Ansell (Australia)

Healthcare systems often delegate surgical consent-seeking to members of the treating team other than the surgeon (e.g., junior doctors in the UK and Australia). Yet, little is known about public attitudes toward this practice compared to emerging AI-supported options. This first large-scale empirical study examines how laypeople evaluate the validity and liability risks of using an AI-supported surgical consent system (Consent-GPT). We randomly assigned 376 UK participants (demographically representative for age, ethnicity, and gender) to evaluate identical transcripts of surgical consent interviews framed as being conducted by either Consent-GPT, a junior doctor, or the treating surgeon. Participants broadly agreed that AI-supported consent was valid (87.6% agreement), but rated it significantly lower than consent sought solely by human clinicians (treating surgeon: 97.6% agreement; junior doctor: 96.2%). Participants expressed substantially lower satisfaction with AI-supported consent compared to human-only processes (Consent-GPT: 59.5% satisfied; treating surgeon 96.8%; junior doctor: 93.1%), despite identical consent interactions (i.e., the same informational content and display format). Regarding justification to sue the hospital following a complication, participants were slightly more inclined to support legal action in response to AI-supported consent than human-only consent. However, the strongest predictor was proper risk disclosure, not the consent-seeking agent. As AI integration in healthcare accelerates, these results highlight critical considerations for implementation strategies, suggesting that a hybrid approach to consent delegation that leverages AI’s information sharing capabilities while preserving meaningful human engagement may be more acceptable to patients than an otherwise identical process with relatively less human-to-human interaction.

Introduction and Objective: The rising prevalence of obesity and metabolic disorders, such as type 2 diabetes, highlights the need for effective dietary strategies to improve health outcomes. The Mediterranean diet has been well studied and shown to reduce chronic disease risk through its beneficial effects on body composition and glucose metabolism. The Australian Guide to Healthy Eating (AGHE) was intended to offer a balanced dietary framework, yet its comparative efficacy with the Mediterranean diet remains unexplored. Thus, this study aims to compare the efficacy of the Mediterranean diet with AGHE on body composition and glucose metabolism. Methods: We conducted a randomised controlled trial including 57 participants (median age 31, IQR: 25-37 years; 71.9% female, BMI = 25.1 kg/m2), with 23 participants randomised to the Mediterranean diet and 34 participants to the AGHE diet for eight weeks. Anthropometric measurements, estimated metabolic rate (indirect calorimetry) and body composition (Dual-Energy X-ray Absorptiometry, DEXA) were assessed. Fasting serum samples were collected to measure glucose and insulin concentrations. Paired t-tests were employed for within-group comparisons, and analysis of covariance (ANOVA) was used for between-group comparisons, adjusted for age and baseline values. Results: The Mediterranean diet intervention resulted in a significant decrease in waist circumference (-1.3 cm, p = 0.043), body fat percentage (-1.8%, p = 0.014), resting metabolic rate (RMR) (-17.9 kcal/day, p = 0.02), and fasting insulin concentration (-1.2 μIU/mL, p = 0.016), along with an increase in body lean mass percentage (1.7%, p = 0.015) compared to AGHE group. Conclusion: The Mediterranean diet demonstrated greater efficacy in improving body composition and maintaining metabolic variables compared to the AGHE. These findings may support the use of the Mediterranean diet in improving health outcomes related to obesity and metabolic disorders. Disclosure R.H. Kabthymer: None. B. de Courten: None. J. Danaher: None.

Abstract This article highlights the regular soldier’s place in political rhetoric that urged the Habsburg Monarchy’s inhabitants to view support for the war against Revolutionary and Imperial France as a moral imperative. It establishes how military honour as a system of sociality and social disciplining, founded on contemporary ideals of virtue and natural law, promoted acts of selfless citizenship within a newly formed standing army that supported Habsburg state-building in the late eighteenth and early nineteenth centuries. The article then shows how regular soldiers of the Monarchy’s army were continually represented by the government and its supporters as selfless servants of the state, eliciting acts of loyalty in different places from those untouched by mandatory wartime demands. Particular attention is paid to the ways in which the educated middle class (Bürgertum) contributed to the Habsburg war effort through decades of localized wartime philanthropy. This article argues these people were motivated to do so through social and cultural changes that made self-identifying with the conscripted poor possible. By participating in civic society in this way, a generally progressive prewar segment of the population actively placed their view of the world within the constraints of the reactionary wartime Habsburg state by meeting military exigencies.

Abstract A number of seventeenth-century books-almost exclusively Restoration playbooks-bear the ownership inscription ‘Ed: Agberowe’ on their title pages (and often a second signature on a subsequent page). This article provides an overview of the books known to have been in Agberowe’s collection and supplies a brief biographical sketch, revealing some impressive literary connections to Butler, Milton, and Marvell. Recovery of Agberowe’s life and library has intrinsic interest in terms of his colourful biography and his literary tastes, which, it is suggested, may have developed in relation to his employment throughout the 1660s and via the family of his wife, Theophila Cornewall. Perhaps more significant, though, is that the recovery of Agberowe’s story provides a new example of a seventeenth-century book-collector who seems to have been interested primarily in acquiring playbooks.

