Funding in 2012: "great recession" starts to bite.

Biomedical research budgets are frozen or falling in developed countries. Can expansion in developing nations continue as economic contagion spreads?

What Western Philosophers of Technology Might Learn from Li Bocong's Philosophy of Engineering.

This essay aims to rectify a failure on the part of Western philosophers of technology to attend to the creative philosophical work of Li Bocong at the University of Chinese Academy of Sciences in Beijing. After a brief account of Li Bocong's personal contacts with the West and some remarks on his relationship to Marxism, we take up three aspects of his philosophy that can contribute to enlarging Western philosophical thinking about engineering and technology: (1) Li's analysis of engineering as more than design, (2) his argument for the relevance of the sociology of engineering, and (3) his conceptualization of engineering ethics as more than professional ethics.

Neither saintly nor psychotic: a narrative systematic review of the evolving Western perception of voice hearing.

We present a social-historical perspective on the evolution of the voice-hearing phenomenon in Western society. Based upon a systematic search from a selection of nine databases, we trace the way hearing voices has been understood throughout the ages. Originally, hearing voices was considered a gifted talent for accessing the divine, but the progressive influence of monotheistic religion gradually condemned the practice to social marginalization. Later, the medical and psychiatric professions of secular society were instrumental in attaching stigma to both voice hearers and the phenomenon itself, thereby reinforcing social exclusion. More recently, the re-integration of voice hearers into the community by health authorities in various countries appears to have provided a new, socially acceptable setting for the phenomenon.

[Preservation of residual kidney function in chronic haemodialysis]. / Préservation de la fonction rénale résiduelle et hémodialyse incrémentale.

Residual kidney function (RKF) is defined as the production of a clinically significant amount of urine in dialysis patients. Observational studies suggest that those with preserved RKF have a better prognosis than anuric patients. Preserved RKF allows the prescription of a lower dialysis dose compared to the traditional thrice weekly schedule. Such an "incremental" approach has also been associated with a better global prognosis. In view of the overall growth of incremental HD in the western world, we review the main studies supporting this approach, as well as the benefits and limitations related to RKF preservation.

Chez les patients hémodialysés, la fonction rénale résiduelle (FRR) est définie comme la production d'une quantité d'urine significative du point de vue clinique. Les données observationnelles suggèrent que les patients en hémodialyse (HD) ayant une FRR conservée ont un meilleur pronostic que les patients anuriques. Une FRR préservée permet également la prescription d'une dose d'HD inférieure au schéma traditionnel de 3 séances par semaine. Ce type d'approche «â€…incrémentale ¼ a elle aussi été associée à une amélioration du pronostic global. Au vu de l'essor de l'HD incrémentale dans les pays développés, nous revenons dans cet article sur les principales études qui soutiennent cette approche ainsi que sur les bénéfices et limitations liées à la préservation de la FRR.

Regulatory landscape of alternatives to animal testing in food safety evaluations with a focus on the western world.

Traditional animal models are increasingly being replaced by new approach methodologies (NAMs) which focus on predicting toxicity of chemicals based on mechanistic data rather than apical endpoint data usually obtained from animal models. Beyond in vitro genetic tests, however, only a handful of NAMs have been successfully implemented in regulatory decision-making processes, mostly in the cosmetics and chemicals sector. Regulatory guidance on food safety testing in many jurisdictions still relies on data obtained from animal studies. This is due to the lack of validated models to predict systemic toxicity, which is essential to develop health-based guidance values for food additives. Other factors limiting the adoption of NAMs into food safety assessment include sector legislation lagging behind scientific progress, and lack of training and expertise to use the new models. While regulatory and industry bodies are working to combat these challenges, more needs to be done before these models can be used as standalone tools for regulatory decision-making. This review summarizes the current state and challenges of regulatory acceptance of NAMs for decision-making, and the efforts by governing bodies and industry to transition from animal testing for food safety assessments.

Self-care behaviours and related cultural factors among Chinese immigrants with cardiovascular disease in western countries: an integrative review.

AIMS AND OBJECTIVES: This review aimed to demonstrate the self-care behaviours of first-generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. BACKGROUND: Self-care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross-cultural context, may find self-care to manage their cardiovascular disease challenging. DESIGN: An integrative review was conducted. METHODS: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer-reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. RESULT: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision-making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. RELEVANCE TO CLINICAL PRACTICE: Understanding self-care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self-care behaviours among immigrant populations. The scarcity of literature on self-care behaviours among Chinese first-generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed.

Impact of Historic Migrations and Evolutionary Processes on Human Immunity.

