Western Countries Research Articles

Issues Behind the Measurement of Political Orientation

Abstract: Given the limited research addressing the construct and content validity of single-item and multiple-item measures of political orientation (PO), we investigated the effect sizes in the relationship between PO and variables categorized into multiple dimensions using a meta-analysis of 511 independent effect sizes from 108 articles published from 2012 to 2022. Multiple-item measures of PO that included economic items had a large effect size ( r = .55 ~ .75) in their association with variables in the economic, environmental, and traditionalism dimensions, whereas we found small effect sizes ( r = .23 ~ .24) between single-item PO and variables in the economic and environmental dimensions and a medium effect size ( r = .31) between single-item PO and variables in the traditionalism dimension. Based on the pooled data consisting of all multiple dimensions’ data subsets, we found medium effect sizes ( r = .35 ~ .39) for multiple-item measures of PO and a small effect size ( r = .27) for single-item PO. Our content analysis of 30 multiple-item measures of PO showed that over 80% of multiple-item measures were grounded in US and/or Western countries’ political contexts and samples and 50% of them did not measure economic aspects of PO. We discuss implications for future research.

Intracerebral hemorrhage

Background: Compared to ischemic stroke, intracerebral hemorrhage (ICH) has higher mortality and more severe disability. Asian such as Chinese and Japanese and Mexican Americans, Latin Americans, African Americans, Native Americans have higher incidences than do white Americans. So, ICH is an important cerebrovascular disease in Asia. Summary: ICH accounts for approximately 10-20% of all strokes. The incidence of ICH is higher in low- and middle-income than high-income countries and is estimated 8-15% in western countries like USA, UK and Australia, and 18-24% in Japan, Taiwan and Korea. The ICH incidence increases exponentially with age, and old age especially over 80 years is a major predictor of mortality independent of ICH severity. Females are older at the onset of ICH and have higher clinical severity than males. Modifiable risk factors include blood pressure, smoking, alcohol consumption, lipid profiles, use of anticoagulants, antiplatelet agents and sympathomimetic drugs. Non-modifiable risk factors constitute old age, male gender, Asian ethnicity, cerebral amyloid angiopathy, cerebral microbleed, and chronic kidney disease. Blood pressure is the most important risk factor of ICH. Imaging markers may help predict ICH outcome, which include black hole sign, blend sign, iodine sign, island sign, leakage sign, satellite sign, spot sign, spot-tail sign, swirl sign, and hypodensities. ICH prognostic scoring system such as ICH scoring system and ICH grading scale scoring system in Chinese and Osaka prognostic score and Naples prognostic score has been used to predict ICH outcome. Early minimally invasive removal of ICH can be recommended for lobar ICH of 30–80 mL within 24 hours after onset. Decompressive craniectomy without clot evacuation might benefit ICH patients aged 18–75 years with 30–100 mL at basal ganglia or thalamus. However, clinical studies are needed to investigate the effect of surgery on patients with smaller or larger ICH, ICH in non-lobar locations, and for older patients or patients with preexisting disability. Surgical treatment is usually associated with neurological sequels if survived. For medical treatment, blood pressure lowering should be careful titrated to secure continuous smooth and sustained control and avoid peaks and large variability in systolic blood pressure. Stroke and cancer are the most common causes of death in Asian ICH patients, compared to stroke and cardiac disease in non-Asian patients. Key Messages: The incidence and outcome are different between Asian and non-Asian patients, and more clinical studies are needed to investigate the best management for Asian ICH patients.

