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Evidence suggests the crucial role of dysfunctional default mode (DMN), salience and frontoparietal (FPN) networks, collectively termed the triple network model, in the pathophysiology of treatment-resistant depression (TRD).
Aims
Using the graph theory- and seed-based functional connectivity analyses, we attempted to elucidate the role of low-dose ketamine in the triple networks, namely the DMN, salience and FPN.
Method
Resting-state functional connectivity magnetic resonance imaging (rs–fcMRI) data derived from two previous clinical trials of a single, low-dose ketamine infusion were analysed. In clinical trial 1 (Trial 1), patients with TRD were randomised to either a ketamine or normal saline group, while in clinical trial 2 (Trial 2) those patients with TRD and pronounced suicidal symptoms received a single infusion of either 0.05 mg/kg ketamine or 0.045 mg/kg midazolam. All participants underwent rs–fcMRI pre and post infusion at Day 3. Both graph theory- and seed-based functional connectivity analyses were performed independently.
Results
Trial 1 demonstrated significant group-by-time effects on the degree centrality and cluster coefficient in the right posterior cingulate cortex (PCC) cortex ventral 23a and b (DMN) and the cluster coefficient in the right supramarginal gyrus perisylvian language (salience). Trial 2 found a significant group-by-time effect on the characteristic path length in the left PCC 7Am (DMN). In addition, both ketamine and normal saline infusions exerted a time effect on the cluster coefficient in the right dorsolateral prefrontal cortex a9-46v (FPN) in Trial 1.
Conclusions
These findings may support the utility of the triple-network model in elucidating ketamine’s antidepressant effect. Alterations in DMN, salience and FPN function may underlie this effect.
This study elucidated the impacts of coenzyme Q10 (COQ10) supplementation in a high-fat diet (HFD) on growth, lipid metabolism and mitochondrial function in spotted seabass (Lateolabrax maculatus). Totally five diets were formulated: a diet with normal fat content (11 % lipid, NFD), a HFD (17 % lipid) and three additional diets by supplementing 5, 20 or 80 mg/kg of COQ10 to the HFD. After an 8-week culture period, samples were collected and analysed. The results demonstrated that COQ10 inclusion prevented the HFD-induced deterioration of growth performance and feed utilisation. COQ10 alleviated the deposition of saturated fatty acids following HFD intake and promoted the assimilation of n-3 and n-6 PUFA. Moreover, COQ10 administration inhibited the surge in serum transaminase activity and reduced hepatic lipid content following HFD ingestion, which was consistent with the results of oil red O staining. In addition, HFD feeding led to reduced hepatic citrate synthase and succinate dehydrogenase activities and decreased ATP content. Notably, COQ10 administration improved these indices and up-regulated the expression of mitochondrial biogenesis-related genes (pgc-1α, pgc-1β, nrf-1, tfam) and autophagy-related genes (pink1, mul1, atg5). In summary, supplementing 20–80 mg/kg of COQ10 in the HFD promoted growth performance, alleviated hepatic fat accumulation and enhanced liver mitochondrial function in spotted seabass.
This study investigates the effects of fat emulsion-based early parenteral nutrition in patients following hemihepatectomy, addressing a critical gap in clinical knowledge regarding parenteral nutrition after hemihepatectomy. We retrospectively analysed clinical data from 274 patients who received non-fat emulsion-based parenteral nutrition (non-fatty nutrition group) and 297 patients who received fat emulsion-based parenteral nutrition (fatty nutrition group) after hemihepatectomy. Fat emulsion-based early parenteral nutrition significantly reduced levels of post-operative aspartate aminotransferase, total bilirubin and direct bilirubin, while minor decreases in red blood cell and platelet counts were observed in the fatty nutrition group. Importantly, fat emulsion-based early parenteral nutrition shortened lengths of post-operative hospital stay and fasting duration, but did not affect the incidence of short-term post-operative complications. Subgroup analyses revealed that the supplement of n-3 fish oil emulsions was significantly associated with a reduced inflammatory response and risk of post-operative infections. These findings indicate that fat emulsion-based early parenteral nutrition enhances short-term post-operative recovery in patients undergoing hemihepatectomy.
