bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep brain stimulation in pediatric populations: A scoping review of the clinical trial landscape
Authors: Jung Youngkyung , Mithani Karim , Suresh Hrishikesh , Warsi Nebras , Harmsen Irene E. , Breitbart Sara , Gorodetsky Carolina , Fasano Alfonso , Fallah Aria , Hadjinicolaou Aristides , Weil Alexander , Ibrahim George
Published: January 2025

Objective: There has been rapid advancement in the development of deep brain stimulation (DBS) as a treatment option for adults for neurological and neuropsychiatric conditions. Here, we present a scoping review of completed and ongoing clinical trials focused on DBS in pediatric populations, highlighting key knowledge gaps.

Methods: Three databases (PubMed, OVID, and Embase) and the clinicaltrials.gov registry were queried to identify clinical trials for DBS in pediatric cohorts (age < 18). Prospective and retrospective case series were excluded. No restrictions were placed on the diagnoses or measured clinical outcomes. Individual patient demographics, diagnosis, DBS target, and primary endpoints were extracted and summarized.

Results: A total of 13 clinical trials were included in the final review, consisting of 9 completed trials (357 screened) and 4 ongoing trials (82 screened). Of the completed trials, 6 studied dystonia (both inherited and acquired; participants aged 4-18), and 3 studied drug-resistant epilepsy (participants aged 4-17). Amongst the 6 trials for dystonia, 5 used the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) as the primary endpoint. There were a total of 18 adverse events documented across 63 participants, with 5 of 9 studies reporting adverse events. Ongoing clinical trials are evaluating DBS for dystonia (N=2), epilepsy (N=1), and self-injurious behaviour (N=1).

Conclusions: This scoping review summarizes the landscape of clinical trials for DBS in children and youth. In dystonia, further research is warranted with more relevant pediatric outcome measures and for understudied patient subgroups and targets. There are also significant gaps in our understanding of evaluate the role of DBS in other neurological and neurodevelopmental disorders in pediatric populations.
Heterochronic development of the perception of different types of visual illusions
Authors: Navarrete Vania , Montiel Valeria , Alarcon Miriam , Ulloa Rosa E. , Szenczi Péter , Rosetti Marcos , Bánszegi Oxána
Published: January 2025

Introduction: The underlying neural and/or perceptual mechanisms of different visual illusions are still unknown; thus, they continue to be the focus of many ongoing studies. Inconsistencies persist in the empirical findings for understanding how the perception of these illusions evolves over the course of development.
Methods: We assessed 513 participants between 6.5 and 18.9 years of age, with 103 pairs of illusory and control images spanning five illusion types (Ebbinghaus, Müller-Lyer, Contrast, Moving Snake, and Subjective Contour). Misleading and helpful contexts were added when possible.
Results: In general, we found that, except for the Ebbinghaus illusion susceptibility changes with age: while for the Müller-Lyer it decreases, for the Contrast, Moving Snake, and Kanizsa susceptibility increases. Across all illusory conditions participants' decision time decreased with age. Context also influenced the performance and choice latency. We also found a gender difference: boys were less susceptible than girls on contrast and moving snake illusions and were faster to answer on Müller-Lyer illusion trials.
Conclusion: The current study found that susceptibility to illusions change in a manner that is age and in some cases sex specific. The different developmental trajectories of the perception of visual illusions support the idea of the lack of a common neural and/or perceptual process behind them. We can suggest that at least some of the cognitive processes and neural pathways involved develop in heterochronically.
Use of Cobalt–Chromium 64 Wires Surpass Evolve for the Treatment of Remnant Intracranial Aneurysms: A Subanalysis From the SEASE International Registry
Authors: Dibas Mahmoud , Vivanco‐Suarez Juan , Lopes Demetrius Klee , Hanel Ricardo A. , Rodriguez‐Calienes Aaron , Cortez Gustavo M. , Fifi Johanna T. , Devarajan Alex , Toth Gabor , Patterson Thomas E. , Altschul David , Pereira Vitor M. , Liu Xiao Yu Eileen , Puri Ajit S. , Kühn Anna L. , Guerrero Waldo R. , Khandelwal Priyank , Bach Ivo , Kan Peter T. , Edhayan Gautam , Martinez‐Galdamez Mario , Given Curtis , Gross Bradley A. , Narayanan Sandra , Galecio‐Castillo Milagros , Derakhshani Shahram , Ortega‐Gutierrez Santiago
Published: January 2025

BACKGROUND

The use of the Surpass Evolve flow diverter for intracranial aneurysms (IAs) has shown promising results, but there are no studies that evaluated its effectiveness for remnant previously treated IAs. This study aimed to evaluate the safety and effectiveness of Surpass Evolve for previously treated IAs.

METHODS

This subanalysis is derived from the SEASE (Safety and Effectiveness Assessment of Surpass Evolve) registry, a retrospective, multicentric, international cohort conducted across 15 academic institutions in North America and Europe between July 2020 and October 2022. Adult patients undergoing Surpass Evolve implantation for single saccular IAs were grouped into those with previously treated IAs by coiling or intrasaccular‐devices and those with untreated IAs. Baseline characteristics and outcomes were compared.

