Midwest regions in the USA completed a battery of questionnaires related to personal attributes (resilience and orientation toward lifelong learning), environmental attributes (innovation support and basic psychological need satisfaction at work), loci of engagement (professional and organizational), career satisfaction, and intention to stay. Data were analyzed using structural equation modeling.

Results

The measurement and structural model fit was acceptable. The greatest total effects on career satisfaction (r = .459) and intention to stay (r = .462) were observed through the influences of basic psychological need satisfaction, professional engagement, and organizational engagement. Orientation toward lifelong learning was negatively associated with career satisfaction (r = −.208) and intention to stay (r = −.154), but this was mitigated by organizational engagement (r = −.060 and − .134, respectively). Small but significant total effects were also observed between innovation support, professional and organizational engagement, and intention to stay (r = .144) and resilience, professional and organizational engagement, and career satisfaction (r = .110).

Conclusion

Clinical learning environments that support rehabilitation professionals’ basic psychological needs (autonomy, competency, and relatedness) are associated with greater career satisfaction and intention to stay. This association is further enhanced by organizational engagement and innovation support.

Impact

Rehabilitation organizations interested in developing and retaining master adaptive learners should create clinical learning environments that reinforce rehabilitation professionals’ sense of autonomy, competency, and relatedness, and are supportive on innovative behaviors.
Physical Activity Supported by Low-Cost Mobile Technology for Back Pain (PAT-Back) to Reduce Disability in Older Adults: Results of a Feasibility Study
Authors: Santos Ana Ellen do Nascimento , Nunes Ana Carla Lima , Pereira Leani Souza Máximo , Ferreira Manuela Loureiro , Ferreira Paulo Henrique , Macedo Luciana Gazzi , de Jesus-Moraleida Fabianna Resende
Published: November 2023

Objective

The purpose of this study was to evaluate the feasibility of a randomized controlled trial investigating the effectiveness of a multimodal program (PAT-Back) compared to best practice advice on pain and disability in older adults with chronic low back pain (LBP) in primary care.

Methods

This feasibility study took place in Fortaleza, Northeast Brazil. The PAT-Back intervention consisted of a program including exercises, pain education, and motivational text messages for the in-home component. The control group received an evidence-based educational booklet. Feasibility outcomes were recruitment, adherence and retention rates, level of difficulty of the education and intervention content, perception of utility of mobile technology, and adverse events. The feasibility criteria were previously defined.

Results

A total of 248 people were screened, of which 46 older adults were eligible. The retention rate was high (100% in the PAT-Back group and 95% in the control group). The adherence rate to intervention was partially met (60%), whereas the adherence rate to unsupervised exercises was adequate (75%), and perception about safety to perform home exercise was partially acceptable (70%) in the PAT-Back group. In addition, 100% of older adults reported which text messages motivated them to perform the exercises in the PAT-Back group. Difficulty reported by participants in understanding and performing the intervention was small in both groups. Six participants reported transient adverse events in both groups.

Conclusion

Older adults accepted both interventions. Results demonstrated that the program is feasible, although minor changes targeting adherence and safety in home exercise are needed.

Impact

This feasibility study supports progression to a full trial investigating the effectiveness of a multimodal program (PAT-Back) on pain and disability in older adults with chronic LBP within a primary health care setting in low to middle income countries where such data from the older population are scarce and the burden of LBP is increasing.
Longitudinal reciprocal association between rheumatoid arthritis and chronic obstructive pulmonary disease and mediation of inflammation
Authors: Yang Kai , Wang Lingwei , Chen Shuyu , Chen Rongchang
Published: November 2023

Objectives

To elucidate the longitudinal reciprocal association between RA and chronic obstructive pulmonary disease (COPD) and the mediating role of systemic inflammation in the association.

Methods

A total of 403 045 participants from UK Biobank were enrolled in this study. A cross-lagged panel model was used to investigate the longitudinal reciprocal association between RA and COPD. Cox proportional hazards regression and logistic regression models were also conducted to examine the association between baseline RA and COPD during follow-up, and vice versa. Causal mediation analysis was then performed to explore the mediating roles of 160 systemic inflammatory biomarkers in the bidirectional association.

