Explore the vast range of titles available.

The shift from traditional diets to a diet characterised by higher consumption of sugars, fats, processed foods and animal-source foods is often termed the nutrition transition. Although research has focused on the health outcomes of this transition, there is an increasing interest in environmental impacts. Here we investigated the potential changes in impacts driven by the nutrition transition in Brazil, China, India, Indonesia, Mexico, South Africa and Turkey between 2011 and 2030. We combined a multi-regional input–output database (EXIOBASE) with food demand projections (OECD-FAO Agricultural Outlook 2018). In a business-as-usual scenario, we assessed the impacts of the projected dietary changes on climate change, marine and freshwater eutrophication, land stress and water scarcity. Then, we built a second, zero-hunger scenario to investigate the impacts due to the eradication of hunger by 2030, a target of Sustainable Development Goal 2. The results show that total growth in environmental impacts through food consumption is the highest for Indonesia (44–54%), India (35–43%) and Mexico (31–48%). The total impacts stay highest in Brazil (land stress), China (eutrophication) and India (climate change and water scarcity), mainly driven by meat, fish and dairy consumption, respectively. The zero-hunger scenario results in similar health improvements across all countries: 0.08 to 0.12 prevented disability-adjusted life years (DALYs) per undernourished person. It would achieve the highest health improvements in India and China with around 375,000 human life equivalents of prevented DALYs combined. There are only slight trade-offs between hunger eradication and environmental goals.

IntroductionData from clinical trials suggest that CT-confirmed nondisplaced scaphoid waist fractures heal with less than the conventional 8–12 weeks of immobilization. Barriers to adopting shorter immobilization times in clinical practice may include a strong influence of fracture tenderness and radiographic appearance on decision-making. This study aimed to investigate (1) the degree to which surgeons use fracture tenderness and radiographic appearance of union, among other factors, to decide whether or not to recommend additional cast immobilization after 8 or 12 weeks of immobilization; (2) identify surgeon factors associated with the decision to continue cast immobilization after 8 or 12 weeks.Materials and methodsIn a survey-based study, 218 surgeons reviewed 16 patient scenarios of CT-confirmed nondisplaced waist fractures treated with cast immobilization for 8 or 12 weeks and recommended for or against additional cast immobilization. Clinical variables included patient sex, age, a description of radiographic fracture consolidation, fracture tenderness and duration of cast immobilization completed (8 versus 12 weeks). To assess the impact of clinical factors on recommendation to continue immobilization we calculated posterior probabilities and determined variable importance using a random forest algorithm. Multilevel logistic mixed regression analysis was used to identify surgeon characteristics associated with recommendation for additional cast immobilization.ResultsUnclear fracture healing on radiographs, fracture tenderness and 8 (versus 12) weeks of completed cast immobilization were the most important factors influencing surgeons’ decision to recommend continued cast immobilization. Women surgeons (OR 2.96; 95% CI 1.28–6.81, p  =  0.011), surgeons not specialized in orthopedic trauma, hand and wrist or shoulder and elbow surgery (categorized as ‘other’) (OR 2.64; 95% CI 1.31–5.33, p  =  0.007) and surgeons practicing in the United States (OR 6.53, 95% CI 2.18–19.52, p  =  0.01 versus Europe) were more likely to recommend continued immobilization.ConclusionAdoption of shorter immobilization times for CT-confirmed nondisplaced scaphoid waist fractures may be hindered by surgeon attention to fracture tenderness and radiographic appearance.

A potentially useful thermochemical cycle developed for the production of hydrogen and oxygen from water consists of three chemical reactions that take place in the temperature range from 400 ° to 1200 ° K. The oxidation and reduction of chromium compounds by barium hydroxide and the hydrolytic disproportionation of barium chromate(IV) and barium chromate(V), the reactions which constitute the proposed cycle, have been demonstrated.