RESULTS

This study included 257 patients with IAs. Of those, 66 patients had previously treated IAs (median time between diagnosis and initial treatment and retreatment: 6.28 months), and 191 patients had untreated IAs. Of the 246 patients with 10.5 months of imaging follow‐up, the core lab adjudicated complete occlusion was less in previously treated IAs compared with untreated IAs (59.7% versus 72.3%; adjusted odds ratio, 0.43 [95% CI, 0.21–0.88];
P
= 0.022). Furthermore, we found similar rates of adequate occlusion between previously treated IAs (83.9%) and untreated IAs (82.1%,
P
= 0.746). There was no difference in rates of major stroke (1.5% versus 2.6%,
P
>0.999), mortality (1.5% versus 1.0%,
P
>0.999), modified Rankin Scale score 0–2 (93.7% versus 95.7%,
P
= 0.504), and retreatment (1.6% versus 3.3%,
P
= 0.684) between the 2 groups.

CONCLUSION

Our results revealed reasonable rates of occlusion and an acceptable safety profile for the use of Surpass Evolve to treat previously treated IAs. Future prospective studies with longer follow‐ups are warranted to explore the findings further.
Influence of Comorbidity on Endovascular Thrombectomy Outcomes for Medium‐Vessel Occlusion Stroke: A Nationwide Prospective Observational Study
Authors: Hall Emma , Wassélius Johan , Pihlsgård Mats , Ullberg Teresa , Hansen Bjorn M.
Published: January 2025

BACKGROUND

Comorbidity burden may affect the outcome following endovascular thrombectomy (EVT) for medium‐vessel occlusions. Since patients with high comorbidity burden are likely to be underrepresented in trials on EVT for medium‐vessel occlusions, observational data are needed to assess the benefit of EVT for these patients.

METHODS

We conducted an observational study on all prestroke independent patients treated with EVT for medium‐vessel occlusions in the MCA territory in Sweden from 2015 to 2021. Comorbidity burden was weighted according to the Charlson Comorbidity Index (CCI) and categorized into no comorbidity (CCI 0); moderate to severe comorbidity (CCI 1–2); and very severe comorbidity (CCI ≥3). The primary outcome was a favorable outcome (modified Rankin Scale 0–2) at 90 days after EVT in relation to comorbidity burden. Excellent outcome (modified Rankin Scale 0–1) and symptomatic intracranial hemorrhage were secondary outcomes. In an exploratory analysis, we compared outcomes on the basis of successful recanalization (modified Thrombolysis in Cerebral Infarction 2b‐3).

RESULTS

Among 983 patients, 37% had no comorbidity (CCI 0), 35% had moderate to severe comorbidity burden (CCI 1–2), and 27% had a very severe comorbidity burden (CCI ≥3). Favorable and excellent outcomes were most frequent in the CCI 0 group (61% and 25%) and least frequent in the CCI ≥3 group (29% and 13%) (
P
 < 0.001), but there was no significant difference in symptomatic intracranial hemorrhage rates. Successful recanalization reduced the severity of stroke symptoms (National Institutes of Health Stroke Scale) and was associated with increased rates of favorable outcomes for all CCI groups: CCI 0: odds ratio, 4.25 (95% CI, 2.18–8.25); CCI 1 to 2: odds ratio, 3.39 (95% CI, 1.71–6.72); and CCI ≥3: odds ratio, 2.57 (95% CI, 1.14–6.00).

CONCLUSION

Moderate to very severe comorbidity burden is common among EVT‐treated patients with medium‐vessel occlusions in routine clinical practice and is associated with worse prognosis compared with patients with no comorbidity. Our results highlight the importance of achieving successful recanalization, which appears highly beneficial across all comorbidity levels.
Effects of strength and/or endurance training on cardiorespiratory characteristics in female horseback riders in the obstacle test track
Authors: Hyttinen A.-M. , Ahtiainen J.P. , Häkkinen K.
Published: January 2025

The purpose of this study was to investigate the effects of the 12-week volume-equated strength (S), endurance (E), and concurrent strength and endurance (SE) training on cardiorespiratory characteristics in the obstacle test track (OTT) in female horseback riders. Subjects (n = 52) (30.4 ± 8.9 years) were randomly assigned to S (n = 8), E (n = 8), SE (n = 9), and control (C) (n = 7) groups. Training consisted of progressive S, E, or SE training 3 ×/week and riding exercise 4-6×/week. The measurements included oxygen uptake (VO2), blood lactate (BLa), and heart rate (HR) in the OTT. The results showed that VO2ridingpeak decreased significantly () after the 12-week volume-equated training period in the E and SE groups. No significant changes were observed in S or C. BLa decreased significantly only in E (), and both E and SE groups rode OTT significantly faster () after the 12-week training intervention. There were no changes in the riding time in groups S or C. No significant differences occurred in HR levels between the subject groups after the 12-week volume-equated training. The present results indicate that the 12-week volume equated endurance and combined strength + endurance training together with the riding training significantly increased the economy and the riding speed during the OTT, although only 77% of the planned training was realised. However, the horseback riders of this study rode the OTT at an anaerobic level already after 30% of the used riding time still after the 12-week volume-equated training. It is important for riders to develop their physical performance to enable them to ride mainly at an aerobic level in all riding situations, including competition. Then the muscles and communication with a horse of the horseback rider can function optimally.
The Aristotelian Plato
Authors: Maggi Claudia
Published: January 2025