Self-Management Support (SMS) in Transition: The Case of Osteoporosis Management Support in a Chinese Hospital

AbstractSelf-management has become increasingly important with the growing population living with chronic conditions. Self-Management Support (SMS) provided in healthcare systems is essential for its success. While prior research mainly focuses on Western countries, this paper presents a study of SMS practices for osteoporosis management as part of a Whole Course Management (WCM) program recently implemented in the healthcare system in China, which features a new role called case manager in the hospital dedicated to SMS and related coordination. Based on interviews with 22 participants, including one case manager, two physicians, three nurses, seven patients, and nine caregivers, we highlight the importance of the role of case manager in promoting awareness of osteoporosis and self-management, integrated care coordination, and emotional support. At the same time, it also reveals challenges and promising directions to make SMS more effective, mainly in terms of self-management education, active patient involvement, and coordination among the care network. We ended by reflecting on our findings and discussing implications for SMS and the design of ICTs.

Cyber Diplomacy through Official Public Attribution: Paving the Way for Global Norms

Abstract International discussions on establishing and implementing norms for behavior in cyberspace have spanned over two decades. However, differences in what constitutes ‘acceptable conduct’ have hindered progress in forming these norms. In recent years, Western countries have adopted a strategy to signal what is considered unacceptable behavior by publicly attributing cyberattacks and intrusions. I argue that this act of official public attribution serves as a practice for countries to express their disapproval of inappropriate cyberspace behavior and condemnation and can cumulatively shape international practices, holding the attacking state accountable. I explore this by (1) analyzing new data from the European Repository of Cyber Incidents, which shows patterns of official public attributions for the years 2000–2023, providing exploratory directions and trends, and (2) examining the Iranian cyberattack against Albania in 2022 and its subsequent official public attributions as an illustrative case study. I demonstrate how repeated instances of official public attribution can contribute to the development of a common practice that signals dissatisfaction of a specific behavior. As state-sponsored cyberattacks and intrusions are on the rise, this practice could have an accumulative effect.

Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences

(1) Background: Creutzfeldt–Jakob disease (CJD) is a rare and fatal neurodegenerative disorder caused by the accumulation of an altered prion protein, which usually leads to death within one year after clinical onset. CJD patients usually present with rapid cognitive impairment associated with declines in cerebellar, motor, visual, behavioral, and swallowing functions. Moreover, CJD patients lose their ability to eat and take medications orally very early on in treatment; nevertheless, there are no specific nutritional guidelines for this disease shared worldwide. (2) Methods: This review aims to describe the nutritional outcomes of CJD patients in Western countries to compare them with those described in East Asian countries and then aims to explore the most recent trends in the nutritional management of CJD patients, including some dietary compounds that present neuroprotective effects. (3) Results: In Japan’s, Taiwan’s, and China’s healthcare systems, CJD patients receive intensive life-sustaining treatment that prolongs their survival (i.e., artificial feeding); conversely, in Western countries, intensive life-sustaining treatments like tube feeding are not commonly provided to CJD patients. (4) Conclusions: It is difficult to pinpoint the reasons for these discrepancies around CJD palliative care supply, but it is clear that specific nutritional guidelines may directly improve the nutritional management of CJD patients and thus allow their families and caregivers to ensure the best end-of-life care for these patients.

Proportion of Gleason Score ≥8 Prostate Cancer on Biopsy and Tumor Aggressiveness in Matched Cohorts of East Asian and Non-East Asian Men.

