bluuebunny/crossref_metadata_2025_split huggingface dataset:
463 Single-use Products and Plastics Contribute Significantly to Surgical Waste and the Carbon Footprint of Tonsillectomies in the United Kingdom
Authors: Moses O , Cahill G , Miraftab-Salo O , Bhutta M F , Stanford-Moore G B 
Published: August 2024

Abstract

Aim
Tonsillectomy is the fifth highest volume surgical procedure in England. The aims of this study were to characterise the cost, waste, and carbon footprint of equipment used in tonsillectomies at our Trust.

Method
A series of tonsillectomies were observed at three sites in our Trust. Details of the equipment were prospectively collected. This included: item and packaging materials; the quantity and reusability of items opened, used, and wasted; and the weight of recyclable, non-recyclable, and clinical waste produced per tonsillectomy. Reusable instrument trays were excluded from cost analysis. Overall carbon footprint was reported in carbon dioxide equivalents (CO2e) and calculated with published estimates of carbon emissions from individual items’ cradle-to-gate production, sterilisation, and waste streams.

Results
20 tonsillectomies were included for analysis. The mean cost of tonsillectomy equipment was 137.75 GBP. 378 items were recorded in total – 70.5% were single-use, of which 91.6% were either composed of, or packaged in, plastic. The mean carbon footprint of the equipment was 6.78kg CO2e per tonsillectomy. 3.93kg CO2e came from single-use items, with 0.11kg CO2e from unused equipment. The incineration of clinical waste (mean weight 0.74kg) caused an additional 0.79kg CO2e of emissions per tonsillectomy.

Conclusions
Single-use equipment represented a significant carbon hotspot in tonsillectomies performed at our Trust. Reusable alternatives exist for many single-use items, and we suggest these be included in autoclavable sets to maximise reusability and minimise both cost and waste in operating rooms. These adjustments may lower emissions from their use and incineration, thus improving sustainability in surgery.
265 Intracranial Haemorrhage Following Spinal Surgery: A Systematic Review of a Rare but Serious Complication
Authors: Kakroo B , Magan P 
Published: August 2024

Abstract

Aim
The aim of this systematic review is to comprehensively gather and analyse all available literature on intracerebral haemorrhages (ICH) following spinal surgery. We aim to elucidate pre/intraoperative variables such as surgery type, patient-specific risk factors and dural opening and also highlight postoperative variables such as symptoms, intervention, and eventual outcome. We have incorporated 134 studies for this analysis making it the most comprehensive review of this topic thus far.

Method
The search engines used for this systematic review were ScienceDirect, PubMed, Google Scholar, Wiley, SpringerLink and SAGE journals, identifying all cases of intracranial haemorrhage following spinal surgery known of, up until the end of 2022. Keywords that were searched included: “intracranial bleed”, “intracerebral haemorrhage”, “spinal surgery complications”, “bleed post spinal surgery”, “spinal surgery complication”, “incidental durotomy “ and “spinal surgery bleed”.

Results
This section will be presented in the form of tables and graphs. This review comprised of 134 cases, of which 52 (39.7%) were male and 79 (60.3%) were female. We report lumbosacral surgery to be the most common level associated with ICH constituting 63.1% of all cases. 50 patients (41.3%) developed symptoms within 24hrs of the index spinal operation. Focal neurological deficit is the most commonly reported presentation which can encompass a breadth of clinical signs.

Conclusions
We report all known cases of ICH following spinal surgery, which remains a rare occurrence and analyse patient risk factors. We conclude that focal neurological signs in any patient with possible CSF leakage through durotomy should prompt a low threshold to request brain imaging.
506 Large Seminal Vesicle Cyst Displacing Bladder into Inguinal Hernia – a First of Its Kind
Authors: Hughes J 
Published: August 2024

Abstract

Aim
Following one of the first cases of Zinner syndrome associated with inguinal hernia, aim to review existing evidence and literature for treatment around this, especially non-surgical treatment.

Patient
A 68-year-old male who was investigated for raised PSA. As part of the work up, he was found to have an incidental finding of right inguinal hernia associated with a large contralateral seminal vesicle cyst and an absent kidney.

