bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Urgenda-Style’ Strategic Climate Change Litigation in Italy: A Tale of Human Rights and Torts?
Authors: Fermeglia Matteo , Luporini Riccardo 
Published: December 2023

Abstract
This contribution addresses the first strategic climate change litigation filed against the Italian State, the Giudizio Universale case. Giudizio Universale’s legal architecture is largely akin to other landmark cases filed in Europe, such as Urgenda in The Netherlands and Klimaatzaak in Belgium. Accordingly, Giudizio Universale is grounded on the state’s breach of international and EU obligations, the encroachment of human rights enshrined in the European Convention on Human Rights and the Italian Constitution, and the consequent attribution of domestic tort liability to the state under the Italian Civil Code. This article thus examines the main arguments raised in Giudizio Universale in light of the underlying domestic human rights and tort liability regimes. It first investigates the interplay between the breach of climate change obligations and human rights infringement as presented in the complaint to understand whether, and to what extent, Italian courts could give deference to an ‘Urgenda-style’ claim. Second, it unpacks the existing interpretation of tort liability as applied to state liability vis-à-vis its citizens by Italian courts. Third, it factors Giudizio Universale in the recent Italian Constitutional reform, which explicitly introduced the protection of the environment, biodiversity and ecosystems, as well as a reference to the ‘interests of future generations’, into the fundamental principles of the Italian Constitution. Overall, the article concludes that several limitations exist in the Italian legal system in the pursuance of strategic climate litigation against the state for its (in)action against climate change. One of the merits of the Giudizio Universale case, however, is that it challenges these limitations to provide another suitable tool for ensuring protection against the climate emergency.
Climate Litigation: Targeting the Aviation Sector
Authors: Balounová Eva 
Published: December 2023

Abstract
With climate litigation growing in importance, the aviation industry, as one of the most energy-intensive forms of consumption, has been also challenged. This article identifies five types of climate litigation concerning the aviation sector, and analyses two main arguments that have led to the dismissal of several types of cases. First, the courts have concluded that the Paris Agreement does not apply to international aviation and thus does not commit the parties to the Agreement to reduce emissions from this sector. The second argument for dismissal was the lack of the Paris Agreement’s direct effect, an argument that is raised mainly in the airport expansion cases, as these plans for expansions were often approved by the local authority. To date, only the so-called ‘climate-washing’ claims and the ‘climate-necessity’ defence cases have resulted in favourable outcomes with respect to climate action. The article notes that the climate-washing cases, including claims over carbon offsetting and fuel sustainability, are on the rise, thus drawing attention to the adequacy of the relevant regulatory instruments to ensure the decoupling of the industry from its CO2 emissions.
Imaging emptiness
Authors: Bouso Raquel 
Published: December 2023

Abstract
Nishitani’s later works, particularly the seminal essay “Kū to soku” and several lectures given at Ōtani University, were devoted to thinking about image and imagination. In this article, I try to reconstruct Nishitani’s theory of imagination in light of these writings. I discuss the role that imagination plays in his philosophical project and how his ideas can contribute to philosophically understanding the phenomenon of imagination itself.
The paper starts from Nishitani’s conception of the “elemental imagination”, closely related to Aristotle’s phantasia, from which, according to the Japanese philosopher, artistic and religious images emerge. Since this raises the question of the degree of reality accorded to the imagined and of the cognitive and affective value attributed to artistic and religious images, then the question of the ontology of images in the Greek, Christian and Buddhist traditions, in which the image serves as a means of manifesting the real, is examined. Finally, since Nishitani’s theory of imagination moves between the being and non-being of images, their subjectification and objectification, an attempt is made to situate it with respect to two opposing tendencies in contemporary philosophy, i.e., to recover the ontophanic value of images or to de-ontologize them.
What are Social Imaginaries?: A Pathway Through the Labyrinth
Authors: Adams Suzi 
Published: December 2023

Abstract
This essay charts a pathway through the labyrinth of social imaginaries. It enters into hermeneutic engagement with Castoriadis, Ricoeur, Taylor, and Arnason to outline a framework that elucidates social imaginaries in relation to social creativity, meaning, action, institutions, and the world horizon. It first situates “imaginaries” within a theory of culture. This section addresses the world as a background horizon of implicit meanings; imaginary significations as world creating; the interpretative aspect of creation; and the symbolic as a bridge between culture and society. The second section addresses the ‘social’ of social imaginaries. It highlights the social-historical as the impersonal dimension of society, and institutions and modes of social doing in which social imaginaries are incarnated. It identifies three varieties of doing: movement, social practices, and social praxis. It draws on the metaphor of the hermeneutic spiral to grasp social imaginaries in their dynamic movement of interpretation and creation.
Goal Length (Short or Long Term) Interacts with Goal Scheduling Strategy (Clock Time or Event Time) for Optimal Achievement
Authors: Nagamine Masato , Tang Li , Miwa Shuhei , Kainuma Ryo , Toyama Miki 
Published: December 2023