Results

At baseline, 4755 (1.2%) and 6989 (1.7%) individuals were diagnosed with RA and COPD, respectively. After adjusting for the covariates, the result of a cross-lagged panel model revealed a bidirectional association between RA and COPD (β = 0.018, P < 0.001 for the RA→COPD path; β = 0.010, P < 0.001 for the COPD→RA path). In the non-COPD population, the risk of future COPD was increased in RA patients [Cox model: hazard ratio (HR) 1.65 (95% CI 1.50, 1.83); logistic model: odds ratio (OR) 1.85 (95% CI 1.66, 2.07)]. In the non-RA population, baseline COPD was associated with a higher risk of RA during follow-up [Cox model: HR 1.67 (95% CI 1.44, 1.92); logistic model: OR 1.70 (95% CI 1.47, 1.97)]. Five inflammatory factors mediated the RA→COPD path and CRP mediated the COPD→RA path (false discovery rate < 0.05).

Conclusions

A significant bidirectional association exists between RA and COPD and it is partially mediated by systemic inflammation.
Efficacy and safety of repository corticotropin injection for refractory cutaneous dermatomyositis: a prospective, open-label study
Authors: Fernandez Anthony P , Gallop Josh , Polly Samantha , Khanna Urmi
Published: November 2023

Objectives

Cutaneous dermatomyositis (DM) is often refractory to multiple medications. Repository corticotropin injection (RCI) is FDA-approved for DM, but little is known about its efficacy and safety for treating cutaneous DM. We conducted a prospective, open-label trial assessing efficacy and safety of RCI for treating refractory cutaneous DM.

Methods

DM patients with moderate-to-severe cutaneous activity [Cutaneous Dermatomyositis Disease Area and Severity Index activity (CDASI-A)] >14 despite prior treatment with ≥2 systemic agents were enrolled. Patients were initiated on 80 u RCI twice weekly for 6 months. Primary outcomes included significant decreases in CDASI-A and Physician’s Global Assessment (PGA) scores at 6 months.

Results

Of 19 patients enrolled, 15 patients (11 females, four males) with DM (seven classic, eight amyopathic) completed 6 months of RCI treatment. Patients were treated with a median 3.0 systemic medications prior to enrolment and were taking a median of 2.0 systemic medications at enrolment. Median baseline CDASI-A score was 19.0 and median PGA activity score was 2.5/10. For patient-reported outcomes, baseline median patient global skin score (PtGSS) was 3.0/10 and median dermatology life quality index (DLQI) score was 7.0/10. At 6 months, there were statistically significant improvements in CDASI-A scores (median = 10.0), PGA scores (median = 0.8/10), PtGSS scores (median = 7.0) and DLQI scores (median = 2.0), among others. Adverse effects were mild.

Conclusions

RCI treatment resulted in statistically significant and clinically meaningful improvement in cutaneous DM activity and quality of life. Our results suggest RCI is an effective, safe and well-tolerated treatment for patients with refractory cutaneous dermatomyositis.

Clinical Trial Registration

This clinical trial was registered with ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT01906372).
Single-cell landscape of peripheral immune response in patients with anti-melanoma differentiation–associated gene 5 dermatomyositis
Authors: He Jiangping , Liu Zhicheng , Cao Ying , Zhang Xiaofang , Yi Caihong , Zhou Yanzi , Yang Chen , Guo Zhenyang , Zheng Quan , Huang Jiao
Published: November 2023

Objective

Anti-melanoma differentiation–associated gene 5 (Anti-MDA5)–positive DM is a rare but life-threatening autoimmune disorder that is associated with a high risk of developing rapidly progressive interstitial lung disease. Current empirical therapies offer limited benefit in terms of patient survival, as little is known about the aetiology of anti-MDA5 DM. To best understand its immune landscape, we applied single-cell RNA sequencing (scRNA-seq) to peripheral blood samples from DM patients and healthy controls.

Methods

Peripheral blood mononuclear cells (PBMCs) from eight DM patients (including three distinct subtypes of DM) and two healthy donors were sequenced using the 10X Genomics platform. Additional scRNA-seq data for four healthy donors were incorporated for further bioinformatic analysis.

