The impact of selective episiotomy on maternal short-term morbidity: a retrospective study.

BACKGROUND: The aim is to investigate the risk of short-term maternal morbidity caused by the selective clinical use of episiotomy (rate < 0.02), and to compare the risk of severe perineal tears with the statewide risk. METHODS: In this retrospective cohort study, we investigated the effect of selective episiotomy on the risk of severe perineal tears and blood loss in singleton term deliveries, using propensity scores with inverse probability weighting. RESULTS: This study included 10992 women who delivered vaginally between 2008-2018. Episiotomy was performed in 171 patients (1.55%), three of whom (1.75%) experienced severe perineal tears compared to 156 (1.44%) in the control cohort. The adjusted odds ratio of severe perineal tears was 2.06 (95% confidence interval [CI]: 0.51, 8.19 with 0.3 p value). Multivariate linear regression showed that episiotomy increased blood loss by 96.3 ml (95% CI: 6.4, 186.2 with 0.03 p value). Episiotomy was performed in 23% (95% CI: 0.228, 0.23) of vaginal deliveries in the state of Hessen, with a risk of severe perineal tears of 0.0143 (95% CI: 0.0139, 0.0147) compared to 0.0145 (95% CI: 0.0123, 0.0168) in our entire cohort. CONCLUSIONS: Selective use of episiotomy does not increase the risk of higher-grade perineal tears. However, it may be associated with maternal morbidity in terms of increased blood loss.

An episiotomy is a cut between the vagina and the anus that may be performed by an obstetrician during childbirth and can result in increased blood loss or severe birth tears. In this study, we investigated the risks of both bleeding and severe tears caused by a highly selective local practice of episiotomies below 2% and compared the results with statewide data. The study included 10992 women who delivered between 2008­2018, 171 of whom underwent episiotomies according to the hospital's protocols. Having an episiotomy did not increase the likelihood of severe birthing tears but was associated with an increase in estimated blood loss. Therefore, although highly selective use of episiotomy is unlikely to cause more severe tears, it has the potential to worsen the mother's health by increasing blood loss.

The "forever" per- and polyfluoroalkyl substances (PFAS): A critical accounting of global research on a major threat under changing regulations.

The European Commission's current efforts to launch the largest proposal to restrict per- and polyfluoroalkyl substances (PFAS) in history reflect the dire global plight of PFAS accumulation in the environment and their health impacts. While there are existing studies on PFAS research, there is a lack of comprehensive analysis that both covers the entire research period and provides deep insights into global research patterns, incentives, and barriers based on various parameters. We have been able to demonstrate the increasing interest in PFAS research, although citation numbers are declining prematurely. Policy regulations based on proving and establishing the toxicity of PFASs have stimulated research in developed countries and vice versa, with increasing emphasis on ecological aspects. China, in particular, is investing increasingly in PFAS research, but without defining or implementing regulations - with devastating effects. The separation of industrial and environmental research interests is clear, with little involvement of developing countries, even though their exposure to PFAS is devastating. It, therefore, requires increased globally networked and multidisciplinary approaches to address PFAS contamination challenges.

Comparison Between Smoked Tobacco and Medical Cannabis Cigarettes Concerning Particulate Matter.

Introduction: Cannabis is a widely used drug like tobacco and alcohol. In the meantime, it is also prescribed for medical treatment in some countries. Tobacco smoke contains chemical carcinogens and particulate matter (PM) that are both harmful to health. Method: In this study, we investigated PM levels in second-hand smoke (SHS) of hand-tamped cannabis cigarettes compared to cigarettes with tubing tobacco and the 3R4F reference cigarette. Results: It could be demonstrated that the largest proportion of the particle mass is attributable to particles with a diameter of less than 1µm and that every tested cigarette emitted more PM than the 3R4F reference cigarette. In addition, our data clearly revealed that cannabis smoke contains higher PM levels in SHS than tobacco cigarettes. Compared to the reference cigarette, the PM1 emissions of cannabis were 105% higher. Also, the cannabis mixed cigarettes had higher PM levels than the 3R4F cigarettes. For instance, the PM10 emissions were 93% higher. Also, the Gauloises Mélange tubing tobacco also reached higher PM concentrations than the 3R4F cigarette. Discussion: Regardless of negative health effects, cannabis is seen as a harmless drug in the public eye. We found strong indications for potential health risks by PM from cannabis products and, therefore, the public should be educated about a potential harm.

Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

Introduction: Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19. Materials and Methods: A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated. Results: The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI > 30 kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome. Conclusion: Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.

The influence of epidural anesthesia in pregnancies with scheduled vaginal breech delivery at term: a hospital-based retrospective analysis.

INTRODUCTION: Epidural anesthesia is a well-established procedure in obstetrics for pain relief in labor and has been well researched as it comes to cephalic presentation. However, in vaginal intended breech delivery less research has addressed the influence of epidural anesthesia. The Greentop guideline on breech delivery states that there's little evidence and recommends further evaluation. OBJECTIVE: The aim of this study was to compare maternal and neonatal outcomes in vaginally intended breech deliveries at term with and without an epidural anesthesia. DESIGN: This study was a retrospective cohort study. SAMPLE: This study included 2122 women at term with a singleton breech pregnancy from 37 + 0 weeks of pregnancy on and a birth weight of at least 2500 g at the obstetric department of University hospital Frankfurt from January 2007 to December 2018. METHODS: Neonatal and maternal outcome was analyzed and compared between women receiving "walking" epidural anesthesia and women without an epidural anesthesia. RESULTS: Fetal morbidity, measured with a modified PREMODA score, showed no significant difference between deliveries with (2.96%) or without (1.79%; p = 0.168) an epidural anesthesia. Cesarean delivery rates were significantly higher in deliveries with an epidural (35 vs. 26.2%, p = 0.0003), but after exclusion of multiparous women, cesarean delivery rates were not significantly different (40.2% cesarean deliveries with an epidural vs. 41.5%, p = 0.717). As compared to no epidurals, epidural anesthesia in vaginal delivery was associated with a significantly higher rate of manual assistance (33.8 versus 52.1%) and a longer duration of birth (223.7 ± 194 versus 516.2 ± 310 min) (both p < 0.0001)". CONCLUSION: Epidural anesthesia can be offered as a safe option for pain relief without increasing neonatal or maternal morbidity and mortality. Nevertheless, it is associated with a longer birth duration and manually assisted delivery.

A virus becomes a global concern: research activities on West-Nile virus.

Currently, West-Nile virus (WNV) is spreading worldwide to colder regions due to climate change. Human mortality and morbidity are prevalent and steadily increasing, associated with costs to public health systems. Therefore, the question of the impact of scientific engagement arises. What trends, barriers, and incentives for research related to global burdens are important in this context? To answer these questions, this study provides detailed insights into the publication patterns of WNV research and interprets them using several parameters, such as absolute and relative publication indices and socioeconomic and epidemiological characteristics. It is shown that national interests combined with regional outbreaks significantly influence publication intensity. Thus, a correlation between national publication volume and the number of WNV cases was observed. In contrast to most life science topics, the scientific interest in WNV significantly decreased after 2006. The USA, as the main actor in WNV research, is at the centre of international networking. Recently, European countries are also getting involved according to their new-emerging outbreaks. The results demonstrate national interest in research activities with a lack of globally focused approaches that are urgently needed to better understand and assess the distribution and characteristics of WNV.

Heatwaves: does global research reflect the growing threat in the light of climate change?