The purpose of this paper is to point out that some mathematical doctrines attributed by Aristotle to Plato find their origin in a threefold order of problems: first, in some allusions contained in the dialogues, which might create ambiguities within the so-called standard model of ideas; second, in the Aristotelian interpretation of ideal entities as universals or predicates, an interpretation in turn partly authorized by Plato himself; third, in the tendency not to emphasize the possibility of understanding participation and the whole-part relationship from a non-quantitative point of view. In this paper I will disregard the complex debate about whether or not to attribute the unwritten doctrines of the Aristotelian account to Plato, but I will appraise in what sense some Aristotelian objections to participation may arise from the fact of conceiving of numbers and magnitudes as ideas.
Good Will Hunting at the WTO
Authors: Panezi Maria
Published: January 2025

Using Polanyi’s double movement, this article applies it to the proliferation of plurilateral phenomena in trade governance. The article defines plurilaterals and examines four examples of plurilateralism in global trade governance: the Government Procurement Agreement; Joint Statement Initiatives; plurilateral dimensions of regionalism and free trade agreements; and plurilateral arrangements of hybrid nature outside the WTO. The article then proposes a theoretical framework that explains the mixed nature of plurilaterals as well as their proliferation, a pendulum that moves between two utopian concepts that are at the heart of global governance, namely sovereignty and multilateralism. In this context, the WTO oscillates between fragmentation and resilience. Using Polanyi’s double movement, strategic geoeconomics are seen as evolving as a reaction to either robust multilateralism or amplified unilateralism and protectionism.
Plurilateralism and the Future of International Investment Law
Authors: Meyer Timothy
Published: January 2025

Despite the absence of a multilateral investment agreement, states have negotiated a wide range of plurilateral investment agreements. Indeed, most of the interesting changes in investment law today are properly conceived of as plurilateral initiatives. These initiatives have made progress where multilateralism has stalled by doing two things. First, they have not tried to address the core of substantive investment law, focusing instead on procedural and ancilliary issues such as dispute resolution, transparency, and investment promotion. Second, they have been attached to institutions, such as the World Trade Organization and World Bank, that are not investment law institutions. This lack of institutional focus on investment law creates two benefits: a) it breaks difficult linkages between substantive investment law and procedural or ancillary issues, allowing progress to be made on the latter, while b) still embedding the resulting agreement in an institutional framework that promotes negotiation, effective implementation, and compliance.
Associations between structural brain changes and blood neurofilament light chain protein in treatment-resistant schizophrenia
Authors: Cilia Brandon-Joe , Eratne Dhamidhu , Wannan Cassandra , Malpas Charles , Janelidze Shorena , Hansson Oskar , Everall Ian , Bousman Chad , Thomas Naveen , Santillo Alexander F , Velakoulis Dennis , Pantelis Christos
Published: January 2025

Objective:

Around 30% of people with schizophrenia are refractory to antipsychotic treatment (treatment-resistant schizophrenia). Abnormal structural neuroimaging findings, in particular volume and thickness reductions, are often described in schizophrenia. Novel biomarkers of active brain pathology such as neurofilament light chain protein are now expected to improve current understanding of psychiatric disorders, including schizophrenia. This study explored whether treatment-resistant schizophrenia individuals exhibit different associations between plasma neurofilament light chain protein levels and regional cortical thickness reductions compared with controls.

Methods:

Plasma neurofilament light chain protein levels were measured, and T1-weighted magnetic resonance imaging sequences were obtained and processed via FreeSurfer for each participant. General linear models adjusting for age and body mass index were estimated to determine whether the interaction between diagnostic group and plasma neurofilament light chain protein level predicted lower cortical thickness across frontotemporal structures and the insula.

Results:

A total of 79 participants were included: 37 treatment-resistant schizophrenia and 42 healthy controls. Significant (false discovery rate-corrected) cortical thinning of the left ( p = 0.005, η2 p = 0.100) and right ( p = 0.002, η2 p = 0.149) insula, and left inferior temporal gyrus ( p < 0.001, η2 p = 0.143) was associated with higher levels of plasma neurofilament light chain protein in treatment-resistant schizophrenia, but not in healthy controls.