Results
For surgical candidates, we would recommend open hernia repair. Bladder resection is rarely indicated. For non-surgical candidates, there is no consensus on how to treat their condition.

Conclusions
The patient was treated conservatively with an alpha blocker to manage outflow obstruction. Further non-surgical treatment could involve a 5 alpha reductase inhibitor or catheterisation. Further research is needed.
389 Assessing the Trend of Best Medical Therapy in Symptomatic Patients Undergoing Carotid Surgery (ATOMIC Study)
Authors: Harper A , Kwan J Yi , Carney E , Sood M , Bailey M , Coughlin P 
Published: August 2024

Abstract

Aim
This study explored the prevalence, intensity, and trend of antithrombotic therapy (ATT) and LLT, and lipid profile monitoring around carotid intervention.

Method
This was a retrospective, single centre, time-series study of 260 symptomatic patients who underwent underwent CEA or CAS from 01/01/17–31/12/21 in a major regional vascular unit. Trend of antithrombotic therapy (ATT) and LLT from a pre-admission, surgery, discharge and 1-year post-procedure were analyzed to identify time points and subgroups requiring optimization. All data were collected from electronic hospital records linked to real-time primary care data with co-morbidities coded. Caldicott approval for consent from the local hospital was obtained.

Results
Prior to admission, 83% of patients were not prescribed ATT of whom 20% should have been. Similarly, 82% of patients were not prescribed LLT of whom 89% had a QRISK3&gt;10% so should have been on primary prevention, and 36% should have been on secondary prevention. At discharge from hospital, 100% of patients were prescribed ATT. There was a failure to uptitrate LLT from discharge to one year follow up with no significant difference in LLT prescriptions. LDL level improved from a median LDL of 2.6mmol/L pre-admission to 1.7mmol/L at 1 year follow up.

Conclusions
To conclude, the study shows that there are significant improvements that should be made regarding medical management of carotid surgery patients including greater use of primary prevention in the community, earlier administration of ATT and the need for improved LDL control with greater use of ezetimibe and uptitration of statins post-procedure.
Development of a Multiplexed Sphingolipids Method for Diagnosis of Inborn Errors of Ceramide Metabolism
Authors: Byeon Seul Kee , Kim Jinyong , Wegwerth Peter Jared , Zenka Roman , George John P , Pinto e Vairo Filippo , Oglesbee Devin , Schultz Matthew J , Matern Dietrich , Pandey Akhilesh 
Published: August 2024

Abstract

Background
Sphingolipids play a crucial role in cellular functions and are essential components of cell membranes, signaling molecules, and lipid metabolism. In particular, ceramide is a key intermediate in sphingolipid metabolism and defects in ceramide metabolism can lead to various inborn errors of metabolism, making ceramides important targets for clinical screening and diagnosis. Detecting altered concentration patterns of sphingolipids is desirable for distinguishing related inborn errors of metabolism for diagnosis and treatment monitoring.

Methods
We developed a liquid chromatography-tandem mass spectrometry method with a pathway-oriented approach to focus on sphingolipids involved in ceramide metabolism. A total of 47 sphingolipids bearing different head groups and side chains were targeted. Precision/reproducibility, linearity, and spike recovery extraction efficiency tests were performed on plasma and serum samples from confirmed cases of sphingolipidosis.

Results
Linearity of the method showed the coefficient of determination (r2) for all standards to be &gt;0.99 with a slope of 1.00 ± 0.01. Intra- and interday reproducibility of standards spiked into plasma and serum revealed a coefficient of variation &lt;20%. Spike and recovery assessment showed recovery values of 80%–120% for all standards. Altered levels of sphingolipids from patients with hereditary sensory and autonomic neuropathy caused by pathogenic variants in SPTLC2 and hypomyelinating leukodystrophy related to variants in DEGS1 were detected, in agreement with trends reported in earlier studies confirming the utility of this pathway-centric method.

