Rudolf Nissen published his first two cases in 1956, thus inaugurating the era of pathological gastroesophageal reflux surgery. From the 1970s onwards, with Nissen fundoplication increasingly used as the treatment of choice for gastroesophageal reflux and hiatal hernia, minor alterations were proposed. Nissen's greatest legacy: not just an operation, but a way of thinking about surgery as a restless, rigorous, and profoundly patient-centered procedure.
This study examines the economic cyclicality of wakame (Undaria pinnatifida) exports across six global markets from 2019 to 2024, testing its conformity to the lipstick effect phenomenon. Using monthly trade data from the World Bank, we analyze export pat-terns relative to GDP growth, unemployment, CPI, and per capita income through correlation analysis, recession period comparisons, and panel regression modeling. Results reveal signif-icant regional heterogeneity: Southeast Asia demonstrates weak counter-cyclical tendencies (12.3% export growth during recessions), while Western markets exhibit strong pro-cyclical patterns (21.5-46.7% declines). Regression analysis confirms GDP growth as the strongest positive predictor of exports ( = 1.82, p < 0.001). Crucially, wakame shows limited lipstick effect characteristics, with recession performance substantially differing from lipstick prod-ucts (+87.2% growth). We attribute cyclical variations to wakames dual role as cultural staple food in Asia versus luxury good in Western markets. These findings establish boundary con-ditions for lipstick effect applicability to agricultural commodities and provide region-specific strategies for export resilience.
Case summary:A 13-year-old castrated male domestic shorthair cat was diagnosed with diabetes mellitus based on hyperglycaemia, glucosuria and an elevated plasma fructosamine concentration. The diagnosis followed a 1-month history of lethargy and weight loss, along with a 1-week history of polyuria and polydipsia, which developed after the patient received a long-acting methylprednisolone injection from the referring veterinarian for pruritus. Treatment with velagliflozin was initiated, resulting in excellent glucose control, weight gain and resolution of clinical signs. However, the owner reported diarrhoea that did not improve with dietary modifications, symptomatic treatments or dose reduction of velagliflozin. Consequently, velagliflozin was discontinued after 64 days. Despite discontinuation, the cat remained euglycemic, with plasma fructosamine levels within the reference interval throughout a 175-day follow-up period. According to the Agreeing Language in Veterinary Endocrinology consensus definition, diabetes mellitus remission was confirmed. Relevance and novel information:This case report highlights that diabetic remission is achievable in cats treated with SGLT2 inhibitors, as described in human patients with type 2 diabetes mellitus.