Historically, Asia had a lower prostate cancer (PCa) incidence and mortality compared with Western countries, but the gap is narrowing. Paradoxically, Asians have been reported to present with more advanced disease though more favorable outcomes. Despite PCa becoming an emerging health priority in East Asia, our knowledge remains limited. We compared the prevalence of high-grade PCa on biopsy and disease progression after radical prostatectomy (RP) in East Asian men from Asia and non-East Asian men from Western countries. This retrospective cohort study included men who underwent prostate biopsy and RP at academic centers in Shanghai, China, and Toronto, Canada (2014-2019). The expanded RP cohort included East Asian men from Singapore (n=282) and non-East Asians from Paris (n=192). Primary endpoints included the proportion of men with Gleason score (GS) ≥8 on biopsy and metastasis-free survival (MFS) after RP for GS ≥8. Multivariable logistic regression and Cox proportional hazard models were performed. Propensity score matching was used to reduce imbalances between cohorts. PCa was found on biopsy in 2,343 of 4,905 (48%) East Asians and 2,317 of 3,482 (67%) non-East Asians (P<.001). Prostate-specific antigen (PSA) levels at presentation and the proportion of men with GS ≥8 were higher in East Asians than non-East Asians (12.4 vs 6.6 ng/mL and 15.0% vs 8.8%, respectively; both P<.001). On multivariable analysis, there was no difference in the proportion of men with GS ≥8 between matched cohorts with PSA <20 ng/mL (n=3,572; odds ratio, 1.05 [95% CI, 0.77-1.43]; P=.76). No difference in MFS was found after RP between matched cohorts (hazard ratio, 0.97 [95% CI, 0.55-1.70]; P=.92). This contemporary study demonstrates that East Asian men are equally as likely to harbor aggressive PCa on biopsy as non-East Asian men at PSA levels observed in screening programs, with no difference in disease aggressiveness after RP. The assumption that unfavorable PCa at diagnosis is more common but less aggressive in East Asians should be revisited and viewed in the context of the expected increase in the PCa burden worldwide.

Liver transplantation for gastroenteropancreatic neuroendocrine liver metastasis: optimal patient selection and perioperative management in the era of multimodal treatments.

Gastroenteropancreatic neuroendocrine tumors (NET) often metastasize to the liver. Although curative liver resection provides a favorable prognosis for patients with neuroendocrine liver metastasis (NELM), with a 5-year survival rate of 70-80%, recurrence is almost inevitable, mainly in the remnant liver. In Western countries, liver transplantation (LT) has been performed in patients with NELM, with the objective of complete removal of macro- and micro-NELMs. However, prognosis had been unsatisfactory, with 5-year overall survival and recurrence-free survival rates of approximately 50 and 30%, respectively. In 2007, the Milan criteria were proposed as indications for LT for NELM. The criteria included: (1) confirmed histology of NET-G1 or G2; (2) a primary tumor drained by the portal system and all extrahepatic diseases removed with curative resection before LT; (3) liver involvement ≤50%; (4) good response or stable disease for at least 6months before LT; (5) age ≤ 55years. A subsequent report demonstrated outstanding LT outcomes for NELM within the Milan criteria, with 5-year overall survival and recurrence rates of 97 and 13%, respectively. In Japan, living donor LT (LDLT) for NELM has been performed sporadically in only 16 patients by 2021 in Japan; however, no consensus has been reached on the indications or perioperative management of LDLT. This article presents the outcomes of these 16 patients who underwent LDLT in Japan and reviews the literature to clarify optimal indications and perioperative management of LDLT for NELM in the era of novel multimodal treatments.

Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia

Background: This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs). Methods: Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs. Results: The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs. Conclusions: Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.

The Cultural Differences Between China and The West in International Business Activities

With the development of economic globalization, more and more enterprises choose to expand their industries abroad, leading that international business activities are becoming more and more frequent. At the same time, the important role of cultural differences in international business activities has become increasingly prominent. Studying the cultural differences between China and the West in international business activities can help multinational corporations understand what cultural differences exist in their business activities between China and Western countries, what challenges they will encounter and how to deal with these challenges, so as to improve their competitiveness, help them carry out international business activities smoothly, and finally promote the prosperity of the global economy.