Results

Aberrantly increased proportions of CD14+ monocytes and plasma cells were observed in anti-MDA5 DM PBMC samples. Moreover, we found an overactivated type I IFN response and antiviral immunity in both innate and adaptive immune cells derived from anti-MDA5 DM patients that was positively correlated with disease severity. Importantly, a unique subset of CD14+ monocytes that highly expressed IFN alpha–inducible protein 27 (IFI27), a biomarker for viral infection, and IFN induced with helicase C domain 1 (IFIH1, which encodes MDA5) was specifically identified in anti-MDA5 DM samples for the first time.

Conclusion

Our study has illustrated the peripheral immune cell atlas of a number of DM subtypes, has provided compelling evidence for a viral infection–derived origin for anti-MDA5 DM, and has indicated potential targets for innovative therapeutic interventions.
BK Channel Depletion Promotes Adipocyte Differentiation by Activating the MAPK/ERK Pathway
Authors: Xin Fang , Cheng Yuan , Wen Xinxin , Zhang Jin , Shi Xin , Liu Ping , Ren Jie , Lu Wenjing , Liu Fan , Li Zihan , Yan Xin , Wang Wei , Wang Meili , Huang Haixia
Published: November 2023

The expression of large conductance calcium-activated potassium channels (BK channels) in adipose tissue has been identified for years. BK channel deletion can improve metabolism in vivo, but the relative mechanisms remain unclear. Here, we examined the effects of BK channels on the differentiation of adipose-derived stem cells (ADSCs) and the related mechanisms. BKα and β1 subunits were expressed on adipocytes. We found that both deletion of the KCNMA1 gene, encoding the pore forming α subunit of BK channels, and the BK channel inhibitor paxilline increased the expression of key genes in the peroxisome proliferator activated receptor (PPAR) pathway and promoted adipogenetic differentiation of ADSCs. We also observed that the MAPK-ERK pathway participates in BK channel deficiency-promoted adipogenic differentiation of ADSCs and that ERK inhibitors blocked the differentiation-promoting effect of BK channel deficiency. Hyperplasia of adipocytes is considered beneficial for metabolic health. These results indicate that BK channels play an important role in adipose hyperplasia by regulating the differentiation of ADSCs and may become an important target for studying the pathogenesis and treatment strategies of metabolic disorder-related diseases.
New Genotypes of Phytophthora nicotianae Found on Strawberry in Florida
Authors: Marin Marcus V. , Ratti Maria F. , Peres Natalia A. , Goss Erica M.
Published: November 2023

Phytophthora cactorum is the most common causal agent of Phytophthora crown rot and leather rot of strawberry, but P. nicotianae is also responsible for the disease in Florida. Studies of P. nicotianae populations have suggested that different groups of genotypes are associated with different hosts; however, it is not yet clear how many lineages exist globally and how they are related to different production systems. The aim of this study was to determine the genetic relationships of P. nicotianae isolates from Florida strawberry with genotypes reported from other hosts, quantify the genetic variation on strawberry, and test for an association with nursery source. A total of 49 isolates of P. nicotianae were collected from strawberry plants originating from multiple nursery sources during six seasons of commercial fruit production in Florida. Microsatellite genotyping identified 28 multilocus genotypes on strawberry that were distinct among 208 isolates originating from various hosts and locations. Based on STRUCTURE analysis, two genetic groups were identified: one consisting of isolates from strawberry, and the other comprising samples from different hosts. Multilocus genotypes were shared among nursery sources, and populations defined by nursery were not differentiated. Both mating types were found among the isolates from North Carolina- and California-origin plants and in most strawberry seasons; however, a predominance of A1 was observed, and regular sexual reproduction was not supported by the data. This study reveals a unique genetic population of P. nicotianae associated with strawberry and emphasizes the vital role of nursery monitoring in mitigating disease spread.
Genomic and Transcriptomic Comparisons of the Twig Blight Pathogen, Passalora sequoiae, with Mycosphaerellaceae Foliar and Conifer Pathogens
Authors: Dobbs John T. , Caballero Jorge R. Ibarra , Ata Jessa P. , Babiker Ebrahiem , Copes Warren E. , Stewart Jane E.
Published: November 2023