Conclusions
This method can serve as a useful tool to simultaneously monitor sphingolipids, enabling screening and diagnosis of inborn errors of ceramide metabolism.
Current situation of tobacco industry carbon emissions based on sensor equipment monitoring and cloud computing and optimization of ‘light storage, straight and flexible’ carbon neutralization path
Authors: Huang Tao , Lian Yongsheng , Guo Lanxia , Zhang Huijuan , Meng Jinghua 
Published: August 2024

Abstract
In recent years, China has faced enormous pressure to reduce carbon emissions. As one of the pillar industries of China’s economy, the tobacco industry has been a high-energy and inefficient industry for a long time. However, the carbon emissions generated by the tobacco industry are also increasing the greenhouse effect. Therefore, this research uses information physics system technology to conduct real-time sensor monitoring and cloud computing on carbon emissions of the tobacco industry and uses an ant colony algorithm to perform multiobjective optimization based on ‘carbon emissions of construction period cost’. The experimental results show that, from the perspective of total carbon cost design, the carbon cost and carbon emission reductions obtained through process decomposition accounting provide a data basis for measuring the emission reduction effect of different low-carbon technology paths using ‘optical storage, direct and flexible’ path optimization. Emission reduction can be seen from three emission reduction technology paths. The supercritical unit technology path of the tobacco industry can reduce 225 000 tons of carbon dioxide emissions annually, while carbon capture technology can reduce 120 000 tons of carbon dioxide emissions annually. The emission reduction of carbon dioxide through online monitoring technology is limited, less than one-tenth of the first two technical approaches. The total carbon cost of carbon dioxide online monitoring technology is 1 953 383 900 yuan, with substantial economic value.
Mechanisms and effects of activation of innate immunity by mitochondrial nucleic acids
Authors: Rai Prashant , Fessler Michael B 
Published: August 2024

Abstract
In recent years, a growing number of roles have been identified for mitochondria in innate immunity. One principal mechanism is that the translocation of mitochondrial nucleic acid species from the mitochondrial matrix to the cytosol and endolysosomal lumen in response to an array of microbial and non-microbial environmental stressors has been found to serve as a second messenger event in the cell signaling of the innate immune response. Thus, mitochondrial DNA and RNA have been shown to access the cytosol through several regulated mechanisms involving remodeling of the mitochondrial inner and outer membranes and to access lysosomes via vesicular transport, thereby activating cytosolic [e.g. cyclic GMP-AMP synthase (cGAS), retinoic acid-inducible gene I (RIG-I)-like receptors], and endolysosomal (Toll-like receptor 7, 9) nucleic acid receptors that induce type I interferons and pro-inflammatory cytokines. In this mini-review, we discuss these molecular mechanisms of mitochondrial nucleic acid mislocalization and their roles in host defense, autoimmunity, and auto-inflammatory disorders. The emergent paradigm is one in which host-derived DNA interestingly serves as a signal amplifier in the innate immune response and also as an alarm signal for disturbances in organellar homeostasis. The apparent vast excess of mitochondria and mitochondrial DNA nucleoids per cell may thus serve to sensitize the cell response to stressors while ensuring an underlying reserve of intact mitochondria to sustain cellular metabolism. An improved understanding of these molecular mechanisms will hopefully afford future opportunities for therapeutic intervention in human disease.
Which Stranger’s Disease? Immigration, Immunization, and the Whitening of Cuba in the Age of Atlantic Revolutions
Authors: Yero Farren 
Published: August 2024

Abstract
In 1804, Cuban physician Tomás Romay tried and failed to create the first yellow fever vaccine. The article analyzes his experimental efforts, foregrounding the enslaved and enlisted subjects at the center of this early vaccine trial. Though a scientific failure, this brief experiment, the desires and logics embedded within it, and the measures deployed in its wake — in the form of European whitening campaigns — allow us to consider the political uses of immunity during the Age of Atlantic Revolutions. Historicizing these events within the wider geopolitics of the Caribbean, the article explicates the central role that yellow fever immunization played in Cuban authorities’ attempts to shore up their political and economic sovereignty in the midst of anti-colonial and anti-slavery resistance. As such, it shows how yellow fever and its threat to social and economic order fits within a broader history of vaccination as a mechanism of colonial governance. Finally, by situating Cuban efforts to prevent yellow fever alongside the health concerns of enslaved people — concerns that arguably informed their resistance to slavery — the article also demonstrates how ideas about immunity and political belonging increasingly intersected through whiteness as an elite ideal in the era that Cuba first became a slave society.
Attitudes toward mothers as sexual beings and the sexual functioning of parents
Authors: Leistner Christine E , Mark Kristen P 
Published: August 2024