Cell salvage in obstetrics-Background and practical implementation

Postpartum hemorrhage (PPH) remains aleading cause of maternal mortality worldwide, with an increasing incidence in western countries over the past decades. During this period the numbers of PPH-related allogeneic red blood cell (RBC) transfusions have also significantly increased. Given the increasing scarcity and risks of allogeneic RBC transfusions, which are also associated with adverse maternal outcomes, optimized blood management strategies are urgently needed in obstetrics. In recent years, patient blood management (PBM) has been increasingly integrated into medical care, resulting in asignificant improvement in patient outcomes. Cell salvage (CS) is one of the PBM blood-sparing techniques that enables the collection, processing and retransfusion of the patient's own blood during major bleeding events. Although recent evidence indicates that CS can significantly reduce the demand for allogeneic RBC transfusions and improve patient outcomes, the utilization in obstetrics in German hospitals remains low, with ausage rate of only 0.07% of births with peripartum hemorrhage. It must be assumed that concerns about patient-related complications, such as amniotic fluid embolism and maternal alloimmunization contribute to this hesitancy, alongside alack of familiarity with the technique. This article provides an overview of the current evidence on the use and safety of CS in obstetrics. To facilitate a practical implementation, fundamental considerations and organizational precautions were prepared based on the experiences of the University Hospitals in Würzburg and Frankfurt and presented in the form of graphics and checklists for the perioperative use of CS during cesarean sections.

Church Union Movement and the Establishment of the “United Church of Christ in Japan”

The establishment of the United Church of Christ in Japan (nihon kirisuto kyōdan 日本基督教団) marked the culmination of the Church Union Movement in Imperial Japan. Although the Church Union Movement can be traced back to the Meiji era, no significant breakthroughs were made until 1939 due to the refusal of some denominations. In this article, I aim to clarify the process and causes behind the formation of the united church, while also attempting to understand the interaction pattern between the State and Christianity under an increasing wartime totalitarian regime. In April 1939, the Diet passed the Religious Organizations Law (syūkyō dantai hō 宗教団体法), a bill aimed at strengthening state control over religions, which required Christian denominations to establish religious organizations. With the war intensifying Japan’s antagonism toward Western countries, Christianity as a foreign religion faced progressive attacks from the nationalist sects. Some denominations, like the Salvation Army, were accused of espionage due to their international connections and were monitored by gendarmerie (kenpeitai 憲兵隊). Facing harsh pressure, Christians sought to project a patriotic image, ultimately leading to the formation of the United Church as a survival strategy amidst a hostile social-political environment.

Comparison of Neoadjuvant Chemotherapy Followed by Radical Surgery with Chemoradiation in Stage IB2 to IIB of Cervical Cancer

Background: The management of locally advanced cervical cancer (stages IB2 to IIB) remains controversial, particularly in regions with limited radiotherapy (RT) resources. While chemoradiation therapy (CRT) is the standard treatment in many Western countries, neoadjuvant chemotherapy followed by radical surgery (NACT-RS) has emerged as an alternative approach. Objectives: The comparative effectiveness and safety of NACT-RS versus CRT in terms of side effects and recurrence rates remain unclear, necessitating further investigation. Methods: A cohort study was conducted from 2020 to 2023, involving 68 patients with cervical carcinoma (stages IB2 to IIB). The patients were stratified into two treatment groups: Neoadjuvant chemotherapy followed by radical surgery (N = 17) and CRT (N = 51). The study compared pathology reports, short-term treatment complications, and one-year recurrence rates between the two groups. Results: Minor complications occurred in 41.2% of the NACT-RS group and 39.2% of the CRT group (P = 0.886), while major complications were observed in 23.5% and 25.5% of the groups, respectively (P = 0.872). All NACT-RS patients responded to chemotherapy with significant tumor size reduction (47.7 ± 8.0 vs. 11.2 ± 8.6, P &lt; 0.001) and resolution of vaginal involvement. During the one-year follow-up, no recurrences were observed in the NACT-RS group, compared to eight out of 51 (16.7%) in the CRT group (P = 0.186). Conclusions: The similar short-term complication rates and potentially lower one-year recurrence rate in the NACT-RS group suggest that this approach may be a viable alternative to CRT, particularly for young patients with bulky tumors and in areas with limited RT facilities.