Passalora sequoiae is a foliar pathogen to conifer tree species. In this study, we conducted whole-genome and transcriptome analyses on isolates of P. sequoiae collected from symptomatic Leyland cypress leaves from a Christmas tree farm in Mississippi. The objectives for this research were to elucidate the pathogenicity mechanisms of P. sequoiae by characterizing the genome and transcriptome and possibly identify unique and shared predicted genes in comparison with non-conifer/canker and foliar pathogens in the family Mycosphaerellaceae. P. sequoiae was found to be similar to other foliar Mycosphaerellaceae pathogens and likely represents a hemibiotrophic lifestyle based on comparisons across pathogens. The genome and in planta transcriptome highlighted some unique features of P. sequoiae: the significant presence of chitin synthases and fructose-degrading carbohydrate-degrading enzymes, trans-AT PKS genes, and antibiotic gene clusters that were unique to P. sequoiae compared with the other Mycosphaerellaceae species genomes. Several transcripts that were highly expressed in planta were identified as effectors, yet the functions were not characterized. These targets provide ample resources to continue to characterize pathogen−conifer host interactions in conifer foliar pathogens. Furthermore, this research helps build genomic resources for an important plant pathogen on Leyland cypress that will further our ability to develop novel management practices that could begin with breeding for resistance.
Spontaneous coronary artery dissection
Authors: Caverley Zachary R. , Tam Lori M.
Published: November 2023

Spontaneous coronary artery dissection (SCAD) is an underrecognized form of nonatherosclerotic acute coronary syndrome, mostly occurring in younger female patients. The knowledge base about the diagnosis and management of SCAD has grown over the past decade, but gaps remain in how best to approach this disease. This article reviews the research on the prevalence, presentation, and management of SCAD.
Vaginal Hysterectomy Compared With Laparoscopic Hysterectomy in Benign Gynecologic Conditions
Authors: Azadi Ali , Masoud Ahmed Taher , Ulibarri Hollie , Arroyo Amanda , Coriell Catherine , Goetz Sydnee , Moir Carmen , Moberly Atley , Gonzalez Daniela , Blanco Madison , Marchand Greg
Published: November 2023

OBJECTIVE:

To compare surgical efficacy outcomes and complications after laparoscopic hysterectomy and vaginal hysterectomy performed for benign gynecologic conditions.

DATA SOURCES:

We performed an online search in major databases, including PubMed, Scopus, Web of Science, ClinicalTrials.gov, and the Cochrane Library from 2000 until February 28, 2023.

METHODS OF STUDY SELECTION:

We searched for randomized controlled trials (RCTs) that compared vaginal hysterectomy with laparoscopic hysterectomy in benign gynecologic conditions. We located 3,249 articles. After reviewing titles and abstracts, we identified 32 articles that were eligible for full-text screening. We excluded nine articles as not-RCT or not comparing vaginal hysterectomy with laparoscopic hysterectomy. Twenty-three articles were included in the final systematic review, with 22 articles included in the meta-analysis.

TABULATION, INTEGRATION, AND RESULTS:

Twenty-three eligible RCTs included a total population of 2,408, with 1,105 in the vaginal hysterectomy group and 1,303 in the laparoscopic hysterectomy group. Blood loss and postoperative urinary tract infection rates were lower in the vaginal hysterectomy group than in the laparoscopic hysterectomy group (mean difference −68, 95% CI −104.29 to −31.7, P<.01, I
2=95% and odds ratio 1.73, 95% CI 0.92–3.26, P=.03, I
2=0%, respectively). Vaginal hysterectomy was associated with less total operative time, less recovery time, and greater postoperative pain on the day of surgery. Other complications, including conversion to laparotomy, visceral organ damage, or wound dehiscence, were uncommon. Because of insufficient data, we were not able to stratify by surgical indication.

CONCLUSION:

Vaginal hysterectomy had a shorter total operative time and recovery time but greater postoperative pain on day of surgery compared with laparoscopic hysterectomy.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42023338538.
Sustainability in Obstetrics and Gynecology
Authors: Wright Kelly N. , Melnyk Alexandra I. , Emont Jordan , Van Dis Jane
Published: November 2023

Current practices in the U.S. health care industry drive climate change. This review summarizes the vast research on the negative health effects of the climate crisis on patients as relevant to obstetrics and gynecology. We further propose solutions to decarbonize operating rooms, labor and delivery units, and nurseries and neonatal intensive care units through evidence-based reduction in our single-use supply, energy, and water, as well as anesthetic gases and appropriate waste sorting.
Opill
Authors: Allen Rebecca H. , Bartz Deborah
Published: November 2023