The aerodynamic deformation and breakup of wall-attached droplets in axisymmetric stagnation flow are investigated experimentally. A vertical shock tube is used to generate the shock wave accompanying the post-wave airflow, and the axisymmetric stagnation flow is formed through the impingement of an air stream on a solid wall. For the wall-attached droplets with initially hemispherical profile, four typical droplet deformation and breakup modes can be identified with the continuous increase of the droplet local Weber number, which are the vibrating mode, the compressing mode, the sheet thinning mode and the shear-induced entrainment mode. Quantitative analyses of droplet evolution dynamics are also conducted for the compressing mode and the sheet thinning mode, and the significant differences of air flow separation at the droplet lateral surface between these two modes are revealed. The potential flow model and the energy conservation model are further developed to predict the entire droplet deformation processes. The vibrating frequency and amplitude of droplets under the vibrating mode are predicted by a spring-mass model, and the surface perturbation wavelengths of droplets under the shear-induced entrainment mode are estimated based on the dispersion relation of Kelvin–Helmholtz instability. This work is proposed to give potential guidance for regulating the aerodynamic fragmentation of wall-attached droplets in practical engineering applications.
Based on a 4f system, a 0° reflector and a single laser diode side-pump amplifier, a new amplifier is designed to compensate the spherical aberration of the amplified laser generated by a single laser diode side-pump amplifier and enhance the power of the amplified laser. Furthermore, the role of the 4f system in the passive spherical aberration compensation and its effect on the amplified laser are discussed in detail. The results indicate that the amplification efficiency is enhanced by incorporating a 4f system in a double-pass amplifier and placing a 0° reflector only at the focal point of the single-pass amplified laser. This method also effectively uses the heat from the gain medium (neodymium-doped yttrium aluminium garnet) of the amplifier to compensate the spherical aberration of the amplified laser.
We have developed an interactive system comprising a soft wearable robot hand and a wireless task board, facilitating the interaction between the hand and regular daily objects for task-oriented training in stroke rehabilitation. A ring-reinforced soft actuator (RSA) to accommodate different hand sizes and enable flexion and extension movements was introduced in this paper. Individually controlled finger actuators assist stroke patients during various grasping tasks. A wireless task board was developed to support the training, allowing for the placement of training objects and seamless interaction with the soft robotic hand. Evaluation with seven stroke subjects shows significant improvements in upper limb functions (FMA), hand-motor abilities (ARAT, BBT), and maximum grip strengths after 20 sessions of this task-oriented training. These improvements were observed to persist for at least 3 months post-training. The results demonstrate its potential to enhance stroke rehabilitation and promote hand-motor recovery. This lightweight, user-friendly interactive system facilitates frequent hand practice and easily integrates into regular rehabilitation therapy routines.
Supporting family caregivers (FCs) is a critical core function of palliative care. Brief, reliable tools suitable for busy clinical work in Taiwan are needed to assess bereavement risk factors accurately. The aim is to develop and evaluate a brief bereavement scale completed by FCs and applicable to medical staff.
Methods
This study adopted convenience sampling. Participants were approached through an intentional sampling of patients’ FCs at 1 palliative care center in Taiwan. This cross-sectional study referred to 4 theories to generate the initial version of the Hospice Foundation of Taiwan Bereavement Assessment Scale (HFT-BAS). A 9-item questionnaire was initially developed by 12 palliative care experts through Delphi and verified by content validity. A combination of exploratory factor analysis (EFA), reliability measures including items analysis, Cronbach’s alpha and inter-subscale correlations, and confirmatory factor analysis (CFA) was employed to test its psychometric properties.
Results
Two hundred seventy-eight participants conducted the questionnaire. Three dimensions were subsequently extracted by EFA: “Intimate relationship,” “Existential meaning,” and “Disorganization.” The Cronbach’s alpha of the HFT-BAS scale was 0.70, while the 3 dimensions were all significantly correlated with total scores. CFA was the measurement model: chi-squared/degrees of freedom ratio = 1.9, Goodness of Fit Index = 0.93, Comparative Fit Index = 0.92, root mean square error of approximation = 0.08. CFA confirmed the scale’s construct validity with a good model fit.
Significance of results
This study developed an HFT-BAS and assessed its psychometric properties. The scale can evaluate the bereavement risk factors of FCs in clinical palliative care.