Leave or stay? The determinants of the migration behavior of university graduates in Shanghai

ABSTRACT Millions of university graduates in China either stay in the cities where they go to universities (for their bachelor’s degree) or migrate to other areas each year. What factors determine their destination choice? This paper investigates migration patterns of university graduates from Shanghai among the university city, hometown, and other cities, and the roles of general factors and special Chinese factors such as hukou in graduate mobility. The main findings are as follows. First, key factors that attract graduates to stay in the university city, return to their hometown, or go to other cities are different and one factor may not have the same impact. Second, there are specific spatial patterns of migration from different types of hometowns to three destination types, as different types of hometowns offer different life experiences as well as opportunities in the spatial administrative system. There is a strong preference for Chinese graduates to move up the urban hierarchy to bigger cities than their hometowns. Third, the impacts of some general factors such as housing price, social capital, and human capital are similar to those of Western countries. The impacts of hukou vary. Although graduates have local hukou in their hometowns, most graduates from big cities, towns, and villages prefer not to return to their hometowns. Only graduates from small and medium-sized cities consider returning to their hometowns. But if graduates go to other cities, they do consider hukou factor. Our research has significant implications for urban and regional development and talent policies in China.

Abstract 4118380: In-Hospital Outcome of Acute Heart Failure in Patients with Active Chronic Lymphocytic Leukemia

Introduction: Chronic lymphocytic leukemia (CLL) is prevalent among adults in Western countries, posing a significant health challenge due to its incurable nature and associated complications. Among these, cardiovascular disease, particularly heart failure (HF), has emerged as a major concern. Despite growing recognition, understanding of acute HF's epidemiology, outcomes, and risk factors in CLL patients remains limited. To address these gaps, we conducted a large-scale study using the National Inpatient Sample (NIS) database, aiming to examine acute HF prevalence, trends, outcomes, and predictors among CLL hospitalizations. Methods: We employed a retrospective cohort design utilizing NIS data from 2016 to 2021. CLL hospitalizations with and without acute HF were identified using ICD-10 codes. Our analysis included demographic characteristics, in-hospital outcomes, and multivariable logistic regression to identify predictors of outcomes. Propensity score matching was performed to mitigate confounding factors. Results: Among 423,829 CLL hospitalizations, 27.8% presented with acute HF. Patients with acute HF were older and had higher rates of comorbidities. While acute HF prevalence remained stable, in-hospital mortality increased over time, contrasting with stable rates among patients without acute HF. Acute HF was associated with higher mortality, cardiogenic shock, cardiac arrest, and major adverse cardiovascular events. Propensity score-matched analysis confirmed these associations. Discussion: Our study highlights acute HF as a common complication in CLL hospitalizations, linked with worse outcomes. The multifactorial nature of HF in CLL involves disease-related factors, treatment toxicities, and traditional cardiovascular risk factors. Prompt recognition and multidisciplinary management are essential for improving outcomes. Future research should focus on developing risk stratification tools and interventions targeting acute HF in CLL patients. Conclusion: Acute HF poses a significant burden on CLL hospitalizations, emphasizing the need for heightened awareness and tailored management strategies. Our findings underscore the importance of early recognition and intervention to improve outcomes in this vulnerable population.

Unravelling the Role of Chitin and Chitosan in Prebiotic Activity and Correlation With Cancer: A Narrative Review.

This review describes the state of the art regarding the prebiotic role of chitin and the interactions of chitin and chitosan with cancer cells. Chitin is the second most abundant polysaccharide in nature and a constitutive component of crustacean shells and the exoskeleton of insects. Chitosan is the deacetylated form of chitin, which is obtained by chemical processing or the enzymatic activity of deacetylases found in microorganisms and insects. Edible insects have recently been introduced in Western countries, thus raising concerns regarding food safety and due to their chitin content and the release of chitosan during the digestive process. The roles of insect chitin and chitosan in the gastrointestinal tract, microbiome modulation, and cancer have been widely investigated. Several in vitro and in vivo studies have shown the possible microbiota modulation of chitin and its relevant communication with the immune system, thus confirming its prebiotic activity. No evidence has been provided on the cancerogenic activity of chitin; however, studies have suggested that chitin has a cytotoxic effect on cancer cell lines. Chitosan has been confirmed to exhibit apoptotic and cytotoxic activities on cancer cells in several in vitro studies on cancer cell lines and in vivo models. In conclusion, the literature does not show a direct connection between the presence of chitin or chitosan and the onset of cancer. However, cytotoxic and apoptotic activities in relation to cancerous lines have been demonstrated.