BACKGROUND: With the increasing impacts of climate change, heatwaves are placing an enormous burden on health and social systems and threatening ecological diversity around the world. Heatwaves are increasing not only in frequency but also in severity and magnitude. They are causing the deaths of thousands of people. Research is needed on a multidisciplinary, supra-regional, and regional level. METHODS: A detailed evaluation of the research conducted is not yet available. Therefore, this study provides a detailed insight into the publication landscape to identify key players, incentives, and requirements for future scientific efforts that are useful not only for scientists but also to stakeholders and project funders. RESULTS: The number of publications on heatwaves is increasing, outpacing the trend of research indexed by the Science Citation Index Expanded. However, funding is lagging behind comparatively. Looking at absolute numbers, the USA, Australia, China, and some European countries have been identified as major players in heatwave research. If socio-economic numbers are included, Switzerland and Portugal lead the way. Australia and the UK dominate if the change in heatwave-exposed people is included. Nevertheless, exposure and economic strength of publishing countries were identified as the main drivers of national research interests. Previous heatwaves, in particular, have driven research efforts primarily at the national level. CONCLUSION: For an efficient monitoring or early detection system that also includes the economically weak regions, internationally networked efforts are necessary to enable preventive measures and damage limitation against heatwaves. Regardless of previous regional extreme heat events, research approaches should be focused to the global level.

Impact of different ventilation conditions on tobacco smoke-associated particulate matter emissions in a car cabin using the TAPaC platform.

Despite antagonizing attempts from the tobacco industry, passive inhalation of tobacco smoke is known to be cancerogenic and toxic to human health for decades. Nonetheless, millions of non-smoking adults and children are still victims of second-hand smoke. Accumulation of particulate matter (PM) in confined spaces such as the car are particularly harmful due to high concentrations. We here aimed to analyze the specific effects of ventilation conditions in the setting of a car. By the use of the measuring platform TAPaC (tobacco-associated particulate matter emissions inside a car cabin), 3R4F reference cigarettes, Marlboro red, and Marlboro gold were smoked in a car interior with a volume of 3.709 m3. Seven different ventilation conditions (C1-C7) were analyzed. Under C1, all windows were closed. Under C2-C7, the car ventilation was turned on power level 2/4 with the air directed towards the windshield. Only the passenger side window was opened, where an outer placed fan could create an airstream speed of 15.9-17.4 km/h at one meter distance to simulate a driving car. C2: Window 10 cm opened. C3: Window 10 cm opened with the fan turned on. C4: Window half-opened. C5: Window half-opened with the fan turned on. C6: Window fully opened. C7: Window fully opened with the fan turned on. Cigarettes were remotely smoked by an automatic environmental tobacco smoke emitter and a cigarette smoking device. Depending on the ventilation condition the cigarettes emitted different mean PM concentrations after 10 min under condition C1 (PM10: 1272-1697 µg/m3, PM2.5: 1253-1659 µg/m3, PM1: 964-1263 µg/m3) under C2, C4, and C6 (PM10: 68.7-196.2 µg/m3, PM2.5: 68.2-194.7 µg/m3, PM1: 66.1-183.8 µg/m3) C3, C5, and C7 (PM10: 73.7-139 µg/m3, PM2.5: 72-137.9 µg/m3, PM1:68.9-131.9 µg/m3). Vehicle ventilation is insufficient to protect passengers from toxic second-hand smoke completely. Brand-specific variations of tobacco ingredients and mixtures markedly influence PM emissions under ventilation conditions. The most efficient ventilation mode to reduce PM exposure was achieved by opening the passenger´s window 10 cm and turning the onboard ventilation on power level 2/4. In-vehicle smoking should be banned to preserve innocent risk groups (e.g., children) from harm.

Global mpox research in the light of the current outbreak: demands, drivers, and obstacles.

Following the current outbreak, the mpox virus (formerly: monkeypox virus) is a highly threatening pathogen with public health significance, although mpox is still considered a neglected disease. Previously confined mainly to Africa, the virus spread globally in 2022. However, knowledge about mpox is limited, causing a distorted perception of the disease. Therefore, this study aimed to collect all information on scientific mpox publishing and to analyse them according to their chronological, geographical, and epidemiological patterns. It was not until the global outbreak that the relatively small number of publications was replaced by the immense increase in annual publication numbers. The most important player is the USA with a central role in international networking. They collaborated mainly with the Democratic Republic of Congo, a primary endemic country where the first viral clades were determined. Nigeria and other African countries were also represented, although mainly in the form of co-authorships. The fact that few of the first authors are from low- or middle-economic countries demonstrates the need to promote equitable networking at the global level and their support for surveillance and targeted immunization programmes.