This study aims to investigate the effects of the vine of Lonicera japonica Thunb (VLT) and marine-derived Bacillus amyloliquefaciens-9 (BA-9) supplementation on the growth performance, antioxidant capacity, and gut microbiota of goat kids. A total of 32 4-week-old kids were randomly assigned into four groups: a control group (CON), a group supplemented with 0.3% BA-9 (BA-9), a group supplemented with 2% VLT (VLT), and a group supplemented with both 0.3% BA-9 and 2% VLT (MIX). The results indicated that VLT supplementation significantly increased both average daily (P < 0.001) and total weight gain (TWG) (P < 0.001), while BA-9 alone had no significant effect (P > 0.05) on the average daily and TWG. Biomarker analysis of oxidative stress revealed that supplementation of VLT or BA-9 alone enhanced antioxidant capacity. The MIX group showing a higher total antioxidant capacity (T-AOC) compared with the CON, VLT, and BA-9 groups (P < 0.05). Plasma albumin (ALB) levels were significantly increased in the both VLT and BA-9 groups. Microbiota analysis revealed significant differences in α-diversity and β-diversity between the MIX and CON groups, with specific genera such as Prevotellaceae_UCG.004 and Rikenellaceae_RC9_gut_group negatively correlated with average daily gain (ADG), while Alistipes was positively correlated with T-AOC. These findings suggest that the combined supplementation of VLT and BA-9 can significantly enhance growth performance and antioxidant capacity in goat kids by modulating the composition of gut microbiota and reducing oxidative stress.
Anomalous left coronary artery from the pulmonary artery is a rare CHD. It is the most common type of anomalous coronary origin. It may cause myocardial ischaemia or infarction, mitral regurgitation, congestive heart failure, and early death in infancy if left untreated. Surgery is the only treatment for anomalous left coronary artery from the pulmonary artery. In recent years, with advancements in surgical techniques and the widespread utilisation of extracorporeal cardiac assist devices such as extracorporeal membrane oxygenation, the treatment outcomes for anomalous left coronary artery from the pulmonary artery have demonstrated significant improvements. However, the surgical indications and methods of anomalous left coronary artery from the pulmonary artery, especially the surgical methods of anomalous left coronary artery from the pulmonary artery with intramural coronary artery, and whether to treat mitral regurgitation at the same time are still controversial. The long-term complications and prognosis remain discouraging simultaneously, with significant variations in outcomes across different centres. The present review specifically addresses these aforementioned concerns. Based on the literature published at home and abroad, we found that no matter what type of anomalous left coronary artery from the pulmonary artery patients, even asymptomatic patients, regardless of the collateral circulation between the left and right coronary arteries, should immediately undergo surgical treatment to promote the recovery of left ventricular function. Based on different coronary artery anatomical morphology and preoperative cardiac function, the long-term follow-up results of individualised surgical treatment of anomalous left coronary artery from the pulmonary artery children show good prognosis, and most children have significant improvement in cardiac function. Patients with moderate to severe mitral regurgitation should undergo mitral valve operation at the same time as anomalous left coronary artery from the pulmonary artery repair. Mitral valvuloplasty can quickly improve mitral regurgitation and promote the early recovery of cardiac function after operation, and does not increase the risk of operation. Mechanical circulatory support is a safe and effective means of early postoperative transition for children with severe anomalous left coronary artery from the pulmonary artery. Anomalous left coronary artery from the pulmonary artery with intramural coronary artery is a rare anomaly. According to different anatomical types, different surgical methods can be used for anatomical correction, and satisfactory early and mid-term results can be obtained.
Pulmonary valve replacement and right ventricular outflow tract reconstruction with valved conduits have been the shortcomings of paediatric cardiac surgeons in the treatment of CHD. In recent decades, encouraging achievements have been made in right ventricular outflow tract technology. Since Klinner reported the first right ventricle-to-pulmonary artery connection using unvalved conduits made of autologous pericardium in 1964, various right ventricle-to-pulmonary artery conduits have gradually been used in the treatment of various complex CHD. Compared with other materials, valved homograft conduit (VHC) is more consistent with physiological characteristics, better haemodynamics, easy suture and good haemostasis, anti-calcification, anti-infection, and without the need for lifelong anticoagulation, which makes VHC the best material for reconstruction of right ventricular outflow tract. However, due to the shortage of donor sources, other alternative conduits such as polytetrafuoroethylene valved conduits have been developed, and the results are not inferior to VHC in clinical application. The emerging tissue engineering technology is expected to utilise recipient-derived endothelial cells for implantation onto the decellularized VHC or degradable synthetic materials in order to construct a recipient-specific tissue-engineered valved conduit. This advancement holds great potential as an ideal biological transplant material and valve replacement for CHD. It will completely solve the problems of immune rejection and the growth of the conduit that cannot adapt to the physical growth of children. This review provides a comprehensive review of the clinical indications for right ventricle-to-pulmonary artery conduits application, optimal timing for surgery, current practices in utilising various types of external conduits, and considerations for re-replacement.