Natural processes and natureculture – A relational understanding of nature amongst local stakeholders in Swiss parks

ABSTRACT Various scholars have criticized that formal Western thinking was dichotomous and substantialist, leading to an alienation from nature and to its exploitation in industrialized societies. Critics argue that a relational turn towards a more holistic, process-based and relational approach to address the world would be an important step to overcome these problems. Such a relational turn involves a shift towards more flexible and inclusive concepts. We analyse ‘nature’ concepts of local stakeholders in Swiss nature parks to examine whether they contain any relational elements. Indeed, we found that all stakeholders interviewed see themselves as part of nature. Many reported how they experience nature in active processes and see nature as a collaborator and partner. Moreover, they do not strictly separate between natural and cultural elements in their environment. We conclude that a relational turn in environmental policy in Western countries could build on these relational elements in nature concepts of the local population.

Excess mortality and life-years lost in people diagnosed with depression: A 20-year population-based cohort study of 126,573 depressed individuals followed for 1,139,073 persons-years

Depression is associated with premature mortality, but evidence is mainly derived from Western countries. Very limited research has evaluated shortened lifespan in depression using life-years-lost (LYLs), a recently developed mortality metric taking into account the illness onset for life expectancy estimation. Temporal trends of differential mortality gap are understudied. This population-based cohort study, which utilized a territory-wide medical-record database of public inpatient and outpatient healthcare services in Hong Kong, evaluated the extent of premature mortality in 126,573 individuals with depression (persons-years=1,139,073) between January 2002 and December 2021 regarding the standardized mortality ratio (SMR) and excess LYLs. Trends in annual SMRs over 20 years were assessed by joinpoint analyses. The results showed that individuals with depression exhibited significantly higher all-cause (SMR=1.84 [95% CI=1.82–1.88]), natural-cause (1.69 [1.66–1.72]), and unnatural-cause (5.24 [4.97–5.51]) mortality rates than the general population. Suicide-specific SMR was markedly elevated (7.92 [7.47–8.38]), particularly in the 15–34 year-olds (12.75 [10.87–14.79]). Respiratory diseases, cardiovascular diseases and cancers accounted for the majority of deaths. Excess LYLs extended to men (5.67 years, 95% CI = 5.45–5.90) and women (4.06 years, 95% CI = 3.89–4.23). Overall and natural-cause mortality rates improved over time, but unnatural-cause and suicide-related mortality gaps persisted. Taken together, this study indicates that depression is associated with increased premature mortality and reduced lifespan in a predominantly Chinese population, mainly attributed to natural causes. Relative suicide-specific mortality is substantially elevated, especially among young people. The pronounced mortality gap underscores an urgent need for effective interventions targeting improved physical health and suicide risk reduction in individuals with depression.

Abstract 4123308: Trends in Gestational Diabetes Mellitus By US State, 2019 -2023