The U.S. Food and Drug Administration has approved the first oral contraceptive pill (OCP) for over-the-counter status. This progestin-only pill contains norgestrel 0.075 mg taken daily, with a Pearl Index estimated at 4.4 (95% CI, 1.9–8.8). This formulation has an excellent safety profile, with current breast cancer as the only absolute contraindication and few relative contraindications. Ultimately, this approval has great potential to improve the accessibility of effective contraception for many pregnancy-capable Americans, especially those who have poor access to the health care system for prescription-required contraception, most notably people who hold marginalized identities. The pill’s overall success in reducing rates of unintended pregnancy will rely on its availability, particularly in rural communities that may rely on one pharmacy, and affordability, especially for uninsured or underinsured individuals. However, given the need for improved contraceptive provision, particularly in abortion-restrictive settings, the over-the-counter approval of this daily OCP is a major advancement in the nation’s contraceptive ecosystem.
Postoperative Changes of Spinopelvic Sagittal Parameters after Cervical Laminoplasty for Cervical Spondylotic Myelopathy
Authors: Sakaura Hironobu , Ikegami Daisuke , Fujimori Takahito , Sugiura Tsuyoshi , Yamada Shutaro , Kanayama Sadaaki
Published: November 2023

Study Design:

A retrospective analysis of prospectively collected data.

Objective:

To investigate postoperative changes of spinopelvic sagittal parameters after laminoplasty for cervical spondylotic myelopathy (CSM) accompanying postoperative cervical kyphotic deformity or cervical regional sagittal imbalance.

Summary of Background Data:

To the best of our knowledge, no study has been reported concerning postoperative changes of spinopelvic sagittal parameters accompanying postoperative deterioration of cervical sagittal alignment or balance after cervical laminoplasty.

Methods:

Forty-five CSM patients without preoperative cervical kyphosis who underwent laminoplasty were included. None of the 45 patients had a medical history of previous spine surgery, hip joint surgery, or knee joint surgery. The patients were divided into 2 groups (kyphosis and lordosis groups) according to postoperative C2-7 angle, and they were also divided into 2 other groups (imbalance and balance groups) according to postoperative C1-7 sagittal vertical axis. Postoperative changes (Δ) of T1 slope (T1S), thoracic kyphosis, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), Pelvic tilt, and C7 sagittal vertical axis were measured comparing lateral radiographs of the whole spine in the standing position taken at 1 year postoperatively with those before surgery.

Results:

Both T1S and TLK significantly decreased after cervical laminoplasty in the kyphosis group compared with the lordosis group. On the other hand, both T1S and TLK increased significantly, and LL significantly decreased after surgery in the imbalance group compared with the balance group.

Conclusions:

At 1 year after laminoplasty for CSM, both T1S and TLK significantly decreased accompanying postoperative cervical kyphotic deformity as a compensatory action for postoperative cervical kyphosis to maintain the global sagittal balance of the spine, whereas both T1S and TLK increased significantly, and LL significantly decreased accompanying postoperative cervical reginal sagittal imbalance which resulted in postoperative forward inclination of the whole spine.
Impact of American Society of Anesthesiologists’ Classification on Postoperative Satisfaction and Clinical Outcomes Following Lumbar Decompression
Authors: Jacob Kevin C. , Patel Madhav R. , Nie James W. , Hartman Timothy J. , Vanjani Nisheka N. , Pawlowski Hanna , Prabhu Michael C. , Singh Kern
Published: November 2023

Study Design:

Retrospective cohort.

Objective:

The aim was to compare patient-reported outcomes (PROMs), minimum clinically important difference (MCID) achievement, and postoperative satisfaction following minimally invasive lumbar decompression in patients stratified by American Society of Anesthesiologists (ASA) classification.

Summary of Background Data:

Some guidelines recommend against performing elective procedures for patients with an ASA score of 3 or greater; however, long-term postoperative outcomes are not well described.