Conclusions:

The association between regional thickness reduction of the bilateral insula and left inferior temporal gyrus with plasma neurofilament light chain protein may reflect a neuroprogressive component to schizophrenia, which is not observed in the normal population.
Metabolic Profiling of Individuals with Missing Teeth and Tooth Loss
Authors: Halme A.M. , Salminen A. , Suominen A.L. , Havulinna A. , Mäntylä P. , Buhlin K. , Paju S. , Männistö S. , Salomaa V. , Sattler W. , Sinisalo J. , Pussinen P.J.
Published: January 2025

Missing teeth have been linked to incident cardiovascular disease, diabetes, and all-cause mortality. Our previous study revealed that signs of oral infections and inflammatory conditions (i.e., periodontal disease and dental caries) are associated with disadvantageous features of circulating metabolites. This study investigates whether missing teeth and tooth loss, the end points of these diseases, are associated with similar metabolic features. The 2 Finnish population-based studies Health-2000 ( n = 6,197) and FINRISK-97 ( n = 6,050) were included, as was Parogene ( n = 465), a cohort of patients with an indication for coronary angiography. The number of teeth was recorded in clinical examinations. Serum concentrations of 157 metabolites were determined by a nuclear magnetic resonance spectroscopy–based method. Health-2000 participants ( n = 3,371) provided follow-up serum samples, and 1,186 of them participated in a repeated oral examination 11 y after the baseline. Linear regression models adjusted for age, sex, smoking, body mass index, and diabetes were fitted to the number of teeth and metabolite measures. The results from the separate cohorts were combined in a fixed-effects meta-analysis. We also analyzed whether the number of teeth at baseline and tooth loss during follow-up were associated with changes in metabolite concentrations. Missing teeth were associated with increased very-low-density lipoprotein–related measures and triglyceride concentrations, as well as with decreased high-density lipoprotein parameters and small particle size. Missing teeth also had an association with low levels of unsaturated fatty acids (FAs), including omega-3 and omega-6 FAs, and elevated proportions of monounsaturated and saturated FAs. The number of teeth at baseline predicted changes in several concentrations, such as measures related to intermediate-density lipoprotein, low-density lipoprotein, and FAs, but no associations with tooth loss during the 11-y follow-up were observed. To conclude, missing teeth are associated with adverse metabolic features characterized by systemic inflammation and several risk factors for cardiometabolic diseases.
Which Values Distinguish Supporters of Radical Right Populist Parties From Their Rivals? Political Authoritarianism As a Key Ideological Feature
Authors: Azedi Arman
Published: January 2025

Studies have investigated many beliefs and values associated with voting for radical right populist (RRP) parties in Europe, but it remains unclear which values uniquely distinguish supporters of RRPs from supporters of other parties. This article analyzes the distribution of several values across the support bases of radical left, center-left, and center-right parties to assess how they compare to RRP parties, devoting particular attention to the role of political authoritarianism and anti-democratic views. Employing survey data from six western European countries ( n = 3554), the results suggest several values commonly thought to characterize radical right citizens, such as socially conservative beliefs, national pride, materialism, and social authoritarianism are not much more prevalent among RRP party supporters than supporters of moderate center-right parties. The findings instead point to the importance of political authoritarianism as a key feature distinguishing RRP supporters from supporters of other parties, along with anti-immigration and political grievances. Supporters of the radical left sharply diverge from supporters of RRP parties on nearly all issues, contradicting the notion that radicals on both sides of the spectrum share beliefs or worldviews.
Metaverse maelstrom: Dissecting information dynamics and polarisation
Authors: Xing Yunfei , Zhang Justin Zuopeng
Published: January 2025

The Metaverse represents a collaborative virtual realm blending physical and digital realities, fostering limitless avenues for online interaction, discovery and innovation. As technological strides propel immersive virtual worlds to the forefront of social media platforms, scholarly interest in the Metaverse surges, prompting extensive discourse. Drawing from social identity theory, this article introduces a novel framework for analysing online polarisation within discussions on the Metaverse, specifically on X (Twitter). Leveraging a multifaceted approach that integrates clustering, social network analysis, and text mining, our study delves into both group and opinion polarisation dynamics surrounding the Metaverse. Our findings uncover distinct community divisions and network structures, shedding light on prevalent themes, such as ‘Non-Fungible Token (NFTs)’, ‘Virtual Products and Collections’, ‘Blockchain Technology’, ‘Gaming’, and ‘Financial Markets’ that resonate within the public discourse.
Consciousness, will, and cultural revolution in Gramsci and Mao
Authors: Hoston Germaine A.
Published: January 2025

This article analyzes the remarkable congruence between the ideas of Antonio Gramsci and Mao Zedong regarding the role of consciousness, human will, and culture in socioeconomic change. These spiritual and humanistic concerns that are central to philosophical idealism were prominent in the young Marx’s writings, to which neither had access. Yet both theorists highlighted these elements as powerful, autonomous factors that can impede or accelerate socioeconomic change. It is argued that this congruence is best explained by the intersection of the Italian and Chinese philosophical traditions resulting from the impact of Neo-Confucianism on European idealist philosophy. While their work anticipated the cultural turn in leftist philosophy, it represents a nexus of Chinese and European humanistic and spiritual values that both challenges assumptions regarding the incommensurability of Eastern and Western philosophies and reaffirms the continued significance of these concerns for the continuing struggle between democratizing and authoritarian forces.
Financializing Shanghai: Entrepreneurial Urban Governance and the Changing Mechanisms of Urban Redevelopment under State-Led Financialized Urbanism
Authors: Xu Zhumin , Lin George C. S.
Published: January 2025