The Influence of Paid Memberships on Physician Rating Websites With the Example of the German Portal Jameda: Descriptive Cross-sectional Study.

BACKGROUND: The majority of Germans see a deficit in information availability for choosing a physician. An increasing number of people use physician rating websites and decide upon the information provided. In Germany, the most popular physician rating website is Jameda.de, which offers monthly paid membership plans. The platform operator states that paid memberships have no influence on the rating indicators or list placement. OBJECTIVE: The goal of this study was to investigate whether a physician's membership status might be related to his or her quantitative evaluation factors and to possibly quantify these effects. METHODS: Physician profiles were retrieved through the search mask on Jameda.de website. Physicians from 8 disciplines in Germany's 12 most populous cities were specified as search criteria. Data Analysis and visualization were done with Matlab. Significance testing was conducted using a single factor ANOVA test followed by a multiple comparison test (Tukey Test). For analysis, the profiles were grouped according to member status (nonpaying, Gold, and Platinum) and analyzed according to the target variables-physician rating score, individual patient's ratings, number of evaluations, recommendation quota, number of colleague recommendations, and profile views. RESULTS: A total of 21,837 nonpaying profiles, 2904 Gold, and 808 Platinum member profiles were acquired. Statistically significant differences were found between paying (Gold and Platinum) and nonpaying profiles in all parameters we examined. The distribution of patient reviews differed also by membership status. Paying profiles had more ratings, a better overall physician rating, a higher recommendation quota, and more colleague recommendations, and they were visited more frequently than nonpaying physicians' profiles. Statistically significant differences were found in most evaluation parameters within the paid membership packages in the sample analyzed. CONCLUSIONS: Paid physician profiles could be interpreted to be optimized for decision-making criteria of potential patients. With our data, it is not possible to draw any conclusions of mechanisms that alter physicians' ratings. Further research is needed to investigate the causes for the observed effects.

Correction: Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

[This corrects the article DOI: 10.1055/a-2196-6224.].

The measuring aerosol spreading during countermeasures (MASC) study presents an automated system to investigate face mask efficacy and other aerosol countermeasures in varying environments.

The COVID-19 pandemic exemplified the importance of research on personal protective equipment. In specific, understanding how effective surgical masks or particulate filter respirators are at reducing the transmission of infectious diseases has suddenly become one of the most pressing issues for legislators, regulators, and everyday life. However, there was a lack of available scientific platforms to assess this issue. Therefore, we designed and built a system entitled MASC: measuring aerosol spreading during countermeasures. This platform allows the simulation of various everyday situations and evaluation of the efficacy of masks and respirators in reducing the amount of inhaled particulate matter from the air. Furthermore, MASC can be used to investigate how aerosols propagate in closed spaces, such as offices or classrooms. It can be used to generate aerosols on command and control the room temperature, humidity, and wind speed. Up to four laser aerosol spectrometers can be read simultaneously, and a camera can automatically take pictures to evaluate the efficacy of countermeasures to prevent the spread of aerosols. The aerosol generation, measurement periods, and the number of repetitions for an experiment can be configured digitally and are executed by a computer automatically. A website displays the data in real time and allows monitoring of the experiment. Upon completion, statistical values are calculated automatically to accelerate the evaluation of the gathered data. Codes and technical drawings in this present methodology publication are open source and can be used by the scientific community to establish similar systems.

Environmental and health-related research on application and production of rare earth elements under scrutiny.