In confined multi-obstacle environments, generating feasible paths for continuum robots is challenging due to the need to avoid obstacles while considering the kinematic limitations of the robot. This paper deals with the path-planning algorithm for continuum robots in confined multi-obstacle environments to prevent their over-deformation. By modifying the tree expansion process of the Rapidly-exploring Random Tree Star (RRT*) algorithm, a path-planning algorithm called the continuum-RRT* algorithm herein is proposed to achieve fewer iterations and faster convergence as well as generating desired paths that adhere to the kinematic limitations of the continuum robots. Then path planning and path tracking are implemented on a tendon-driven four-section continuum robot to validate the effectiveness of the path-planning algorithm. The path-planning results show that the path generated by the algorithm indeed has fewer transitions, and the path generated by the algorithm is closer to the optimal path that satisfies the kinematic limitations of the continuum robot. Furthermore, path-tracking experiments validate the successful navigation of the continuum robot along the algorithm-generated path, exhibiting an error range of 2.51%–3.91%. This attests to the effectiveness of the proposed algorithm in meeting the navigation requirements of continuum robots.
This study proposes a novel super-resolution (or SR) framework for generating high-resolution turbulent boundary layer (TBL) flow from low-resolution inputs. The framework combines a super-resolution generative adversarial neural network (SRGAN) with down-sampling modules (DMs), integrating the residual of the continuity equation into the loss function. The DMs selectively filter out components with excessive energy dissipation in low-resolution fields prior to the super-resolution process. The framework iteratively applies the SRGAN and DM procedure to fully capture the energy cascade of multi-scale flow structures, collectively termed the SRGAN-based energy cascade reconstruction framework (EC-SRGAN). Despite being trained solely on turbulent channel flow data (via ‘zero-shot transfer’), EC-SRGAN exhibits remarkable generalization in predicting TBL small-scale velocity fields, accurately reproducing wavenumber spectra compared to direct numerical simulation (DNS) results. Furthermore, a super-resolution core is trained at a specific super-resolution ratio. By leveraging this pretrained super-resolution core, EC-SRGAN efficiently reconstructs TBL fields at multiple super-resolution ratios from various levels of low-resolution inputs, showcasing strong flexibility. By learning turbulent scale invariance, EC-SRGAN demonstrates robustness across different TBL datasets. These results underscore the potential of EC-SRGAN for generating and predicting wall turbulence with high flexibility, offering promising applications in addressing diverse TBL-related challenges.
This paper proposes an air-filled substrate integrated waveguide (AFSIW) bandpass filter with a miniaturized non-resonant node (NRN). The NRN structure is introduced between the three resonators, and its size is smaller than the resonator size, which can realize the NRN structure’s miniaturization and reduce the model’s size. The NRN size of this filter is 41% of the NRN size of the existing AFSIW filter. This filter also introduces a transmission zero (TZ) above the passband. The measured results show that the filter’s center frequency is 20.73 GHz, and the bandwidth is 0.86 GHz. The insertion loss in the passband is 0.95 dB, and the return loss is better than 23 dB. Due to the TZ in the upper stopband, the AFSIW filter obtained good selectivity.
The clinical data of patients with total anomalous pulmonary venous connection who underwent repair in our centre in the past 13 years were reviewed. In this study, we systemically reviewed our experience in the optimal surgical strategy for patients with total anomalous pulmonary venous connection, aiming to provide evidence for clinical decision-making.
Methods:
From January 1, 2009, to December 31, 2021, 122 patients undergoing surgical treatment for total anomalous pulmonary venous connection in our hospital were enrolled. Among them, 18 patients with single ventricle repair were excluded from the study. Multivariate analysis was used to determine the risk factors for early and late death and the risk factors for pulmonary vein obstruction.