There are two strategies for scheduling personal goals: (i) clock-time, based on time passage; and (ii) event-time, based on the progress made. Neither strategy is always superior to the other; rather it is necessary to consider the environment and other conditions such as whether the goal is long or short term. We focused on goal lengthas an important factor for determining the best scheduling strategy, hypothesizing that clock-time and event-time strategies would differentially activate higher performance for long-term and short-term goals, respectively. Thus, we conducted a two-part laboratory experiment (Part 1: n = 63, Part 2: n = 86 ) in which we manipulated both goal length and scheduling strategy. Subsequently, we examined the effects of each combination of goal length and scheduling strategy on task performance (i.e., completion of a mathematical problem). Although our two studies were designed identically in most respects, they differed in the number of task problems, task time limits, and question content. Our data supported our hypothesis that clock-time scheduling was optimal for long-term goals while event-time scheduling was optimal for short-term goals.
Efficacy and recommendations for the delivery of telehealth psychotherapy for people with personality disorder
Authors: Bailey Rachel C. , Knowles Nacquel G. , Grenyer Brin F. S. 
Published: December 2023

Objective There are few studies on the efficacy and acceptability of psychotherapy conducted via telehealth technology for people with personality disorder. This study aims to examine clinician perspectives on virtual psychotherapy. Method Twenty multidisciplinary mental health clinicians (85% female, average age 42 years) with at least 2 years of experience in telehealth psychotherapy contributed quantitative and qualitative ratings of acceptability and efficacy of this modality. Results Likert scale ratings (1 = not, 5 = very) demonstrated high client acceptability (mean = 4.0), effectiveness (4.0) and high clinician acceptability (4.2) and sustainability (4.2). Three recommendations emerged from qualitative analysis: prioritising frame establishment, ensuring client safety online and maximising alliance-enhancing strategies. Conclusions This study, which collected quantitative and qualitative ratings of virtual psychotherapy, found that telehealth psychotherapy can be effective and acceptable for people with personality disorder. Strategies associated with success included strong governance, secure technology and careful attending to relationship management.
Biomarkers for Early Detection of Charcot Arthropathy: A Prospective Study on Type 2 Diabetes Patients with Severe Neuropathy
Authors: Dharmadas Salini , Kumar Harish , Pillay Minnie , Sukumaran Mangalanandan Thacho , Vivek Lakshmanan , Praveen Valiyaparambil Pavithran , Bal Arun 
Published: December 2023

Background: Charcot arthropathy (CA) is a progressive noninfectious inflammatory disease that causes irreversible destruction to pedal architecture in diabetic neuropathy (DN) patients. The debilitating prognosis demands early detection to prevent the development and progression of this disorder. Dysregulated and persistent production of inflammatory cytokines is reported as the key element in initiating osteoclastogenesis in CA. The study analyzed the potential association of markers of inflammation and bone turnover of prediagnostic serum samples on CA. Methods: Seventy-one type 2 severe DN patients were selected based on inclusion-exclusion criteria. Serum samples of interleukin 6 (IL-6), osteoprotegerin (OPG), bone alkaline phosphatase (BALP), and C-reactive protein (CRP) were analyzed. These patients were followed for the development of symptoms of CA for 12 months. In the year of monitoring, 7 patients developed CA (group 1), whereas the remaining 64 patients did not develop CA (group 2). Results: The rate of development of CA in patients with severe DN was 9.8%. In this group, significantly increased median values of HbA1c (group 2: 8.00 [7.00-9.00], group 1: 10.00 [9.25-11.50], P = .013); IL-6 (group 2: 1.21 [0.72-2.16], group 1: 11.08 [6.65-63.64], P = .008); and CRP (group 2: 1.25 [0.78-3.20], group 1: 3.31 [1.18-41.33], P = .041) were found. The receiver operating characteristic analysis showed that IL-6 was more strongly associated with the onset of CA (IL-6: area under the curve = 0.808; P = .008) than CRP. Cut-off values of ≥6.6 for IL-6 show potential to rule out CA in high-risk patients, with a positive predictive value of 26.1%, a negative predictive value of 97.9%, a sensitivity of 85.7%, and a specificity of 73.4%. Conclusion: In our study population, we found that an exacerbated inflammatory state, reflected by IL-6 values, generally occurred in DN patients before the clinical detection of CA. Level of Evidence: Level II, prospective comparative study.
Aberrant Functional Connectivity in Core–Periphery Structure Based on WSBM in ADHD
Authors: Li Dandan , Hou Dianni , Zhang Yating , Zhao Yao , Cui Xiaohong , Niu Yan , Xiang Jie , Wang Bin 
Published: December 2023