Abstract

Background
Research has shown that negative sexual attitudes are associated with lower levels of sexual functioning among men and women, however, little is known about how attitudes about mothers as sexual beings are associated with sexual functioning for parents.

Aim
The aim of the current study was to examine how attitudes toward mothers as sexual beings (ATMSB) were associated with sexual functioning for women and partners of women among parents with young children.

Methods
Cross-sectional retrospective data were collected online via Qualtrics Panels from 475 women and men (partnered to women) who reported having their first child within the last 5 years.
Outcomes: The Revised Female Sexual Function Index and revised Expanded Prostate Cancer Index Composite–Short Form were used to measure sexual function in women and men, respectively.

Results
Results indicated that after controlling for age and relationship length, more positive ATMSB predicted higher levels of sexual functioning (and multiple domains of functioning) for men and women.
Clinical Implications: These findings indicate that sexual functioning, especially in parents, is linked to the attitudes held toward seeing mothers as inherently sexual (or not).

Strengths and Limitations
This is the first study to examine how attitudes toward mothers as sexual beings can impact sexual functioning, though the cis heterosexual mostly white sample is a notable limitation.

Conclusion
ATMSB may need to be examined and challenged in the context of treating sexual dysfunction during this transitional period for mothers and those partnered to mothers.
Antioxidant, antibacterial, and anti-biofilm activities of selected indigenous plant species against nosocomial bacterial pathogens
Authors: Mnisi Talita J , Matotoka Mashilo M , Masoko Peter 
Published: August 2024

Abstract
Biofilms are responsible for over 60% of nosocomial infections. The focus of this study was to investigate the antioxidant, antibacterial, antibiofilm, and anti-motility activities of Gardenia volkensii, Carissa bispinosa, Peltophorum africanum, and Senna petersiana. Antioxidant activity was evaluated using free radical (DPPH) scavenging and ferric reducing power assays. Antibacterial and antibiofilm activities were evaluated using the broth micro-dilution and the crystal violet assays, respectively. Anti-motility was evaluated using anti-swarming activities, and the brine shrimp lethality assay was used for cytotoxicity. Gardenia volkensii and C. bispinosa acetone extracts had low EC50 values of 9.59 and 9.99 μg ml−1on the free-radical scavenging activity, respectively. All the plant extracts demonstrated broad-spectrum antibacterial activity against Klebsiella pneumoniae, Pseudomonasa aeruginosa, Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus [minimum inhibitory concentration (MIC) &lt; 0.63 mg ml−1]. The initial cell adherence stage of P. aeruginosa and E. coli was the most susceptible stage where sub-MICs resulted in inhibitions &gt;50%. Peltophorum africanum had the least cytotoxic effects. All extracts had anti-motility activity against P. aeruginosa and E. coli. This study showed that not only do the plants have strong antibacterial activity but had noteworthy inhibition (&gt;50%) of initial cell adherence and may be suitable candidates for the treatment of nosocomial pathogens.
The Right to Scientific Progress and to Scientific Freedom
Authors: Romano Cesare PR , Boggio Andrea 
Published: August 2024