Results:
There were 64 males and 40 females. The median age at surgery was 107 days (range, 25 days–788 days), the median weight at surgery was 4.8 kg (range, 3 kg–22 kg), and the median follow-up was 59 months (range, 0–150 months). Seven patients died early after surgery and six died late after discharge. Multivariable analysis indicated that prolonged cardiopulmonary bypass time was the only independent risk factor for early postoperative mortality. Multivariate analysis did not identify risk factors for late death. Emergency surgery, preoperative moderate and severe pulmonary hypertension, and prolonged cardiopulmonary bypass time were independent risk factors for postoperative pulmonary vein obstruction.
Conclusion:
Early and long-term late outcomes of repair in patients with total anomalous pulmonary venous connection have been encouraging. Postoperative pulmonary vein obstruction remains a major problem for specialists worldwide. Pulmonary vein obstruction should be considered in children with preoperative emergency surgery, moderate to severe pulmonary hypertension and prolonged cardiopulmonary bypass time, and regular follow-up is necessary.
We report the unified constitutive law of vibroconvective turbulence in microgravity, i.e. $Nu \sim a^{-1} Re_{os}^\beta$ where the Nusselt number $Nu$ measures the global heat transport, $a$ is the dimensionless vibration amplitude, $Re_{os}$ is the oscillational Reynolds number and $\beta$ is the universal exponent. We find that the dynamics of boundary layers plays an essential role in vibroconvective heat transport and the $Nu$-scaling exponent $\beta$ is determined by the competition between the thermal boundary layer (TBL) and vibration-induced oscillating boundary layer (OBL). Then a physical model is proposed to explain the change of scaling exponent from $\beta =2$ in the TBL-dominant regime to $\beta = 4/3$ in the OBL-dominant regime. Our finding elucidates the emergence of universal constitutive laws in vibroconvective turbulence, and opens up a new avenue for generating a controllable effective heat transport under microgravity or even microfluidic environment in which the gravity effect is nearly absent.
The aims of this study were to evaluate the 16-year experience with arterial switch operation at Beijing Children’s Hospital and to determine early and late mortality and late morbidity, to explore risk factors for late complications and reintervention, and finally to evaluate whether the neoaortic sinotubular junction reconstruction technique reduces late complications of arterial switch operation.
Methods:
The clinical data of 185 patients with transposition of the great arteries who underwent arterial switch operation in Beijing Children’s Hospital from January 2006 to January 2022 and 30 patients who underwent modified arterial switch operation with neoaortic sinotubular junction reconstruction technique in Fuwai Hospital during the same period were retrospectively analysed. Propensity score matching was also used to match the neoaortic sinotubular junction reconstruction patients in Fuwai Hospital with 30 non-neoaortic sinotubular junction reconstruction patients in Beijing Children’s Hospital.
Results:
There were 13 early deaths (7.03%) and five late deaths (3.01%). Nineteen patients (11.45%) developed new aortic valve regurgitation and 28 patients (16.87%) developed aortic root dilation. Late right ventricular outflow tract obstruction occurred in 33 patients (19.88%). Late reintervention occurred in 18 cases (10.84%). Multivariate analysis showed that aorto-pulmonary diameter mismatch, previous pulmonary artery banding, and mild moderate or above new aortic valve regurgitation at discharge were independent risk factors for late new aortic valve regurgitation and aortic root dilation. Low surgical weight was an independent risk factor specific to new aortic valve regurgitation, and bicuspid native pulmonary valve was an independent risk factor specific to aortic root dilation. Older surgical age and aortic root dilation were independent risk factors for late right ventricular outflow tract obstruction. Older surgical age, operation before 2014, late right ventricular outflow tract obstruction, and late aortic root dilation were independent risk factors for late intervention. Propensity score matching showed that new aortic valve regurgitation and aortic root dilation were not followed up in the neoaortic sinotubular junction reconstruction group, while seven cases of aortic root dilation and five cases of new aortic valve regurgitation occurred in the non-neoaortic sinotubular junction reconstruction group, respectively, and the differences were statistically significant (P = 0.003; P = 0.015).
Conclusions:
The increased incidence of new aortic valve regurgitation, aortic root dilation, and right ventricular outflow tract obstruction as children age is a major concern outcome in the future and may mean more late reintervention. neoaortic sinotubular junction reconstruction technique may reduce the incidence of new aortic valve regurgitation and aortic root dilation, and improve the late prognosis of arterial switch operation. Careful follow-up of neo-aortic valve and root function is imperative, especially in patients with aorto-pulmonary diameter mismatch, previous pulmonary artery banding, mild new aortic valve regurgitation at discharge, low surgical weight, and bicuspid native pulmonary valve structures.