The evolution of mankind has constantly been influenced by the pathogens encountered. The various populations of modern humans that ventured out of Africa adapted to different environments and faced a large variety of infectious agents, resulting in local adaptations of the immune system for these populations. The functional variation of immune genes as a result of evolution is relevant in the responses against infection, as well as in the emergence of autoimmune and inflammatory diseases observed in modern populations. Understanding how host-pathogen interactions have influenced the human immune system from an evolutionary perspective might contribute to unveiling the causes behind different immune-mediated disorders and promote the development of new strategies to detect and control such diseases.

[Endoscopic submucosal dissection: advances and perspectives]. / Dissection sous-muqueuse endoscopique : avancées et perspectives.

Endoscopic submucosal dissection (ESD) is a mini-invasive technique allowing to resect superficial lesions of the digestive tract and maintaining organ function. High technical expertise is required as well as a network approach with referring physicians, pathologists, radiologists, surgeons and oncologists. Rigorous selection of cases as well as endoscopic management of potential complications (hemorrhage, perforation) is mandatory. Therefore, ESD should preferably be performed in expert centers with high volumes of cases, in order to maintain competency and offer optimal patient's management. Most frequent indications in the Western world are early cancers of the esophagus, stomach and colon as well as non-non-lifting polyps and gastrointestinal stromal tumors (GIST).

La dissection sous-muqueuse (DSM) est une technique permettant la résection des lésions superficielles du tube digestif, de façon mini-invasive, afin de conserver la fonction de l'organe atteint. L'expertise technique aboutissant à ce geste doit s'accompagner d'un travail en réseau associant médecins référents, pathologistes, radiologues, chirurgiens et oncologues. Elle nécessite une sélection rigoureuse des indications, ainsi que la maîtrise des complications éventuelles (hémorragie, perforation) et doit préférablement être réalisée en centre expert, avec un volume suffisant de cas afin de maintenir la compétence. Les indications les plus fréquentes en Occident concernent les cancers super­ficiels de l'œsophage, de l'estomac et du côlon ainsi que les polypes ne se soulevant pas lors de l'injection sous-muqueuse et les tumeurs stromales gastro-intestinales (GIST).

Similarities and differences in peripheral artery disease between China and Western countries.

OBJECTIVE: Peripheral artery disease (PAD) affects more than 200 million people worldwide, among whom more than two-thirds reside in low- and middle-income countries. China, as the largest low- and middle-income country, faces a challenge from the burden of PAD as the country undergoes economic expansion. We compared the patterns of PAD between China and Western countries to determine if there are differences in risk factors, awareness, or treatment of PAD. METHODS: Literature searches were performed both in English databases and Chinese databases covering January 1, 1995, to March 1, 2020. Both landmark and high-quality articles were evaluated. RESULTS: The prevalence of PAD in high-income countries increases linearly with age, whereas PAD increases slowly until the middle 60s and exponentially thereafter in China. In contrast with Western countries, the prevalence of PAD in China is reported to be higher in women than in men. There is a higher prevalence of risk factors in China, but the rates of awareness and treatment of these risk factors are low. CONCLUSIONS: The lack of awareness and lower rates of treatment and control of PAD and its risk factors in China may be underlying the higher prevalence of PAD in women than in men as well as the steep increase in PAD after the middle 60s. In all countries, more attention should be paid to the planning and implementation of preventative strategies and clinical services. The societal and economic effects of PAD are considerable and ongoing studies are needed to help curtail the burden of this disease.

College students in the western world are becoming less emotionally intelligent: A cross-temporal meta-analysis of trait emotional intelligence.

OBJECTIVE: Over the last two decades, Western society has undergone a marked cultural transformation characterized by rising individualism. Concurrently, the digital landscape has transformed through the rise of social media and smartphones. These factors have previously been implicated in changing individuals' attitudes, behavior, and interpersonal interactions. We investigated whether these societal changes have coincided with changes in trait emotional intelligence (EI) over the last 17 years in Western university students. METHOD: We examined this question using a cross-temporal meta-analysis (k = 70; N = 16,917). RESULTS: There was no change in overall trait EI; however, the trait EI domains "well-being," "self-control," and "emotionality" demonstrated significant decreases with time, after controlling for gender composition and between-country differences. CONCLUSION: We discuss these findings in relation to how they contribute to our understanding of trait EI, and how they add to the literature on how Western society is changing with time.

The Art of Rhinoplasty: Researching Technical and Cultural Foundations of Western World Rhinosurgery, from the Middle Ages to the Renaissance.

