bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining differences in exposure to digital marketing of unhealthy foods reported by Canadian children and adolescents in two policy environments
Authors: Vergeer Laura , Soto Carolina , Bagnato Mariangela , Pauzé Elise , Amson Ashley , Ramsay Tim , Olstad Dana Lee , Welch Vivian , Potvin Kent Monique 
Published: February 2025

Abstract

Background
There has been relatively little research on youth’s exposure to food marketing on digital media, which is important as new digital platforms emerge and youth spend more time online. Evidence evaluating different policy approaches to restricting digital food marketing to children is also limited. This study examined differences in self-reported exposure to digital food marketing between children and adolescents in different policy environments: Ontario (where food marketing is self-regulated) and Quebec (where advertising is government regulated).

Methods
An observational cross-sectional online survey was conducted in April 2023 among children (aged 10–12 years) and adolescents (13–17 years) from Ontario and Quebec, recruited by Leger Marketing. Participants self-reported their frequency of exposure to food marketing via various digital platforms and marketing techniques. Logistic regression and proportional odds models examined differences in exposure by province and age group, adjusting for sociodemographic characteristics and digital device usage.

Results
The odds of reporting more frequent exposure to marketing of sugary drinks (OR: 0.48; 95% CI: 0.33, 0.69), sugary cereals (OR: 0.59; 95% CI: 0.41, 0.86), salty/savoury snacks (OR: 0.67; 95% CI: 0.47, 0.96), fast food (OR: 0.65; 95% CI: 0.45, 0.92), and desserts/sweet treats (OR: 0.54; 95% CI: 0.37, 0.78) were lower among Quebec children than Ontario children. Quebec children were less likely than Ontario children (OR: 0.56; 95% CI: 0.38, 0.84), but more likely than Quebec adolescents (OR: 1.58; 95% CI: 1.04, 2.42), to report exposure to unhealthy food marketing on one or more gaming/TV/music streaming platform/website(s). Compared with Ontario children, Quebec children were less likely to report exposure to marketing featuring characters or child/teenage actors (OR: 0.51; 95% CI: 0.34, 0.76), child-appealing subjects, themes and language (OR: 0.59; 95% CI: 0.40, 0.89), and visual design, audio and special effects (OR: 0.64; 95% CI: 0.41, 0.99), and to report exposure to a greater number of marketing techniques (OR: 0.60; 95% CI: 0.43, 0.84).

Conclusions
Exposure to unhealthy food marketing on digital media is high for youth from Ontario and Quebec, particularly for Ontario children. These findings reinforce the need for federal regulations to protect Canadian youth from unhealthy food marketing on digital media.
A Personalized Muscle–Tendon Assessment and Exercise Prescription Concept Reduces Muscle–Tendon Imbalances in Female Adolescent Athletes
Authors: Domroes Theresa , Weidlich Kolja , Bohm Sebastian , Mersmann Falk , Arampatzis Adamantios 
Published: February 2025

Abstract

Background
Imbalances between muscle strength and tendon stiffness influence the mechanical demand on the tendon (i.e., tendon strain) and may increase tendon injury risk. The purpose of this study was to identify muscle–tendon imbalances and to promote a more balanced musculotendinous adaptation through a personalized assessment and exercise prescription concept in female adolescent handball athletes (13–16 years).

Methods
At four measurement time points during a competitive season, we used dynamometry and ultrasonography to assess knee extensor muscle strength, patellar tendon stiffness and strain. Tendon micromorphology was assessed with a peak spatial frequency (PSF) analysis of proximal tendon ultrasound images. Muscle–tendon imbalances were identified based on tendon strain during maximum voluntary contractions. A control group (n = 15) followed their usual training. In the intervention group, athletes with a deficit in tendon stiffness (strain ≥ 9%; n = 6) or no muscle–tendon imbalances (strain between 4.5% and 9%; n = 15) performed exercises (3x/week for 32 weeks) with a personalized load to reach ~ 6.2% tendon strain to predominantly promote tendon or both muscle and tendon adaptation. Individuals with a muscle strength deficit (strain ≤ 4.5%; n = 1) trained with submaximal loads to failure to promote muscle strength.