Methods:

Primary, single-level, minimally invasive lumbar decompression procedures were identified. PROMs were administered at preoperative, 6-week, 12-week, 6-month, 1-year, 2-year timepoints and included Patient-Reported Outcomes Measurement Information System-Physical Function, visual analog scale (VAS) back/leg, Oswestry disability index (ODI), and 12-item short form physical component score. Satisfaction scores were collected postoperatively for VAS back/leg, ODI, and individual ODI subcategories. Patients were grouped (ASA<3, ASA≥3), and propensity scores were matched to control for significant differences. Demographic and perioperative characteristics were compared using χ2 and the Student’s t test. Mean PROMs and postoperative satisfaction were compared at each time point by a 2-sample t test. Postoperative PROM improvement from the preoperative baseline within each cohort was calculated with a paired t test. MCID achievement was determined by comparing ΔPROMs to established thresholds and comparing between groups using simple logistic regression.

Results:

One hundred and twenty-nine propensity-matched patients were included: 99 ASA<3 and 30 ASA≥3. No significant demographic differences were observed between groups. ASA≥3 patients experienced significantly increased length of stay and postoperative narcotic consumption on surgery day (P<0.048, all). Mean PROMs and MCID achievement did not differ. The ASA<3 cohort significantly improved from the preoperative baseline for all PROMs at all postoperative time points. ASA<3 patients demonstrated higher levels of postoperative satisfaction at 6 weeks for VAS leg, VAS back, ODI, sleeping, lifting, walking, standing, sex, travel, and at 6 months for VAS back (P<0.045, all).

Conclusion:

ASA≥3 patients may achieve similar long-term clinical outcomes to ASA<3 patients, though they may show poorer short-term satisfaction for disability, leg pain, and back pain, which could be related to differing preoperative expectations.
Pharmacobezoar-Related Fatalities: A Case Report and a Review of the Literature
Authors: Drevin Guillaume , Malbranque Stéphane , Jousset Nathalie , Férec Séverine , Zabet Donca , Baudriller Antoine , Briet Marie , Abbara Chadi
Published: November 2023

Pharmacobezoars develop after an acute overdose or during routine drug administration. Here, the authors present a case of fatal multidrug overdose involving a 62-year-old woman. Her usual treatment included tramadol extended-release, citalopram, and mirtazapine. Furthermore, she self-medicated and misused her husband's medications. The autopsy revealed the presence of a voluminous medication bezoar in the stomach. No mechanical complication was noted. Toxicologic analyses were performed using gas chromatography with flame ionization detection, liquid chromatography with diode array detection, gas chromatography with mass spectrometry detection, and liquid chromatography coupled to tandem mass spectrometry. Tramadol (34,000 mcg/L), O-desmethyltramadol (2200 mcg/L), propranolol (6000 mcg/L), bromazepam (2500 mcg/L), zopiclone (1200 mcg/L), and citalopram (700 mcg/L) were identified in femoral blood at toxic concentrations. Interestingly, the femoral blood and vitreous humor concentration ratio was approximately 0.7. Furthermore, an English exhaustive literature search was performed using several different electronic databases without any limiting period to identify published pharmacobezoar-related fatalities. Seventeen publications were identified reporting a total of 19 cases. Decedents' mean age was 47.6 years [0.8–79] and a clear female predominance emerged. Several drugs were involved in pharmacobezoar formation. Death was attributed to drug toxicity in 13 cases, and to mechanical complications and/or sepsis in 4 cases. A mixed cause of death was reported in 2 cases. Although rare, pharmacobezoars remain potentially lethal and raise challenges in therapeutic management.
Skin Allograft after Bone Marrow Transplantation of Patient with Recessive Dystrophic Epidermolysis Bullosa
Authors: AlMarshad Felwa A. , AlZahrani Abdullah M. , Mahabbat Nehal A. , AlShammari Eman M. , AlObaida Saud A. , AlMalaq Ali A.
Published: November 2023

In this study, we present a 26-year-old woman with case presentation of recessive dystrophic epidermolysis bullosa who had developed squamous cell carcinoma. The patient underwent bone marrow transplant and skin grafting with the same bone marrow donor. After excision of squamous cell carcinoma and skin grafting, no tumor was observed; thus, chemotherapy and radiation were no longer needed.
MicroRNA-206-3p suppresses hepatic lipogenesis and cholesterol synthesis while driving cholesterol efflux
Authors: Liu Ningning , Tian Jing , Steer Clifford J. , Han Qinghua , Song Guisheng
Published: November 2023

Background and Aims:

Hepatosteatosis, hypertriglyceridemia, and hypercholesterolemia are interconnected metabolic disorders. This study is designed to characterize how microRNA-206-3p (miR-206) simultaneously prevents de novo lipogenesis (DNL), cholesterol synthesis, and VLDL production in hepatocytes while promoting cholesterol efflux in macrophages.