BACKGROUND: Unlike most other commodities, rare earth elements (REEs) are part of a wide range of applications needed for daily life all over the world. These applications range from cell phones to electric vehicles to wind turbines. They are often declared as part of "green technology" and, therefore, often called "green elements". However, their production and use are not only useful but also risky to the environment and human health, as many studies have shown. Consequently, the range of global research efforts is broad and highly variable, and therefore difficult to capture and assess. Hence, this study aims to assess the global parameters of global research on REE in the context of environment and health (REEeh). In addition to established bibliometric parameters, advanced analyses using market driver and scientific infrastructure values were carried out to provide deep insight into incentives, necessities, and barriers to international research. RESULTS: The focus of REE research is in line with national aspirations, especially from the major global players, China and the USA. Whereas globally, regional research interests are related to market interests, as evidenced by the inclusion of drivers such as electric vehicles, wind turbines, and permanent magnets. The topics receiving the most attention are related to gadolinium used for magnetic resonance imaging and the use of ceria nanoparticles. Since both are used for medical purposes, the medical research areas are equally profiled and mainly addressed in high-income countries. Nevertheless, environmental issues are increasingly in focus. CONCLUSIONS: There is still a need for research that is independent and open-ended. For this, market-independent technologies, substitutes and recycling of REEs need to be addressed scientifically. The results of this study are relevant for all stakeholders, from individual scientists to planners to funders, to improve future research strategies in line with these research mandates.

Ticks in medical and parasitological research: Globally emerging risks require appropriate scientific awareness and action.

BACKGROUND: The spread of ticks has also led to the emergence of regional, previously unknown tick-borne diseases (TBDs) that pose an immediate threat to public health systems worldwide. People who spend time or work outdoors are at risk without closer awareness of regional exposures. That is especially true for tourists, who very easily come into contact with ticks and get bitten while hiking and climbing. A regional lack of surveillance, lack of awareness, lack of scientific background, and misdiagnosis makes it hard to assess the actual threat properly. METHODS: Therefore, this bibliometric study aims to assess the global research on ticks and some TBDs. Geographical and temporal patterns are elaborated under epidemiological and socioeconomic aspects. That will provide a factual basis for targeted action at the scientific, societal, and policy levels against the growing threat associated with ticks. RESULTS: The USA and Brazil can be identified as the key players in tick research, followed by Russia and some Central European countries. The socioeconomic analysis points to epidemiologically relevant regions, as also shown by comparison with the TBD analysis. A correlation between countries' gross domestic product and publication performance was found. Lack of scientific resources limits the necessary research and surveillance programs. CONCLUSIONS: Many regions that are popular travel destinations are threatened by new tick species and thus new health risks. Therefore, outdoor activities in many locations may pose an unknown hazard that requires regionally differentiated scientific investigation and better, globally networked research strategies.

TAPaC-tobacco-associated particulate matter emissions inside a car cabin: establishment of a new measuring platform.

BACKGROUND: Particulate matter (PM) emission caused by tobacco combustion leads to severe health burdens worldwide. Second-hand smoke exposure is extraordinarily high in enclosed spaces (e.g., indoor rooms, car cabins) and poses a particular threat to the health of vulnerable individuals (e.g., children, elderly, etc.). This study aimed to establish a new measuring platform and investigate PM emissions under four different ventilation conditions inside a car cabin without exposing any person to harmful tobacco smoke. METHODS: PM concentrations were measured during the smoking of 3R4F reference cigarettes in a Mitsubishi Space Runner (interior volume 3.709 m3). The cigarettes were smoked with a machine, eliminating exposure of the researchers. Cigarettes were extinguished 4.5 min after ignition, and PM measurements continued until 10 min after ignition. RESULTS: High mean PM concentrations were measured for cigarettes without ventilation after 4.5 min (PM10: 1150 µg/m3, PM2.5: 1132 µg/m3, PM1: 861.6 µg/m3) and after 10 min (PM10: 1608 µg/m3, PM2.5: 1583 µg/m3, PM1: 1133 µg/m3). 3R4F smoked under conditions with turned on ventilation resulted in reduction of PM compared to those smoked without ventilation after 4.5 min (PM10:-47.5 to -58.4%, PM2.5:-47.2 to -58%, PM1:-39.6 to -50.2%) and after 10 min (PM10:-70.8 to -74.4%, PM2.5:-70.6 to -74.3%, PM1:-64.0 to -68.0%). Cigarettes smoked without ventilation generated high PM peaks at 4.5 min (PM10: 2207 µg/m3, PM2.5: 2166 µg/m3, PM1: 1421 µg/m3) and at 10 min (PM10: 1989 µg/m3, PM2.5: 1959 µg/m3, PM1: 1375 µg/m3). PM peaks of cigarettes smoked under different ventilation modes varied at 4.5 min (PM10: 630-845 µg/m3, PM2.5: 625-836 µg/m3, PM1: 543 - 693 µg/m3) and 10 min (PM10: 124 - 130 µg/m3, PM2.5: 124 - 129 µg/m3, PM1: 118 - 124 µg/m3). CONCLUSION: The new measuring platform provides a safer way for researchers to investigate PM emissions of cigarettes. These data are comparable to published research and show that smoking in a parked vehicle with the windows closed generates harmful PM emissions even when the vehicle ventilation is in operation. Future studies should be carried out using the new measuring platform investigating PM exposure and PM distribution of in-vehicle smoking under a wide range of conditions.

Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women-A Frabat Study.

(1) Background: Guidelines on vaginal breech delivery require birth weight restrictions and neglect the impact of pelvic measurements despite contradicting evidence. There is a great need for more evidence on delivery outcome predicting factors for patients counselling. (2) Methods: We performed a prospective cohort study on 748 primiparous women intending vaginal breech birth and analyzed combined influence of fetal birth weight (BW) and the obstetric conjugate (conjugate vera obstetrica, CVO) on delivery outcome. (3) Results: We generated a BW/CVO ratio and devided our study cohort at median (257.8 g/cm) into a low ratio group (LR, with low birth weight and wide obstetric conjugate) and a high ratio group (HR, high birth weight and narrow obstetric conjugate). Cesarean section (CS) rate was significantly higher in HR (50.3%) as compared to LR (28.3%, p < 0.0001). Fetal morbidity was not different. In vaginally completed deliveries duration of birth was significantly longer in vHR (557 min) as in vLR (414 min, p < 0.001). Manual assistance to deliver the arms ('Louwen maneuver') positively correlated with birth weight (r2 = 0.215; p = 0.005) and the BW/CVO ratio (r2 = 0.0147; p = 0.02). (4) Conclusions: A high fetal birth weight combined with a tiny CVO predicts higher cesarean section probability, longer birth duration and the necessity to perform arm delivery assistance. Birth weight and pelvic measurements should be topics of great importance in patients counselling.

Neonicotinoids: A critical assessment of the global research landscape of the most extensively used insecticide.

The broad-spectrum insecticides in the neonicotinoid group are the most widely used worldwide because of their widely recognized advantages in the mode of action. Therefore, their use is growing on a large scale and, moreover, is often used preventively without considering the ecological impact. Studies demonstrated harmful effects on non-target organisms, which in turn negatively impact biodiversity and thus food production. The dramatic decline of honey bee colonies, for example, could be linked to the use of neonicotinoids. Ecologically sustainable solutions to this conflict must be focused by scientific research. The question arose whether the global research efforts meet these requirements on a global scale. Therefore, this review article aimed to analyze the global research landscape on neonicotinoids under ecological, economic, and temporal aspects. To this end, key players and incentives for investigations in this research field are identified. The increase in publications over time is significant and shows a dynamic citation pattern. It indicates a comparatively high interest in current research, with ecological issues becoming more and more the focus of international research. It has been shown that national publication performance and funding are in line with global market interests, with the most publishing country being China. In addition, the elevated status quo of the scientific infrastructure in high-economy countries and their willingness to support research can be linked to national research output. Lower economies are sparsely involved in published studies. The research performance accumulates with a high North-South divide. Therefore, future research projects must have a sustainable focus and take regional requirements worldwide into account. This requires greater involvement of developing countries as the most economically dependent regions with enormously increasing consumption rates. Solutions must be found to ensure sustainable food production against a backdrop of already declining biodiversity due to the large-scale use of neonicotinoids.

Does health-related poverty publication landscape reflect global needs in the light of the current poverty rebound?