Results
In the intervention group we found lower fluctuations of maximum tendon strain (p = 0.005) and a decrease in tendon strain over time (p = 0.010), which was more pronounced in individuals with initially high tendon strain. While there were no systematic changes in muscle strength or tendon stiffness at the group level (p > 0.05), the marked decrease in tendon strain in individuals with a deficit in tendon stiffness was caused by a predominant increase in tendon stiffness. Overall, the prevalence of muscle–tendon imbalances was reduced in the intervention group, while it temporarily increased in the control group. PSF did not differ between groups at baseline but decreased significantly in the intervention group (p = 0.013).

Conclusions
The findings suggest that the personalized concept is suitable to promote a more uniform adaptation of knee extensor muscle strength and patellar tendon stiffness and to reduce the prevalence of musculotendinous imbalances in female adolescent athletes, which may have important implications for tendon injury prevention.

Trial Registration
DRKS, DRKS00035110. Registered 20 September 2024–retrospectively registered, https://drks.de/search/de/trial/DRKS00035110.
Scrotal migration of the abdominal end of the ventriculoperitoneal shunt
Authors: Karatas Fatih , Yuksek Muhammed Erkam , Gul Busra , Kenan Mehmet , Erdi Mehmet Fatih 
Published: February 2025

Abstract

Background
The most common treatment of hydrocephalus is ventriculoperitoneal shunt (VPS) operation. Shunt dysfunction may develop in patients with ventriculoperitoneal shunt. The most common causes of shunt dysfunction, which are more common in pediatric patients, are infection, obstruction, visceral injury, pseudocyst formation, and excessive or inadequate drainage. Shunt migration is a rare complication of VPS operation, and the shunt catheter may migrate to the gastrointestinal tract, scrotum, bladder, and other organs. Revision surgery is a safe treatment option in most cases of shunt dysfunction or migration.

Case presentation
In this report, a 2-year and 10-day-old baby patient was observed to have bilateral hydrocele in the outpatient clinic follow-up after the VPS operation, and after radiological imaging, it was determined that the shunt peritoneal catheter was in the scrotum. The patient underwent shunt revision surgery.

Conclusion
Although malposition of the VPS peritoneal catheter is not always an emergency, reinsertion and surgical revision should be done promptly due to the risk of perforation due to malposition. Close follow-up of patients with VPS is important for early diagnosis and treatment of complications.
A comprehensive review on elucidating the host disease resistance mechanism from the perspective of the interaction between cotton and Verticillium dahliae
Authors: Zhang Yalin , Zhao Lihong , Li Dongpo , Li Ziming , Feng Hongjie , Feng Zili , Wei Feng , Zhou Jinglong , Ma Zhiying , Yang Jun , Zhu Heqin 
Published: February 2025

Abstract
Verticillium wilt, caused by the infamous pathogen Verticillium dahliae, presents a primary constraint on cotton cultivation worldwide. The complexity of disease resistance in cotton and the largely unexplored interaction dynamics between the cotton plant host and V. dahliae pathogen pose a crucial predicament for effectively managing cotton Verticillium wilt. Nevertheless, the most cost-effective approach to controlling this disease involves breeding and cultivating resistant cotton varieties, demanding a meticulous analysis of the mechanisms underlying cotton’s resistance to Verticillium wilt and the identification of pivotal genes. These aspects constitute focal points in disease-resistance breeding programs. In this review, we comprehensively discuss genetic inheritance associated with Verticillium wilt resistance in cotton, the advancements in molecular markers for disease resistance, the functional investigation of resistance genes in cotton, the analysis of pathogenicity genes in V. dahliae, as well as the intricate interplay between cotton and this fungus. Moreover, we delve into the future prospects of cutting-edge research on cotton Verticillium wilt, aiming to proffer valuable insights for the effective management of this devastating fungus.
Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study
Authors: Awad Gehad , Fetoh Fetoh Alaaeldin , Gwely Noureldin Noaman , Hamza Usama , Amer Sameh , Yehya Yomna Mohammed , Abdellateef Amr 
Published: February 2025

Abstract

Background
Minimally invasive mitral valve surgery has been introduced as a safe alternative to full sternotomy through smaller chest wall incisions to reduce the potential sternal complications in addition to the favorable aesthetic effect. This observational study has been designed to evaluate and compare operative and short-term postoperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement. The study was conducted on 40 cases and divided into two groups: group 1, comprised of 20 patients who underwent video-assisted mitral valve replacement (VAMVR), and group 2, comprised of 20 patients who underwent right anterior mini-thoracotomy mitral valve replacement (ATMVR). Preoperative data, intraoperative procedures, and early postoperative results have been compared between both techniques.