The analysis of the written sources allowed to follow the gradual development of every new technique in the field of rhinoplasty but also to understand the value of this surgery in those ancient times, highlighting a deep connection between traumatologic surgery of the nose and the development of modern "aesthetic and reconstructive" Rhinosurgery. Specifically, we analyzed the techniques described by less known surgeons to emphasize their cultural and surgical value. As a matter of fact, the descriptions offered by these authors clearly show the importance of rhinoplasty as a cardinal and autonomous practice since Antiquity, also clarifying the persistence and development of specific techniques for this surgical practice in the History of medicine. In the manuscript, the contributions of the Italian surgeons, such as Brancas and Vianeos families, are highlighted, demonstrating their influence on the progress of this surgical specialty in the Early Modern Age. Finally, we deepen the description of Gaspare Tagliacozzi's work, pointing out the topics and controversial debates arising from his techniques and innovations in "rhinosurgery" and also in the field of tissue transplantation, laying the foundations of modern Plastic Surgery.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Endovascular and open surgical repair of abdominal aortic aneurysms: A comparative analysis of western and Chinese studies.

Abdominal aortic aneurysms (AAA) are life-threatening serious conditions that require effective and quick management. Although it is generally acknowledged that patients with AAA obtain the greatest benefit from endovascular repair (EVAR) compared to open surgical repair (OSR), there are few comparisons between the surgical approaches in Western versus Chinese patients. We aimed to perform a meta-analysis of studies in which EVAR was compared with OSR in the management of abdominal aortic aneurysms. We searched the Western literature through PubMed, OVID and Web of Science from 1991 until December 2018 and the Chinese-language literature from 1998 until December 2018. We pooled the results in January 2019 based on standardized inclusion and exclusion criteria and analyzed them using a conventional meta-analysis. Forty-five English papers with 31,074 AAA patients and twenty-one Chinese studies with 1,405 patients were included in this study. Chinese subjects were more likely to undergo endovascular repair than Western subjects (44.5% versus 41.5%, P = 0.012). The 30-day post-discharge mortality rate in Western studies was significantly lower for EVAR than for OSR (odds ratio (OR) = 0.481, P < 0.001). However, there was no significant reduction in the 30-day mortality rate following EVAR compared to OSR (OR = 0.733, P = 0.425) for Chinese patients. In Western patients, the postoperative complication rate of respiratory system and cardiac system was lower in the EVAR group than in the OSR group (OR = 0.270, P < 0.001 and OR = 0.411, P < 0.001, respectively), nevertheless, for Chinese patients, limb ischaemia was more common (OR = 1.539, P = 0.049) in the EVAR group. Whether in Western patients with an eight-year follow-up period or Chinese patients with a maximum four-year follow-up period, there was no significant difference between the EVAR and OSR groups in the all-cause death rate (hazard ratio (HR) = 1.026, P = 0.483 and HR = 1.173, P = 0.247, respectively). Chinese patients were more likely to receive EVAR than OSR and the 30-day mortality was significantly lower for EVAR than for OSR in Western patients but not in Chinese patients. Endovascular repair can be applied to Chinese patients with a reasonable safety margin. Further work is needed to explore the causes of these treatment differences.

Maternal western diet causes inflammatory milk and TLR2/4-dependent neonatal toxicity.

For all newborn mammals, mother's milk is the perfect nourishment, crucial for their postnatal development. Here we report that, unexpectedly, maternal western diet consumption in mice causes the production of toxic milk that contains excessive long chain and saturated fatty acids, which triggers ceramide accumulation and inflammation in the nursing neonates, manifested as alopecia. This neonatal toxicity requires Toll-like-receptors (TLR), but not gut microbiota, because TLR2/4 deletion or TLR4 inhibition confers resistance, whereas germ-free mice remain sensitive. These findings unravel maternal western diet-induced inflammatory milk secretion as a novel aspect of the metabolic syndrome at the maternal offspring interface.

Food-Derived Opioid Peptides in Human Health: A Review.

World Health Organization data suggest that stress, depression, and anxiety have a noticeable prevalence and are becoming some of the most common causes of disability in the Western world. Stress-related disorders are considered to be a challenge for the healthcare system with their great economic and social impact. The knowledge on these conditions is not very clear among many people, as a high proportion of patients do not respond to the currently available medications for targeting the monoaminergic system. In addition, the use of clinical drugs is also associated with various side effects such as vomiting, dizziness, sedation, nausea, constipation, and many more, which prevents their effective use. Therefore, opioid peptides derived from food sources are becoming one of the safe and natural alternatives because of their production from natural sources such as animals and plant proteins. The requirement for screening and considering dietary proteins as a source of bioactive peptides is highlighted to understand their potential roles in stress-related disorders as a part of a diet or as a drug complementing therapeutic prescription. In this review, we discussed current knowledge on opioid endogenous and exogenous peptides concentrating on their production, purification, and related studies. To fully understand their potential in stress-related conditions, either as a drug or as a therapeutic part of a diet prescription, the need to screen more dietary proteins as a source of novel opioid peptides is emphasized.

Lymphoganuloma venereum in the Western world, 15 years after its re-emergence: new perspectives and research priorities.