Hypertrophic cardiomyopathy is the second most common cardiomyopathy affecting children and adolescents and is the main cause of sudden death of young athletes. The natural prognosis of children with severe hypertrophic obstructive cardiomyopathy is not optimistic, and it is not uncommon for children with hypertrophic obstructive cardiomyopathy who do not respond to medication. Surgical treatment is often the only solution. Conventional surgical methods in the past include classic or modified extended Morrow operation, classic or modified Konno operation, and Ross-Konno operation. In recent years, with the development of minimally invasive surgery, various minimally invasive surgical methods have emerged endlessly. Because the incision of minimally invasive cardiac surgery is significantly smaller than that of traditional surgery, it causes less trauma, recovers quickly after surgery, and has the advantage of no difference in surgical effect compared with traditional median sternotomy. Tally endoscopic transmitral myectomy, RTM, minimally right thoracotomy, and other surgical methods have achieved encouraging results in adults and some older children with hypertrophic obstructive cardiomyopathy. The appearance of transapical beating-heart septectomy has brought the treatment of hypertrophic obstructive cardiomyopathy from the era of cardiopulmonary bypass and cardiac arrest to a new era of minimally invasive beating-heart surgery. In the past, there were few articles about the treatment of children with hypertrophic obstructive cardiomyopathy. This article reviewed the new progress and prognosis of surgical treatment of children with hypertrophic obstructive cardiomyopathy at home and abroad.
The clinical data of patients with subaortic stenosis who underwent surgical treatment in our centre in the past 12 years were reviewed. The short-term and long-term clinical outcomes were analyzed, and the long-term outcomes of different surgical methods for subaortic stenosis were compared to determine the optimal surgical treatment strategy for subaortic stenosis.
Methods:
From December 2010 to December 2022, 90 patients undergoing surgical treatment for subaortic stenosis in our hospital were enrolled. There were 55 males and 35 females with a median age of 72 (46,132) months and an average surgical weight of (21.35 ± 15.84) kg. According to the operation method, 90 patients were divided into group A (50 patients with simple subaortic membrane resection) and group B (40 patients with subaortic membrane and muscle resection or modified Konno procedure).
Results:
There were three early deaths (3.33%). One late death occurred in group B. There was no significant difference in long-term survival rate between the two groups (p = 0.904). The preoperative left ventricular outflow tract pressure gradient in group B was (91.56 ± 36.98) mm Hg, which was higher than that in group A(51.13 ± 36.04)mm Hg(p < 0.001). There was no significant difference in immediate postoperative left ventricular outflow tract pressure gradient between group B [(5.44 ± 8.43) mm Hg] and group A [(7.82 ± 13.44) mm Hg] (p = 0.343). In the long-term follow-up, left ventricular outflow tract pressure gradient in group B was (5.86 ± 9.53) mm Hg, which was not statistically significant compared with group A (8.83 ± 14.52) mm Hg (p = 0.294). Eleven patients with moderate or greater aortic regurgitation (group A/group B: 3/8) underwent simultaneous aortic valvuloplasty. In group B, moderate or greater aortic regurgitation was significantly improved immediately after operation (p = 0.013) and was not significantly aggravated in long-term follow-up (p = 0.083), and there was no significant improvement in group A after operation and long-term follow-up.
Conclusions:
According to the different anatomical lesions of left ventricular outflow tract, the individualised surgical treatment strategy for patients with subaortic stenosis can achieve good long-term outcomes. The long-term survival rate and freedom from reoperation due to late left ventricular outflow tract obstruction after simple subaortic membrane resection and extended left ventricular outflow tract resection are comparable. For patients with moderate or greater aortic regurgitation before extended left ventricular outflow tract resection, simultaneous aortic valvuloplasty is beneficial to improve postoperative aortic valve function.
Using a hand-collected sample of 18,269 equity analysts from 42 countries over the period of 2004 to 2019, we establish an intriguing negative association between a country’s institutional/economic development and its female share of equity analysts. We show that, in individualistic countries only, there is no gender gap in analyst forecast accuracy. We further show that female analysts are more skilled and more likely to drop out when underperforming in individualistic countries compared to peers in collectivistic countries. The evidence supports our hypothesis that the national cultural value of individualism encourages women to make career choices consistent with their general aversion to competition.