Results
Intraoperative parameters showed no statistical difference between the two groups. Wound length in the VAMVR group was statistically smaller than the ATMVR group, 5.33 ± 0.96 cm versus 7.08 ± 1.24 cm, respectively (P < 0.001). The intraoperative assessment by TEE showed a well-suited, well-functioning prosthetic valve, and no paravalvular leak in the two groups. In both groups, there were statistically significant reductions in left ventricular end diastole, left atrial diameter, and pulmonary artery systolic pressure in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). There was a statistically significant decrease in left ventricular end-systole in the VAMVR group in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). ICU visual analog scale (VAS) was significantly lower in the VAMVR group than in the ATMVR group (P = 0.049). There was a gradual reduction in VAS in both groups along the period of 3 months postoperatively without significant differences between the two groups in 2 weeks and 3 months postoperatively.

Conclusions
VAMVR and ATMVR could be considered safe, feasible approaches with favorable perioperative surgical and echocardiographic results. VAMVR showed statistically significant smaller wounds and less postoperative pain than ATMVR, which may offer potential advantages in terms of reduced postoperative discomfort and cosmetic appearance for the thoracoscopic technique. Further randomized studies with larger cohorts and longer follow-ups are recommended to evaluate the long-term benefits and safety of both techniques.
Professorships in child and adolescent psychiatry relative to a similarly sized medical specialty in the UK and Ireland: cross-sectional study
Authors: Kelleher Ian , Poziemska Aleksandra Z. , Kieseppä Valentina , Thapar Anita , Dubicka Bernadka , Lockhart Elaine , Ford Tamsin , Minnis Helen , Gallagher Louise , McNicholas Fiona , O'Hare Kirstie 
Published: February 2025

Background
A youth mental health crisis is considered one of the great challenges of our time, and research and clinical services in child and adolescent psychiatry have become a priority for governments and funders. Academic leadership is needed to drive forward research. It is not clear how many senior academic leadership posts (professorships) there are in child and adolescent psychiatry, nor how this benchmarks against a similarly sized medical specialty.

Aims
This study aimed to determine the number of professorships in child and adolescent psychiatry in the UK and Ireland compared to a similarly sized specialty. A secondary aim was to identify the number of clinical trials registered for mental and behavioural disorders in children.

Method
We identified registered specialists in child and adolescent psychiatry and a similarly sized specialty who held full professorships in medical schools. We searched the International Standard Randomised Controlled Trial Number (ISRCTN) and ClinicalTrials.gov for trials.

Results
As of 23 March 2023, there were 1725 doctors on the General Medical Council's (GMC) specialist register in child and adolescent psychiatry. The closest specialty in terms of number of registered specialists was neurology (N = 1724). We identified 24 professors in child and adolescent psychiatry across the UK and Ireland, compared to 124 in neurology. For every intervention trial registered for mental and behavioural disorders in children, there were approximately ten trials registered for diseases of the nervous system.

Conclusions
Despite equivalent numbers of medical specialists in child and adolescent psychiatry and neurology, there is a striking disparity in the number of professorship appointments. While young peoples’ mental health has, ostensibly, become a priority for policy-makers and funders, this is not reflected in medical professorship appointments. The paucity of senior academic child and adolescent psychiatrists has real-world implications for training, research, innovation and service development in mental health services.
Ten years of the digital twin brain: Perspectives and challenges
Authors: Guo Shuqi , Zhang Ge , Zeng Xin , Xiong Yue , Xu Yuanhang , Cui Yan , Yao Dezhong , Guo Daqing 
Published: February 2025