This article critically evaluates the practices of entrepreneurial urban governance in China’s urban redevelopment under state-led financialized urbanism. The research identifies a new trajectory of transition in urban governance from the growth machine mentality into a new fashion of debt machines. Urban redevelopment has enhanced land use efficiency, but equitable outcomes for various stakeholders remain elusive. A peculiar pattern of changes in urban governance is unveiled to show how a municipal government under a Party-state has manipulated financial instruments for revenue generation and political ambition. This study contributes insights into the diverse trajectories of changing urban governance in the era of financialization.
Research on electrolytic plasma polishing process for internal flow channel of superalloys alloy additive manufacturing parts
Authors: Yan Xiangtong , Han Yang , Wang Lei , Wang Bingren
Published: January 2025

To solve the problem of poor surface quality of internal channel parts in additive manufacturing, the internal electrode electrolyte plasma polishing technology was used to improve the surface quality of the workpiece. The influence of different process parameters on the surface roughness of the internal channel was studied by orthogonal test. The experimental results show that for small caliber channels, polishing is more suitable for low voltage conditions. Under the conditions of polishing voltage 40 V, electrolyte temperature 80°C, moving speed of cathode wire 3 mm/min, and peristaltic pump speed 100 rpm, the roughness of the GH3536 inner channel sample is reduced from 15.1 to 2.793 μm. The order of influence of each factor is as follows: firstly voltage, secondly electrolyte temperature, then cathode wire traveling speed, and finally peristaltic pump speed. The roughness of GH4169 was reduced from 6.724 to 0.47 μm by polishing experiment. The results of the internal surface performance test show that the spherical powder on the surface of the workpiece disappears after polishing through the internal flow channel, the electrolyte component residue is not detected on the surface of the internal flow channel, and the corrosion resistance is significantly improved.
Characterisation and evaluation of global uneven heating during railway tread braking – Brake rig testing and field study
Authors: Voortman Landström Eric , Vernersson Tore , Lundén Roger
Published: January 2025

In this paper, an effort has been made to characterise and evaluate the risks caused by global uneven heating, which can occur on tread braked railway wheels during prolonged braking. Brake rig experiments and a field study were performed on tread braked railway wheels exposed to brake power levels corresponding to down-hill braking. The brake rig testing was performed at the brake test rig at Chalmers University, with controlled testing at constant power levels of three different types of railway freight wheels. The field experiments were performed on the Ofoten Line outside of Narvik, where the wheel temperatures were measured thermographically. It is found that both the rig testing and the field study may generate a substantially uneven circumferential distribution of the wheel temperatures during tread braking. For the brake rig results an initially even distribution of tread temperatures changes into a state with one concentrated hot zone covering roughly one-fourth to one-third of the wheel circumference. Temperature differences between hot and cold zones on the wheel may then be more than 200°C. Similar behaviour is seen for wheels in the field study at the Ofoten Line, with temperature differences of up to 70°C. Ultrasonic measurements on wheels tested in the brake rig show that the residual stress level in the wheel rim had shifted significantly towards a detrimental tensile state compared to what could be expected from uniform heating. The thermal behaviour is similar for the three wheels that have different web shapes and propensities for the build-up of residual stresses. The global uneven heating is most pronounced at intermediate brake power levels of 25 to 40 kW. The conclusions drawn from the present study are that there can be severe consequences of an assumption of uniform wheel heating with respect to the thermomechanics of the brake–wheel–rail system.
Atherosclerotic Cardiovascular Disease Risk Scores are Associated with Carotid Intima-Media Thickness
Authors: Mewborn Emily K. , Tolley Elizabeth A. , Wright David B. , Doneen Amy L. , Stanfill Ansley G.
Published: January 2025

Atherosclerotic cardiovascular disease (ASCVD) risk calculators estimate the 10-year incident risk of myocardial infarction (MI), coronary artery disease (CAD) death, or stroke; however, they lack comprehensiveness and accuracy. Carotid intima-media thickness (CIMT) is a surrogate marker that may improve risk estimation acumen. The objective of this study was to derive ASCVD risk scores from historical data and determine whether these risk scores are associated with the history of subclinical CAD and CIMT. This retrospective cross-sectional study used an existing dataset of individuals with prediabetes. Subclinical CAD history was defined as the history of CAD, coronary plaque, or coronary revascularization without a history of MI. The online ASCVD Risk Estimator Plus calculator was used to derive individual risk scores. Chi-square or Fisher’s exact tests for categorical variables and ANOVA for continuous variables detected differences among ASCVD risk categories. Linear regression of CIMT measurements on ASCVD risk scores ascertained ASCVD risk scores’ utility in predicting CIMT measurements. The sample included 86 participants, 28% with a history of CAD, 60% male, and 95% White. No differences in risk scores existed between participants with or without CAD. Individuals with higher ASCVD risk scores were older ( p ≤ .001) and had higher systolic blood pressure ( p ≤ .001), CIMT arterial age ( p = .003), mean IMT common ( p ≤ .001), mean IMT maximum ( p ≤ .001), and plaque burden ( p = .02) measurements. ASCVD risk scores were significantly associated and moderately correlated with CIMT measurements. ASCVD risk scores were not associated with CAD history but were associated with CIMT measurements. While risk calculators provide a starting point for ASCVD risk estimation, physical tools like CIMT can diagnose ASCVD, categorize plaque quality, and track intervention efficacy. CIMT may be used for more direct ASCVD risk estimation. Risk scores are easily imputed from existing records but are only intended for incident risk, and their accuracy relies on the variables’ availability and validity and the boundaries of the calculators.
Development and Validation of the “Career Confidence for Activities in the Future” to Assess Italian Adolescents’ Self-Efficacy Beliefs in Handling Global Challenges
Authors: Valbusa Isabella , Zammitti Andrea , Ginevra Maria Cristina , Santilli Sara , Soresi Salvatore , Nota Laura
Published: January 2025