BACKGROUND: After nearly a quarter-century of declining poverty, the numbers are rising again significantly. This is due not only to effects of climate change but also to the COVID-19 pandemics and armed conflict. Combined with the enormous health impacts, that will cause misery and health care costs worldwide. Therefore, this study provides background information on the global research landscape on poverty and health to help researchers, stakeholders, and policymakers determine the best way to address this threat. RESULTS: The USA is the key player, dealing mainly with domestic issues. European countries are also involved but tend to be more internationally oriented. Developing countries are underrepresented, with Nigeria standing out. A positive correlation was found between publication numbers and economic strength, while the relationship between article numbers and multidimensional poverty was negatively correlated. CONCLUSIONS: These findings highlight the need for advanced networking and the benefits of cross-disciplinary research to mitigate the coming impacts.

A RULA-Based Comparison of the Ergonomic Risk of Typical Working Procedures for Dentists and Dental Assistants of General Dentistry, Endodontology, Oral and Maxillofacial Surgery, and Orthodontics.

BACKGROUND: In general, the prevalence of work-related musculoskeletal disorders (WMSD) in dentistry is high, and dental assistants (DA) are even more affected than dentists (D). Furthermore, differentiations between the fields of dental specialization (e.g., general dentistry, endodontology, oral and maxillofacial surgery, or orthodontics) are rare. Therefore, this study aims to investigate the ergonomic risk of the aforementioned four fields of dental specialization for D and DA on the one hand, and to compare the ergonomic risk of D and DA within each individual field of dental specialization. METHODS: In total, 60 dentists (33 male/27 female) and 60 dental assistants (11 male/49 female) volunteered in this study. The sample was composed of 15 dentists and 15 dental assistants from each of the dental field, in order to represent the fields of dental specialization. In a laboratory setting, all tasks were recorded using an inertial motion capture system. The kinematic data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). RESULTS: The results revealed significantly reduced ergonomic risks in endodontology and orthodontics compared to oral and maxillofacial surgery and general dentistry in DAs, while orthodontics showed a significantly reduced ergonomic risk compared to general dentistry in Ds. Further differences between the fields of dental specialization were found in the right wrist, right lower arm, and left lower arm in DAs and in the neck, right wrist, right lower arm, and left wrist in Ds. The differences between Ds and DAs within a specialist discipline were rather small. DISCUSSION: Independent of whether one works as a D or DA, the percentage of time spent working in higher risk scores is reduced in endodontologists, and especially in orthodontics, compared to general dentists or oral and maxillofacial surgeons. In order to counteract the development of WMSD, early intervention should be made. Consequently, ergonomic training or strength training is recommended.

Global cervical cancer research: A scientometric density equalizing mapping and socioeconomic analysis.

Cervical cancer has caused substantial morbidity and mortality for millions of women over the past decades. While enormous progress has been made in diagnosis, prevention and therapy, the disease is still fatal for many women-especially in low-income countries. Since no detailed studies are available on the worldwide research landscape, we here investigated the global scientific output related to this cancer type by an established protocol. The "New Quality and Quantity Indices in Science" platform assessed all relevant cervical cancer research published in the Web of Science since 1900. A detailed analysis was conducted including country-specific research productivity, indicators for scientific quality, and relation of research activity to socioeconomic and epidemiologic figures. Visualization of data was generated by the use of density equalizing map projections. Our approach identified 22,185 articles specifically related to cervical cancer. From a global viewpoint, the United States of America was the dominating country in absolute numbers, being followed by China and Japan. By contrast, the European countries Sweden, Austria, and Norway were positioned first when the research activity was related to the population number. When the scientific productivity was related to annual cervical cancer cases, Scandinavian countries (Finland #1, Sweden #4, Norway #5, Denmark #7), the Alpine countries Austria (#2) and Switzerland (#6), and the Netherlands (#3) were leading the field. Density equalizing mapping visualized that large parts of Africa and South America were almost invisible regarding the global participation in cervical cancer research. Our data documented that worldwide cervical cancer research activity is continuously increasing but is imbalanced from a global viewpoint. Also, the study indicated that global and public health aspects should be strengthened in cervical carcinoma research in order to empower more countries to take part in international research activities.