PURPOSE OF REVIEW: Lymphogranuloma venereum (LGV) is a serious sexually transmitted infection caused by Chlamydia trachomatis. If left untreated LGV can cause irreversible late sequelae. LGV is endemic among a high-risk population of men who have sex with men (MSM), and largely reported in Western metropoles. RECENT FINDINGS: Although the majority of LGV patients are HIV positive, in recent years the proportion of HIV-negative MSM with LGV is rising. This could indicate a shift toward lower risk populations. Apart from a few European countries, no proper LGV surveillance efforts have been implemented so far. Moreover, a considerable proportion of the infections are asymptomatic. As a result, the true magnitude of the LGV epidemic is underestimated.Depending on the stage and location of infection, LGV manifests in a variety of clinical presentations. Among MSM, anorectal infections are overreported as opposed to genital LGV infections in a ratio of 15 to 1, respectively. Therefore, other modes of transmission apart from anal sex are here discussed. SUMMARY: To improve surveillance, cheaper and more practical screening methods are needed. Moreover, randomized clinical trials are needed to evaluate more simple treatment modalities as opposed to the currently recommended 3-week course of doxycycline.

Disparities in Contemporary Treatment Rates of Abdominal Aortic Aneurysms Across Western Countries.

OBJECTIVE/BACKGROUND: Several abdominal aortic aneurysm (AAA) screening programs have demonstrated a similar prevalence of this disease in Westerns countries, ranging from 1.2% to 2.8%. However, the annual rate of AAA repair is significantly less even, and its relationship to AAA prevalence is not clear. The objective was to perform a systematic review, describing an international overview in the yearly rate of AAA repairs. METHODS: The number of elective and emergency AAA repairs was obtained via thorough review of publications indexed in PubMed and Scopus from 2010 to October 2018. Portuguese data were obtained from the national administrative database of health care. Data from the UK were extracted from the National Vascular Registry's 2015 annual report. Each country's population was assessed from published national censuses, thus allowing estimation of the number of AAAs treated per 100,000 habitants. RESULTS: Data from 14 countries were obtained. The yearly number of elective operations per 100,000 habitants was 2.2 in Hungary, 3.8 in Portugal, 5.3 in Spain, 5.9 in Iceland, 6.5 in Finland, 7.0 in New Zealand, 7.8 in the UK, 10.0 in Denmark, 10.2 in Sweden, 13.3 in the USA, 14.8 in Norway, 15.3 in the Netherlands, 15.6 in Italy, and 17.3 in Germany. The yearly rate of ruptured repairs was 0.5 in Hungary, 1.5 in Portugal, 1.8 in Spain, 1.7 in Iceland, 1.7 in Finland, 1.3 in New Zealand, 1.8 in the UK, 3.3 in Denmark (2013), 2.7 in Sweden (2013), 1.7 in the USA, 2.1 in Norway, 3.1 in the Netherlands, 2.3 in Italy, and 2.7 in Germany. CONCLUSION: The rate of AAA treatment is highly variable, with a nearly eightfold variance between the countries with the highest and lowest rates of elective repair. Correlation between elective and ruptured repairs was not clear. A deeper understanding of the reasons for the disparities in AAA treatment among Western countries is of the utmost importance.

Laboratory values in Japanese children with newly diagnosed inflammatory bowel disease.

BACKGROUND: Laboratory data in children with newly diagnosed inflammatory bowel disease (IBD) have been reported from Europe and North America, but not Asia. The aim of this study was to clarify laboratory data in Japanese children with newly diagnosed IBD, and to compare them with those in Western reports. METHODS: We retrospectively reviewed patients <16 years old, newly diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) at Kurume University Hospital between January 2008 and December 2015. RESULTS: UC and CD patients numbered 31 and 15, respectively. The percentages of patients with normal values for hemoglobin (Hb), platelet count (Plt), albumin (Alb), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in the UC and CD groups were 45% and 47%; 68% and 53%; 84% and 40%; 81% and 7%; and 35% and 0%, respectively. The frequency of normal results for these five tests were similar to Western findings except for the greater frequency of normal CRP in UC. Alb and ESR differed significantly between UC and CD in both mild and moderate-severe cases. Plt, Alb, CRP, and ESR differed significantly between diseases in late-onset IBD, whereas early onset IBD showed no differences. In UC, ESR correlated positively, while Hb and Alb correlated negatively, with disease activity. In CD, CRP and ESR correlated positively with activity. CONCLUSIONS: The proportion of Japanese children with IBD having normal values at diagnosis was mostly similar to that in Western reports. In early onset cases, UC parameters may be similar to CD. Of the five tests, ESR was particularly indicative of disease activity at diagnosis in both pediatric UC and CD.