Approach and Results:

MiR-206 levels were reduced in hepatocytes and macrophages of mice subjected to a high-fat, high-cholesterol diet. A negative feedback between LXRα (liver X receptor alpha) and miR-206 is formed to maintain high LXRα and low miR-206 in hepatocytes. Systemic administration of miR-206 alleviated hepatosteatosis, hypertriglyceridemia, and hypercholesterolemia in mice. A significant reduction in LDL cholesterol and VLDL cholesterol but unaltered HDL cholesterol was observed in miR-206-treated mice. Mirroring these findings, miR-206 reprogrammed the transcriptome of hepatocytes towards the inhibition of DNL, cholesterol synthesis, and assembly and secretion of VLDL. In macrophages, miR-206 activated the expression of genes regulating cholesterol efflux. Hepatocyte-specific expression of miR-206 reduced hepatic and circulating triglycerides and cholesterol, as well as VLDL production, while transplantation of macrophages bearing miR-206 facilitated cholesterol efflux. Mechanistically, miR-206 directly targeted Lxrα and Hmgcr in hepatocytes but facilitated expression of Lxrα in macrophages by targeting macrophage-specific tricho-rhino-phalangeal syndrome 1 (TRPS1), a transcription repressor of Lxrα. By targeting Hmgcr and Lxrα, miR-206 inhibited DNL, VLDL production, and cholesterol synthesis in hepatocytes, whereas it drove cholesterol efflux by activating the TRPS1-LXRα axis.

Conclusions:

MiR-206, through differentially modulating LXRα signaling in hepatocytes and macrophages, inhibits DNL, promotes cholesterol efflux, and concurrently hinders cholesterol synthesis and VLDL production. MiR-206 simulates the functions of lipid-lowering medications, statins, and LXRα agonists.
Glanzmann's thrombasthenia associated with gastrointestinal angiodysplasias successfully treated with bevacizumab
Authors: Saladino Agustina , Gonzalez María L. , Chuliber Fernando A. , Serra Marcelo M.
Published: November 2023

Glanzmann's Thrombasthenia (GT) is a rare hemorrhagic condition caused by a platelet surface receptor disorder of the glycoprotein (GP) IIb/IIIa. Symptoms of GT are various forms of hemorrhages, such as purpura, epistaxis and menorrhagia. Gastrointestinal bleeding (GIB) is a rare expression of the condition and may occur due to traumas in the GI tract or as a consequence of gastrointestinal angiodysplasia (GIADs). In this case report, we present a middle-aged woman with recurrent GIB consequent to GIADs with persistent melena and iron deficiency anemia. After several unsuccessful therapeutic interventions, the patient was studied by the hereditary hemorrhagic telangiectasia's (HHT – Osler–Weber–Rendu disease) unit, where she received bevacizumab, showing a complete improvement in symptoms as well as a reduction in her GIADs. This case shows that bevacizumab could be a possible line of treatment for patients with coagulation disorders with GIADs.
New score for predicting thromboembolic events in patients with atrial fibrillation using direct oral anticoagulants
Authors: Ma Fuxin , Chen Jiana , Chang Sijie , Huang Nianxu , Zhang Wang , Dai Hengfen , Zheng Qiaowei , Li Ruijuan , Lin Xiangsheng , Liu Yuxin , Du Xiaoming , Su Jun , Huang Xiaohong , Chen Xia , Hu Wei , Liu Xiumei , Zhang Yanxia , Gu Ping , Zhang Jinhua
Published: November 2023