Cyberbullying is associated with various mental health concerns in adolescents, including body dissatisfaction and disordered eating behaviours. However, there is a significant research gap concerning the unique effects of appearance-related cyberbullying (ARC) on adolescent mental health. This study examined the prevalence and psychological consequences of ARC among middle to late adolescent females (aged 14–19 years, Mage = 15.98, N = 336). Participants completed an online survey regarding their experiences of ARC, body image variables, and eating disorder symptomology. Findings indicate the widespread occurrence of ARC among adolescent females, with body shape and size emerging as predominant targets. Experiences of ARC-victimisation positively correlated with increased concerns about body shape, body shame, and eating disorder symptomology. Conversely, experiences of ARC-victimisation were negatively correlated with body esteem and body appreciation. Finally, appearance-related cybervictimisation was significantly associated with adolescent females’ desire to pursue appearance alterations through methods such as dieting and exercising, altering self-presentation, and undergoing cosmetic procedures due to perceived experiences of ARC. These findings highlight the urgent need for preventative measures, such as age-appropriate social media policies and health promotion programs that encourage positive online behaviour, and strategies to address the impacts of ARC to protect the mental well-being of adolescent females.

Introduction: Endovascular thrombectomy (EVT) reduces disability in patients with large ischemic core stroke. Increasing core volume is prognostic but does not modify treatment effect. CT hypodensity can vary within an area of core. We assessed the relationship between the severity of CT core hypodensity and clinical outcome in the SELECT2 trial. Methods: Non-contrast CT ischemic core was drawn manually by two blinded investigators with consensus review by a third investigator. An absolute Hounsfield unit (HU) threshold for severe hypodensity was set at the lower 99% confidence interval [CI] for normal contralateral thalamic grey matter. Outcomes assessed included ordinal mRS, functional independence (mRS 0-2), independent ambulation (mRS 0-3), and mortality at 90 days. The association between the volume of severe hypodensity and outcome was adjusted for age, baseline NIHSS, and total baseline core volume, via logistic and proportional odds models with treatment*hypodensity interaction. Results: Of 317 assessable patients, the median hypodensity of ischemic core was 31HU (IQR 28-33). Median density of normal thalamus was 38HU. The severe hypodensity threshold (lower 99% CI) was 26HU with median volume affected 14mL (IQR 5.6-29.2) or median 19% (IQR 9-35%) of the total hypodensity volume. The volume of core ≤26HU (per 1 mL increase) was associated with a 90-day mRS shift towards worse outcomes in EVT patients (n=161, adjusted common odds ratio, acOR 1.03, 95%CI 1.01-1.05) but not medical management ([MM], n=156, acOR 1.00, 95%CI 0.98-1.02, p-interaction 0.005); lower functional independence in EVT (aOR 0.96 95%CI 0.93-0.99) but not MM (aOR 1.02, 95%CI 0.99-1.06, p-interaction 0.004); lower independent ambulation in EVT (aOR 0.97, 95%CI 0.94-0.99) but not MM (aOR 1.01, 95%CI 0.98-1.04, p-interaction 0.002) and higher mortality in EVT (aOR 1.03, 95%CI 1.01-1.05) but not MM (aOR 1.00, 95%CI 0.98-1.02, p-interaction 0.02). Conclusion: In patients with large ischemic core, areas of significant CT hypodensity are associated with worse clinical outcomes after EVT but not MM. This is independent of total core volume and modifies the treatment effect of EVT. This may improve prognostic decision-making and drive developments in automated image processing.

Introduction: Seizures are a common initial manifestation of cerebral venous thrombosis (CVT). We sought to establish predictive factors for delayed seizures to stratify risk and guide clinical management. Methods: We analyzed data from the Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT) study of consecutive patients with CVT from 2015 - 2020. The primary outcome was delayed seizure(s), occurring after 7 days from CVT diagnosis. Patients with outcome data for late seizures and follow-up of at least 7 days from time of diagnosis were included. Univariate analysis was performed using Chi-square, rank-sum, and t-tests. Variables with P-value < 0.2 were included in the backward stepwise regression model with 0.2 as cutoff, based on which we constructed the Delayed Seizure CVT (Delayed Seizures after CVT) score. Results: We identified 599 patients who met inclusion criteria: mean age 44.9(± 16.6) years, 62.9% female. Delayed seizures occurred in 37 (6.1%) patients. Risk factors included intracranial hemorrhage (OR 2.0 95% CI 0.7-5.74 p=0.196), alcohol abuse (OR 3.88 95% CI 1.45-10.38 p=0.007), focal neurologic deficit (OR 2.05 95% CI 0.95-4.44 p=0.067), seizure on presentation (OR 2.88 95% CI 1.32-6.29 p=0.008), hormonal birth control (OR 2.38 95% CI 1.06-5.37 p=0.0036), endovascular therapy (OR 2.86 95% CI 1.16-7.07 p=0.023) and decompressive hemicraniectomy (OR 3.357 95% CI 1.02-10.99 p=0.046), respectively. Based on coefficients of these variables, a 7-item score was created with acceptable performance for seizure prediction (AUC 0.796, 95% CI 0.72 - 0.86) (Table 1). Conclusions: Delayed seizure CVT score is a clinical tool to identify risk of delayed seizure in CVT. Further research is needed to validate these findings in an external cohort.