This paper reports the development and psychometric requisites of the Career Confidence for Activities in the Future (CCAF). This scale of 25 items assesses adolescents’ self-efficacy beliefs about the capacity to learn and execute professional activities necessary to handle six global challenges. These are the safeguard of the environment and life on the planet, health and well-being of all the people, fair and sustainable economic development, the use of technology for the benefit of all, the construction of right-conscious and inclusive societies, and the valorization of culture and education to cosmopolitanism. Two studies were carried out. Study 1 included 706 adolescents (Mage = 17.39; SD = 0.81; 31.9% male and 67.8% female) and examined the factor structure through exploratory and confirmatory factor analyses. Additionally, this study examined the convergent and discriminant validity of the questionnaire with measures of career adaptability and the propensity to sustainability in making decisions about one’s future. Study 2 included 706 adolescents (Mage = 17.31; SD = 0.89; 50% male and 50% female) and provided measurement invariance across genders. Results supported the use of the CCAF in career guidance activities to encourage adolescents to positively contribute to handling the six global challenges considered.
In Brexit’s wake: The birth of the left behind
Authors: Barratt Edward , Sliwa Martyna
Published: January 2025

This paper addresses the problematisation of the ‘left behind’ in right wing populist governmental strategies in the aftermath of Brexit. As diverse political actors, journalists and commentators questioned and sought to account for the outcome of the vote, we explore Theresa May’s particular contribution, as the left behind came into view as a problem for state rule. We reveal May’s shifting and often ambiguous ontology of the left behind, highlighting the manner in which she deploys discourses of globalisation, as she challenges an avaricious and culturally detached business elite, and the state, for their failure to hold business in check and to advance the interests of the left behind. Nonetheless, we argue for the continuing relevance of neoliberal discourse for the way May questions the predicament of the left behind, and reimagines their government. Brexit’s wake, we suggest, marks not a radical break with the logic of neoliberal reason that Foucauldians in MOS have explored, but a compromised mutation that brings the state to the fore. Crucially, May’s intervention also portends the government of what came to be known as ‘culture wars’. On the one hand, the left behind were to be the target object of haphazard schemes for the remediation of the inequalities they experience. On the other, their cultural marginalisation was to be addressed by enrolment in countless cultural wars mobilised by elite political actors. Our paper contributes to the literature by offering a Foucauldian analysis addressing the consequences of Brexit for the marginalised and economically vulnerable.
Static load sharing performance of non-orthogonal and offset helical face gear dual-branch drivetrain
Authors: Fu Xuezhong , Zhang Chunyu , Xu Haijun , Xu Yingqiang , Ma Guo , He Houbing
Published: January 2025

To research the static load sharing performance of non-orthogonal offset helical (NOH) face gear dual-branch drivetrain, the non-orthogonal offset layout forms of the system are explored, and the meshing phase differences of split-stage and converge-stage are analyzed. Based on the torque balance condition, deformation coordination condition, and static balance condition of the system, a static torque distribution model of the system was generated, and the static load sharing coefficients (SLSCs) were obtained results. The influence of assembly errors, support stiffness, torsional stiffness, meshing stiffness, and input load on the static load sharing performance was analyzed. The results indicate that assembly errors have a strong influence on the SLSCs, with the shaft angle errors exerting the strongest influence on the SLSCs; When there are assembly errors, the impact of input load and torsional stiffness on the static load sharing performance is greater than without assembly error. To increase the load sharing performance of the system, the meshing phase differences should be eliminated, and the offset layout form should be adopted in the dual-branch transmission system. In addition, reducing the support stiffness of the input helical gear and the fluctuation amplitude of meshing stiffness can also improve the load sharing performance.
Management of metastatic colorectal cancer: consensus in the Gulf Cooperation Council countries
Authors: Shouki Bazarbashi , Abdelsalam Alnajjar , Abdullah Al Sharm , Kanan Alshammari , Ahmed Al Sherhi , Emad Dawoud , Volker Heinemann , Mohamed Aseafan , Aref Chehal , Mohammed Alghamdi , Dina Hamza , Maroun Khoury , Ajit Venniyoor , Mervat Mahrous , Kakil Rasul , Shereef Elsamany , Diaeddine Trad
Published: January 2025

Colorectal cancer (CRC) represents a major public health challenge globally, particularly in the Gulf Cooperation Council (GCC) countries, where it is identified as the second most prevalent form of cancer. Despite advancements in management strategies, tailored guidelines specific to the Gulf region are lacking. This paper presents consensus recommendations developed by a panel of experts from the GCC countries to address this gap. The guidelines cover epidemiology, screening, biomarkers, and treatment strategies for metastatic CRC. Treatment guidelines emphasize tailored approaches based on tumor characteristics, including sidedness and molecular profiles. Furthermore, the importance of maintenance therapy and emerging biomarkers are discussed. These guidelines aim to improve CRC management and outcomes in the Gulf region.
Love Doesn’t Run Out: Children and Adults Do Not View Social Resources as Inherently Zero-Sum
Authors: Wei Kevin , Yang Fan
Published: January 2025