Abstract
This chapter describes the normative basis and content of the first cluster of rights within the right to science: to scientific progress and what makes it possible, namely, scientific freedom. It contains eleven distinct rights, divided into four groups, labeled “intellectual,” “social,” “labor,” and “cultural.” The “intellectual” group includes (1) the freedom of scientific thought; (2) the freedom of scientific opinion and investigation; and (3) the freedom of scientific expression. The “social” group includes (4) the freedom of scientific assembly; (5) the freedom of scientific association; (6) the freedom of movement of scientists; and (7) the right of scientists to take part in the conduct of public affairs (passive and active participation). The “labor” group includes (8) the right of scientists to work and follow scientific vocation freely; and (9) the right of scientists to just and favorable conditions of work and safe and healthy working conditions. The “cultural” group includes (10) the right to take part in cultural life; and (11) the right to benefit from the protection of the moral and material interests resulting from scientific production. The chapter starts by conceptualizing scientific freedom and identifying its normative basis in international legal instruments. Then, it discusses each of the eleven rights, analyzes what States must do to respect, protect, and fulfill those rights, and finishes by putting forward indicators (structural, process, and outcome) that are or could be used to measure progress (or regress) toward their implementation.
The Right to Participate in Scientific Progress
Authors: Romano Cesare PR , Boggio Andrea 
Published: August 2024

Abstract
This chapter presents the normative basis and content of the third cluster of rights within the right to science: the right to participate in scientific progress. This right contains four distinct rights: to scientific literacy; to access the scientific professions; to participate in research as citizen scientists or as research subjects (as citizen scientists and as research subjects); and to participate in science affairs. The chapter discusses the responsibility of States to implement public engagement and participation strategies to enable participation in scientific progress. The chapter closes by proposing indicators to monitor compliance with participatory standards associated with the human right to science.
Sphere of application
Authors: Schwenzer Ingeborg , Schroeter Ulrich G 
Published: August 2024

Abstract
This chapter concerns Article 1 of the CISG. This article contains the basic rules regarding the applicability of the CISG, which requires in general that parties in different States concluded a contract for the sale of goods and specifically requires that the either the parties have their relevant places of business in Contracting States or that the forum’s conflict of laws rules lead to the law of a Contracting State. The CISG does not distinguish between commercial and other parties and is indifferent to domestic registration requirements, if such exist. Where the internationality of the contractual relationship was not apparent from objective circumstances at contract formation, the CISG does not apply. The provision does not define any of the concepts it mentions (contract of sale, goods, place of business), nor do the other provisions of the CISG requiring interpretation in accordance with Article 7.
Effectiveness and withdrawability of offer
Authors: Schwenzer Ingeborg , Schroeter Ulrich G 
Published: August 2024

Abstract
This chapter discusses Article 15. Article 15(1) enshrines the principle that an offer only becomes effective it reaches the offeree (receipt principle, Zugangsprinzip). The moment when an offer ‘reaches’ the offeree is not governed by Article 15(1), but by Article 24. Article 15(2) allows for the withdrawal of an offer if the declaration of withdrawal reaches the offeree before or at the same time as the offer. A comparable provision for the withdrawal of acceptances can be found in Article 22. By contrast, the offeror’s right to distance themselves from an offer that has already reached the offeree (‘revocation’) is governed by Article 16.
Judgment for specific performance
Authors: Schwenzer Ingeborg , Schroeter Ulrich G 
Published: August 2024

Abstract
This chapter focuses on Article 28 of CISG. It explores the difference between continental European legal system and the English and American legal system on the grounds of the right to require performance. In common law, a breach of contract will result in the right to claim damages. Moreover, Article 28 covers the buyer’s rights to require performance such as delivery of goods. However, foreign exchange and currency laws are not applicable with Article 28. The chapter also discusses the legal consequence of rejecting the action for performance. It explains Article 28 is directed to the national courts and does not affect the rights and duties of the parties subject to private autonomy.
General obligations of the seller
Authors: Schwenzer Ingeborg , Schroeter Ulrich G 
Published: August 2024

Abstract
This chapter tackles the general obligations of the seller under the CISG. It outlines the main obligations of delivering goods, handing over documents, and transferring the property in goods. Moreover, the scope and substance of the sellers’ obligations are determined by the parties’ contracts. Delivery pertains to either the dispatch of goods to the buyer or the seller’s placing the goods at the buyer’s disposal. On the other hand, the detailed rules on documents that the seller provides will be in line with the Incoterms. The transfer of property is usually governed by the lex rei sitae. Good faith, confidentiality, the exclusivity of agreements, and trade usages are further obligations of the seller.