Determinants of thrombotic events remain uncertain in patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). Our aim was to identify risk factors associated with thromboembolism in patients with at atrial fibrillation on DOACs and to construct and externally validate a predictive model that would provide a validated tool for clinical assessment of thromboembolism. In the development cohort, prediction model was built by logistic regression, the area under the curve (AUC), and Nomogram. External validation and calibration of the model using AUC and Hosmer–Lemeshow test. This national multicenter retrospective study included 3263 patients with atrial fibrillation treated with DOACs. The development cohort consisted of 2390 patients from three centers and the external validation cohort consisted of 873 patients from 13 centers. Multifactorial analysis showed that heavy drinking, hypertension, prior stroke/transient ischemic attack (TIA), cerebral infarction during hospitalization were independent risk factors for thromboembolism. The Alfalfa-TE risk score was constructed using these four factors (AUC = 0.84), and in the external validation cohort, the model showed good discriminatory power (AUC = 0.74) and good calibration (Hosmer–Lemeshow test P value of 0.649). Based on four factors, we derived and externally validated a predictive model for thromboembolism with DOACs in patients with atrial fibrillation (Alfalfa-TE risk score). The model has good predictive value and may be an effective tool to help reduce the occurrence of thromboembolism in patients with DOACs.
The value of whole-body dual-energy x-ray absorptiometry in assessing body composition in patients with inflammatory bowel disease: a prospective study
Authors: Nguyen Anke L. , Herath Madhuni , Burns Megan , Holt Darcy , Ebeling Peter R. , Milat Frances , Gibson Peter R. , Moore Gregory T.
Published: November 2023

Objectives

Low skeletal muscle index (SMI) is common in inflammatory bowel disease (IBD) but has an uncertain relationship with active intestinal inflammation. This study evaluated body composition by whole-body dual-energy X-ray absorptiometry (DXA) in patients with IBD and healthy controls to enable the value of formal body composition analysis to be judged.

Methods

Patients with IBD and sex/age-matched controls prospectively underwent full body composition assessment by DXA, assessment by BMI, eating questionnaires and handgrip strength. Disease activity was assessed by faecal calprotectin (active ≥150 µg/g). A cohort undergoing biologic induction therapy were assessed at baseline and after ≥13 weeks.

Results

Total fat mass was higher in 54 patients with IBD (56% Crohn’s disease, 61% male) than in 30 controls (median 25.1 vs. 18.7 kg, P = 0.042). DXA offered little more than BMI. Low SMI was more common than in controls (15% vs. 0%, P = 0.027). A normal BMI was seen in many patients with low SMI and handgrip strength was a poor marker of change in SMI. Body composition was similar in 28 patients with active vs. 22 with inactive disease. However, SMI increased specifically by 9.7% (P = 0.004) and BMI by 6.4% (P = 0.012) in 9 responders to therapy.

Conclusion

DXA identifies many patients with reduced SMI who are not detected by standard methodologies. While disease activity is not associated with low SMI, resolution of inflammation leads to improved SMI. The potential for recognition of such patients to influence therapeutic decisions underlines the need for DXA assessment in clinical practice.
Enhancing education service outcomes through value co-creation
Authors: Survilaite Eimante , Auruskeviciene Vilte , Židonis Žilvinas , Misiunas Dalius , Sidlauskiene Justina
Published: November 2023

Purpose

The purpose is to investigate the impact of the value co-creation behaviour of parents on a set of education service outcomes, including perceived school reputation, parent satisfaction and teacher competence.

Design/methodology/approach

An online survey of 932 parents of primary and secondary school children was conducted. Canonical correlation analysis (general linear model) was used to test the impact of parental involvement in value co-creation behaviour on education service outcomes.

Findings

Value co-creation behaviour has a positive impact on education service outcomes, but the impact differs depending on the type of behaviour. Parent citizenship behaviour positively affects satisfaction, school reputation and perceived teacher competence. However, parent participation behaviour positively affects satisfaction with the school and perceived teacher competence.

Research limitations/implications

The study used self-reported data from parents, which may be biased and subject to errors. Future research could use more objective measures such as administrative records or teacher reports. The study's results are limited to one country, highlighting the need for further research in multiple countries.

Practical implications

The study's findings have implications for education service providers in terms of the importance of supporting parental involvement in their child's school life via value co-creation behaviour.

Originality/value

The study contributes to the service dominant logic, value co-creation theory and educational marketing literature by providing the detailed empirical evidences of parents' value co-creation outcomes in the context of the primary and secondary schools.