It is not uncommon to witness individuals competing for social resources such as affection and status. Does this mean that people view social resources as inherently zero-sum—where gains for one person result in losses for another? Two preregistered studies found that U.S. adults and 4- to 9-year-old U.S. children did not view nonrival social resources (love and trust) or rival social resources (popularity and leadership) as zero-sum, both less zero-sum than material resources like stickers. Importantly, zero-sum thinking was not determined by the inherent properties of the resources but was influenced by renewability: Perceived renewability of resources predicted lower levels of zero-sum beliefs, and both social and material resources were perceived as less zero-sum when presented as renewable compared with nonrenewable. These findings shed light on the nature and origins of zero-sum beliefs, highlighting renewability as a key mechanism and a potential intervention for reducing competition and promoting cooperation.
Non-fatal acute barium carbonate poisoning following suicidal ingestion: A case report
Authors: Leong Waiian , Li Chunlian , Long Yuhui , Wang Yanli , Wai Abraham KC , Huang Yi , Lau Feilung
Published: January 2025

Acute barium poisoning is a rare but life-threatening method of suicide attempt, and it is a challenging disease in the emergency department. We report a case of barium carbonate poisoning in a 21-year-old man who ingested a large dose to attempt suicide and presented with gastrointestinal symptoms, gradual muscular weakness, and severe hypokalemia (K+1.63 mmol/L). He was promptly managed with gastric lavage, respiratory support, and large doses of oral and intravenous potassium supplementation. In addition, intravenous sodium thiosulfate and continuous venovenous hemodiafiltration were administered to reduce the serum concentration of barium ions. Following comprehensive treatment, the patient recovered within 5 days and discharged home for 12 days. Clinicians should be vigilant when a patient presents gastrointestinal symptoms and limb weakness, associated with severe hypokalemia and cardiac arrhythmia over a short disease course as these may indicate potential barium poisoning. Furthermore, we advocate for paying more attention to the management of toxic substances and the mental health education of young adults.
Challenges and Prospects ofValue-Based Healthcare in Brazil
Authors: Veiga Cassia Rita Pereira da , Saliba Yasmin Yohana , Damázio Luciana Faluba , Abicalaffe César Luiz Lacerda , Rocha Fabio , Stevan Guedes Furquim Thales , da Veiga Claudimar Pereira
Published: January 2025

This paper aims to conduct a systematic literature review (SLR) on value-based health care (VBHC) in Brazil, providing an overview of the state-of-the-art practice of an emerging and strategic topic for the country’s health system. The SLR involved analyzing academic literature (AL) and gray literature (GL) in separate and parallel analyses to answer seven research questions. The results show that Brazil’s VBHC theme has evolved from a theoretical and practical perspective in recent years. However, the topic still needs more consensus, which makes it difficult to share best practices or compare health organizations. The practical initiatives on the subject are punctual and partial and show, in most cases, an attempt to measure results and care costs with an emphasis on economic aspects. The findings also showed the challenges for the Brazilian health system in modifying its structure to correct the flaws that prevent the delivery of value-based health care. This study makes three central contributions to the literature: (i) it shows the scenario of VBHC initiatives in Brazil; (ii) validates the use of GL in SLR for the health area, and (iii) links the state of the art and practice, bringing academia closer to health institutions with theoretical, practical, and managerial implications for VBHC initiatives in the country. This paper presents the current status of the VBHC reality in the country and the challenges to be faced so that the Brazilian health system can seek the required transformation and anticipate its future needs.
Norepinephrine titration in patients with sepsis-induced encephalopathy: cerebral pulsatility index compared to mean arterial pressure guided protocol: randomized controlled trial
Authors: Salem Mai Salah , Abosabaa Motaz Amr , Abd El Ghafar Mohamed Samir , EI-Gendy Hala Mohey EI-Deen Mohamed , Alsherif Salah El-din Ibrahim
Published: January 2025

Background

Although surviving sepsis campaign (SSC) guidelines are the standard for sepsis and septic shock management, outcomes are still unfavourable. Given that perfusion pressure in sepsis is heterogeneous among patients and within the same patient; we evaluated the impact of individualized hemodynamic management via the transcranial Doppler (TCD) pulsatility index (PI) on mortality and outcomes among sepsis-induced encephalopathy (SIE) patients.

Methods

In this prospective, single-center randomized controlled study, 112 patients with SIE were randomly assigned. Mean arterial pressure (MAP) and norepinephrine (NE) titration were guided via the TCD pulsatility index to achieve a pulsatility index < 1.3 in Group I, whereas the SSC guidelines were used in Group II to achieve a MAP ≥ 65 mmHg. The primary outcome was intensive care unit (ICU) mortality and the secondary outcomes were; MAP that was measured invasively and values were recorded; daily in the morning, at the end of NE infusion and the end of ICU stay, duration of ICU stay, cerebral perfusion pressure (CPP), sequential organ failure assessment (SOFA) score, norepinephrine titration and Glasgow coma scale (GCS) score at discharge.