Abstract
Over the past decade, the digital twin brain (DTB) has emerged as a transformative brain science paradigm, integrating multimodal data to construct dynamic models closely simulating biological brain function. This approach has advanced understanding of structure-function relationships, cognitive behaviors, and disease mechanisms, while supporting personalized therapies. Recent progress highlights DTB's potential in capturing functional heterogeneity, simulating information integration, and predicting individual cognitive and pathological variations. Looking forward, the development of a high-precision DTB is expected to drive breakthroughs in understanding brain mechanisms and enabling precision medicine. This perspective summarizes DTB modeling strategies, including multimodal data integration and optimization, while addressing challenges such as model granularity, and biological interpretability. Future efforts should focus on refining modeling techniques and integrating with brain cognition and disease. We believe these advancements will pave the way for breakthroughs in brain science and precision medicine, ushering in a new era of neuroscience and personalized healthcare.
Fetuin B Is Related to Cytokine/Chemokine and Insulin Signaling in Adipose Tissue and Plasma in Humans
Authors: Kemper Esther J , Goossens Gijs H , Blaak Ellen E , Adriaens Michiel E , Meex Ruth C R 
Published: February 2025

Abstract

Context
Fetuin B is a steatosis-responsive hepatokine that induces glucose intolerance in mice. Recently, we found that fetuin B in white adipose tissue was positively associated with peripheral insulin resistance in mice and a small study population, possibly through a fetuin B–induced inflammatory response in adipocytes.

Objective
This translational study aimed to investigate the link between plasma fetuin B and the adipose tissue transcriptome and plasma proteome in a large cohort of humans.

Methods
Continuous linear regression analysis in R was applied to investigate the link between plasma fetuin B and the adipose tissue transcriptome (n = 207) and plasma proteome (n = 558) in humans, after adjustment for sex, age, and study center (model 1); model 1 + BMI (model 2); and model 2 + insulin sensitivity (Matsuda index) (model 3).

Results
Plasma fetuin B was associated with more than 100 genes in white adipose tissue, belonging to pathways related to cytokine/chemokine signaling (models 1 and 2) and insulin signaling (all models), and with more than 146 plasma proteins involved in pathways related to metabolic processes and insulin signaling (all models).

Conclusion
Plasma fetuin B is related to adipose tissue genes and plasma proteins involved in metabolic processes and insulin signaling. Our findings provide evidence for the involvement of white adipose tissue in fetuin B-induced insulin resistance.
The Hypothalamic Arcuate Nucleus Dopaminergic Neurons: More Than Just Prolactin Secretion
Authors: Lim Luis Wei Cheng , Egnot Christopher Thomas , Papaioannou Panagiotis , Yip Siew Hoong 
Published: February 2025

Abstract
The hypothalamic arcuate nucleus dopaminergic (A12) neurons are well known for their central role in regulating prolactin secretion through a sophisticated negative feedback loop. In this canonical pathway, prolactin stimulates A12 neurons to release dopamine, which suppresses further prolactin release from lactotrophs in the anterior pituitary. However, a collective of recent and past evidence strongly implies that the A12 neurons are far more dynamic and multifaceted than previously appreciated. This minireview discusses the developmental trajectory of A12 neurons, from prenatal origins to postnatal maturation, highlighting their diversity and heterogeneity. Beyond their well-characterized role in prolactin regulation, the A12 neurons contribute to a broader array of hypothalamic functions, including autoregulation, metabolism, and growth. By shedding light on these underexplored roles, this review outlines the expansive significance of A12 neurons as more than mere gatekeepers of prolactin secretion, positioning them as versatile players in endocrine and metabolic homeostasis.
External Validation of the Simple Postoperative Acute Kidney Injury Risk Index in Patients Admitted to the Intensive Care Unit After Noncardiac Surgery
Authors: Li Nan , Wang Jinwei , Zhou Weijie , Li Shuangling , Yang Li 
Published: February 2025

BACKGROUND:
The Simple Postoperative AKI Risk (SPARK) index is a novel model for predicting risk of postoperative acute kidney injury (PO-AKI) among patients after noncardiac surgery. However, the performance of the index has been inconsistent partly due to heterogeneity in case mix and effects of the involved clinical features. To clarify potential reasons for poor performance, we tested the SPARK index in a cohort of high-risk patients requiring intensive care unit (ICU) care after noncardiac surgery and examined whether model modification by refitting coefficients of clinical features could optimize model performance.