Introduction/ Background: Gestational diabetes mellitus (GDM) is one of the most frequent adverse pregnancy outcomes and increases the risk of lifetime cardiometabolic disease. Given known geographic disparities in maternal morbidity and mortality in the US, we examined state-level prevalence and trends in GDM from 2019-2023. Methods: We conducted a serial, cross-sectional analysis of maternal health data recorded on birth certificates from all livebirths in the US using the National Center for Health Statistics Natality Files. We included pregnant individuals aged 15-44 years who gave birth from 2019-2023, had a singleton, live birth, and did not have pre-pregnancy diabetes. We calculated the age-standardized prevalence and average-annual percent change (AAPC) in GDM from 2019-2023, overall, by U.S. census region (Northeast, Midwest, South, and West), and in each US state and the District of Columbia (DC). Results: Of the 17,432,486 individuals with live births between 2019 and 2023, overall prevalence of GDM per 100 live births (95% confidence interval) was 6.9 (6.9, 6.9) in 2019 and 8.0 (8.0, 8.1) in 2023 (AAPC 3.2 [-1.7, 8.5]). There was significant geographic variation in overall prevalence of GDM by US region and state ( Figure 1 ). In 2023, prevalence was higher in the Midwest (8.8 [8.7, 8.9]) and Western states (8.6, [8.5,8.6]) compared with the Southern (7.3, [7.3, 7.4]) and Northeastern states (8.1, [8.0,8.2]), ranging from 5.5 (4.9,6.0) in DC to 13.0 (12.2,13.8) in Alaska. Prevalence was higher in 2023 compared with 2019 in all US regions and states and DC, except Alaska, Connecticut, Idaho, Maine, New Jersey, and Wyoming. Prevalence increased most rapidly in the Western US states (AAPC 4.2%/year [0.1, 8.4]) with the greatest change observed in Montana from 5.1 (4.7, 5.6) in 2019 to 8.0 (7.5, 8.5) in 2023 (AAPC 10.3%/year [5.6, 15.3]). Conclusions: GDM prevalence increased significantly from 2019-2023 with substantial heterogeneity by US region and state. More localized state-level analysis with context-specific polices that address factors associated with geographic differences in GDM are needed to promote maternal cardiometabolic health equity in the US.

Impact of Arable Land Abandonment on Crop Production Losses in Ukraine During the Armed Conflict

The outbreak of Russia-Ukraine conflict casted an impact on the global food market, which was believed to be attributed to that Ukraine has suffered significant production losses due to cropland abandonment. Nevertheless, recent outbreaks of farmer protests against Ukraine’s grain exports demonstrated that the production losses might not be as severe as previous estimates. By utilizing the adaptive threshold segmentation method to extract abandoned cropland from the Sentinel-2 high-resolution imagery and calibrating the spatial production allocation model’s gridded crop production data from Ukraine’s statistical data, this study explicitly evaluated Ukraine’s crop-specific production losses and the spatial heterogeneity. The results demonstrated that the estimated area of abandoned cropland in Ukraine ranges from 2.34 to 2.40 million hectares, constituting 7.14% to 7.30% of the total cropland. In Ukrainian-controlled zones, this area spans 1.44 to 1.48 million hectares, whereas in Russian-occupied areas, it varies from 0.90 to 0.92 million hectares. Additionally, the total production losses for wheat, maize, barley, and sunflower amount to 1.92, 1.67, 0.70, and 0.99 million tons, respectively, with corresponding loss ratios of 9.10%, 7.48%, 9.54%, and 8.67%. Furthermore, production losses of wheat, barley, and sunflower emerged in both the eastern and southern states adjacent to the conflict frontlines, while maize losses were concentrated in the western states. The findings imply that Ukraine ought to streamline the food transportation channels and maintain stable agricultural activities in regions with high crop production.

Costs and benefits of a formal academic qualification beyond the PhD

AbstractIn many Western and Eastern European countries, the habilitation is the highest formal qualification awarded by universities, ranking above the doctorate. Despite its central role in the European higher education system, little is known about the career trajectories of those who have obtained this degree. This paper systematically analyzes the career trajectories of scientists and scholars who have completed a habilitation in Germany, comparing these to those of individuals who did not complete a further degree after their PhD. To do so, linked social insurance data from a period of 2 years prior to 15 years after receiving the doctorate are used. My analysis reveals the substantial monetary costs of pursuing an additional qualification after the PhD. The empirical findings indicate that the benefits of an additional qualification beyond the PhD are primarily non-monetary, for example having a cognitively demanding and challenging job requiring a high level of education, and an increased likelihood of employment within the academic sector. These findings may indicate that beyond a certain level of education, and with an already fairly strong integration into the labor market, non-financial aspects of work could become more significant to individuals than income maximization.