Results

ICU mortality percentage wasn`t significantly different between the two groups (p value 0.174). There was a significant increase in the MAP at the end of norepinephrine infusion (mean value of 69.54 ± 10.42 and p value 0.002) and in the GCS score at ICU discharge (Median value of 15 and p value 0.014) in the TCD group, and episodes of cerebral hypoperfusion with CPP < 60 mmHg, were significantly lower in the TCD group (median value of 2 and p value 0.018). Heart rate values, number of episodes of tachycardia or bradycardia, Total norepinephrine dosing, duration of norepinephrine infusion, SOFA score, serum lactate levels, and ICU stay duration weren`t significantly different between the two groups.

Conclusions

Individualizing hemodynamic management via the TCD pulsatility index in SIE patients was not associated with significant mortality reduction. However, it reduces episodes of cerebral hypoperfusion and improves GCS outcome but doesn’t significantly affect heart rate values, SOFA score, serum lactate level, length of ICU stay, total NE dosing, and duration of NE infusion.

Trial registration

The clinical trial was registered on clinucaltrials.gov under the identifier NCT05842616 https://clinicaltrials.gov/study/NCT05842616?cond=NCT05842616&rank=1 on 6-May-2023 before the enrolment of the first patient.
Successful pregnancy of an SMA type 3 sitter on Nusinersen therapy - a case report
Authors: Hiebeler Miriam , Thiele Simone , Walter Maggie C.
Published: January 2025

Background

Due to improved treatment options, more SMA patients reach childbearing age. Currently, limited data on pregnant SMA patients is available, especially in relation to disease-modifying therapies (DMT). This case report helps to elucidate new approaches for future guidelines in the management of pregnancy and SMA.

Case Report

A 33-year-old wheelchair-bound patient with SMA type 3 (sitter) became pregnant following 36 months of Nusinersen treatment. The last dose was administered in the third gestational week. After pregnancy was confirmed, therapy was stopped immediately. A healthy child was born in the 34th gestational week by caesarean section. After a short nursing period, Nusinersen was restarted 6 weeks after the expected gestational date. At this time, the patient reported deteriorated motor functions, which stabilized at a lower level compared to pre-pregnancy in the 2-year follow-up, despite restarting Nusinersen treatment.

Discussion

So far, only few cases of successful pregnancies of SMA patients on DMT have been reported. In natural history, the majority of patients experienced an increased deterioration of motor function while fetal outcome was not impaired. Our case shows that although Nusinersen treatment was applied in the third gestational week prior to proof of pregnancy, outcome was positive for mother and child. Future studies will have to determine whether ongoing treatment with Nusinersen during pregnancy should be recommended.
Using the Nutri-Score to visualise food reformulation in Germany: the case of breakfast cereals
Authors: Gréa Corinna , Dittmann Anna , Wolff David , Haidar Hanna , Roser Silvia , Merz Benedikt , genannt Bonsmann Stefan Storcksdieck
Published: January 2025

Background

The reformulation of commonly consumed foods towards less sugar, fat, and salt is an important public health strategy to improve food choices of consumers and thus address the high prevalence of overweight and obesity. Front-of-pack nutrition labels like the Nutri-Score may drive reformulation and support nutritionally favourable food choices. Breakfast cereals are of special interest in that they tend to be high in sugar and are relatively often targeted at children. This study therefore aimed to evaluate the German breakfast cereal market in terms of reformulation efforts and to what extent these would show in a better Nutri-Score.

Methods

Using data from the German monitoring of packaged foods, changes in energy and nutrient content and the final nutritional score (FNS) of breakfast cereals, differentiated into children’s and non-children’s products, between 2019 (n = 888) and 2022 (n = 1473) were evaluated (Mann-Whitney test for two independent samples). Reformulation efforts were analysed in a subsample of paired products available in both years (n = 424). The Nutri-Score was calculated using the 2023 algorithm.

Results

Sugar content of children’s and non-children’s breakfast cereals decreased by 25.5% (p < 0.001) and 8.7% (p < 0.001), respectively, while fat content increased (+ 32.0% (p < 0.001) and + 7.0% (p < 0.036)). Especially for children’s breakfast cereals, the share of products with a ‘green’ (A or B) Nutri-Score was higher in 2022 than in 2019. At the same time, the share of less favourable breakfast cereals (Nutri-Score C-E) was higher for children’s than for non-children’s breakfast cereals in both years. For paired products, the FNS changed (positively or negatively) in 34.6% and concomitantly the Nutri-Score in 14.2% of cases. Products showing a better Nutri-Score were often reformulated in a way to just make it into the better class.

Conclusion

Improvements in nutrient content and FNS of breakfast cereals in Germany were mainly driven by shifts in the product portfolio, not by reformulation of existing products. Hence, any benefit for public health would require that consumers switch to (newly introduced) breakfast cereals with a more favourable composition. Overall, more reformulation efforts guided by a holistic product monitoring are needed to improve the nutritional quality of the food supply.