METHODS:
This was a single-center prospective cohort study. Preoperative variables of the SPARK index were extracted from electronic medical records. PO-AKI was defined by an increase in sCr ≥26.5 mmol/L within 48 hours or 150% compared with the preoperative baseline value within 7 days after surgery, whereas critical AKI was defined as AKI stage 2 or greater and/or any AKI connected to postoperative death or requiring renal replacement therapy during the hospital stay. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), and calibration was evaluated by the Hosmer–Lemeshow χ2 test and calibration plot. Model modification was performed by rebuilding the model with the original variables of the SPARK index through proportional odds logistic regression among participants in the earlier study period and was validated in the later one.

RESULTS:
A total of 973 patients were enrolled, among whom 79 (8.1%) PO-AKI cases and 14 (1.4%) critical AKI cases occurred. Our study participants demonstrated a higher SPARK risk score than the SPARK discovery cohort (eg, 8.02% vs 1.20% allocated in the highest risk group), and the incidence of both outcomes increased through the classes of the score (incidence proportion of PO-AKI increased from 2.56% in the lowest risk group to 25.64% in the highest risk group). The AUCs for PO-AKI and critical AKI were 0.703 (95% confidence interval [CI], 0.641–0.765) and 0.699 (95% CI, 0.550–0.848), respectively. The sensitivity, specificity, negative predictive value and positive predictive value were 68.35%, 57.49%, 95.36%, and 12.44%, respectively, when using 10% of predicted probability of PO-AKI as threshold. Calibration plots suggested acceptable consistency between the predicted and actual risk. After model modification, external validation demonstrated a significantly improved AUC for PO-AKI.

CONCLUSIONS:
The SPARK index showed fair discrimination and calibration among patients admitted to the ICU after noncardiac surgery. Modification of the model improved the performance of the model in terms of predicting PO-AKI.
A Randomized Controlled Trial of Sublingual Sufentanil in Early Management of Pain in Trauma
Authors: Guyette Francis X. , Chaudhary Prasanna , Vincent Laura E. , Love Emily T. , Brubaker DonavanP. , Neal Matthew D. , Brown Joshua B. , Rixe Jeffrey , Barton David J. , Yates Adam , Wisniewski Stephen R. , Sperry Jason L. 
Published: February 2025

BACKGROUND:
Pain management is essential in trauma. Sufentanil is a potent sublingual opioid analgesic with no active metabolites and rapid onset relative to oral medications. We hypothesize that compared to standard care, Sufentanil reduces the verbally administered numerical pain scale (VNRS) at 30 minutes.

METHODS:
We performed a prospective multicenter, open-label, randomized trial utilizing level-1 trauma centers from within the Linking Investigator in Trauma and Emergency Services (LITES) network. Participants were randomly assigned in a 1:1 ratio to either sublingual sufentanil or standard care. We enrolled 150 patients from July 2022 to January 2024. The study was approved by the human subjects research protection offices of the University of Pittsburgh and the Department of Defense. Subjects were eligible if they had a trauma evaluation, were 18 to 70, had a VNRS (0–100) score ≥50, and remained in the ED for at least 30 minutes. We excluded patients who were prisoners, pregnant, allergic to opioids, required airway management, body mass index (BMI) >40, significant respiratory depression, suspected gastrointestinal obstruction, or other contraindication to analgesics. The primary outcome was the VNRS for clinical pain measurement (0–100) at 30 minutes after treatment. Secondary outcomes included adverse events (hypoxia, hypotension, need for airway management) and the incidence of nausea/vomiting/headache/dizziness requiring treatment. We hypothesize that sublingual sufentanil as compared to emergency department standard care, will reduce the VNRS at 30 minutes.

RESULTS:
The study population had a mean age of 48 years (standard deviation [SD] 15) and was 32% female. The mechanism of injury was mostly blunt (96%). The VNRS at 30 minutes was 67 (SD 25) for the entire cohort, 66 (SD 23) in the sufentanil group, and 68 (SD 27) in the standard care group (P = .37). The Health care Professional Global Assessment (HPGA) at 30 minutes showed decreased pain scores in the standard care group compared to sufentanil, with standard care having more patients scored as good or excellent (P = .009). There was no difference in the incidence of nausea, vomiting, headache, dizziness, hypoxia, hypotension, or need for an advanced airway.

CONCLUSIONS:
In this cohort of trauma patients with moderate to severe pain, the VNRS at 30 minutes after administration of analgesics did not differ between sublingual sufentanil and standard care. Adverse events did not differ between the groups suggesting the sublingual sufentanil in this population.