Objective: Brain network studies have revealed that the community structure of ADHD is altered. However, these studies have only focused on modular community structure, ignoring the core–periphery community structure. Method: This paper employed the weighted stochastic block model to divide the functional connectivity (FC) into 10 communities. And we adopted core score to define the core–periphery structure of FC. Finally, connectivity strength (CS) and disruption index (DI) were used to evaluate the changes of core–periphery structure in ADHD. Results: The core community of visual network showed reduced CS and a positive value of DI, while the CS of periphery community was enhanced. In addition, the interaction between core communities (involving the sensorimotor and visual network) and periphery community of attention network showed increased CS and a negative valve of DI. Conclusion: Anomalies in core–periphery community structure provide a new perspective for understanding the community structure of ADHD.
Rethinking the Utility of the Audio-Only Encounter: A Case of Herpes Zoster Co-Infection in Asymptomatic SARS-CoV-2
Authors: Harada Fumiue , Takita Morihito , Yamamoto Kana , Tachiya Yosuke , Yamamoto Chika , Saito Hiroaki , Kami Masahiro , Shineha Ryuzaburo 
Published: December 2023

Background: Telemedicine with video communication has become commonly applied during and after the COVID-19 pandemic. While audio-only encounters are not allowed in Japan after August 2023. The Centers for Medicaid and Medicare Services (CMS) in the United States revised the telehealth policy to make the video visit standard. We present here a case with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and diagnosed her with the Herpes zoster at audio-only encounters followed by an in-person clinic visit. Case Presentation: A 31-year-old woman called our hospital for a complaint of right chest discomfort and a tingling sensation. The SARS-CoV-2 infection was confirmed on her with the polymerase chain reaction (PCR) test 4 days before the symptom onset. A telephone encounter was made for her since the video communication failed to be prepared. The attending physician made a diagnosis of herpes zoster based on her verbal explanation of symptoms and localized skin lesions. An anti-viral medication with amenamevir was given. The photos of skin lesions were sent 3 days after the audio visit, which was consistent with herpes zoster. The patient visited our outpatient clinic and was confirmed for herpes zoster serologically with positive antibodies of both varicella-zoster IgM and IgG. Conclusions: The audio-only visit could help diagnose herpes zoster if the follow-up examinations are performed adequately. Audio-only encounters preserve the flexibility of telemedicine when video communication cannot be prepared promptly.
Despite celiprolol therapy, patients with vascular Ehlers–Danlos syndrome remain at risk of vascular events: A 12-year experience in an Italian referral center
Authors: Buso Giacomo , Paini Anna , Agabiti-Rosei Claudia , De Ciuceis Carolina , Bertacchini Fabio , Stassaldi Deborah , Salvetti Massimo , Ritelli Marco , Venturini Marina , Colombi Marina , Muiesan Maria Lorenza 
Published: December 2023

Background: Vascular Ehlers–Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol has been suggested to significantly reduce rates of vascular events in this setting, though real-world evidence is limited. The aim of this study was to report our experience with celiprolol therapy in vEDS management. Methods: Patients with a genetically confirmed diagnosis of vEDS who were referred for outpatient consultation at the Brescia University Hospital between January 2011 and July 2023 were included. At each visit, patients’ medical history, results of vascular imaging, and office blood pressure measurements were recorded. Celiprolol therapy was progressively titrated to the maximum tolerated dose of up to 400 mg daily, according to the patients’ tolerance. Results: Overall, 26 patients were included. Female sex was prevalent (62%). Mean (SD) age was 37 (16) years. Follow-up duration was 72 (41) months. At the last follow-up visit, all patients were on celiprolol therapy, 80% of whom were taking the maximum recommended dose. The yearly risk of symptomatic vascular events was 8.8%, the majority of which occurred after reaching the maximum recommended dose of celiprolol. No significant predictor of symptomatic vascular events was identified among patients’ clinical characteristics. Conclusion: In our cohort, rates of celiprolol use were high and the drug was well tolerated overall. Nonetheless, the risk of symptomatic vascular events remained nonnegligible. Future studies should identify reliable predictors of major adverse events and explore additional therapeutic strategies that could further lower the risk of life-threatening events in this population.
Presence of anomalous flexor carpi radialis brevis (FCRB) in Madelung’s deformity
Authors: Cheung Kevin , Wang Kemble K. , McCombe David 
Published: December 2023

An anomalous flexor carpi radialis brevis (FCRB) muscle was present in four of nine patients undergoing surgery for Madelung’s deformity. This disproportionately frequent finding suggests an embryologic dysgenesis of forearm formation rather than a developmental tethering of Vicker’s ligament. Level of evidence: IV (case series)
ER status conversion and subsequent treatment: an assessment of negative ER expression detected by 18F-FES PET in metastatic breast cancer patients with ER-positive primary tumors
Authors: You Shuhui , Xie Yizhao , Ji Mengjing , Liu Cheng , Zhao Yannan , Gong Chengcheng , Hu Shihui , Li Yumeng , Yang Zhongyi , Wang Biyun 
Published: December 2023

Background: The 18F-fluoroestradiol positron emission tomography/computed tomography (18F-FES PET/CT) technique provides a convenient method to evaluate the overall estrogen receptor (ER) expression in metastatic breast cancer (MBC) patients. There are long debates on the characteristics and treatment strategy of patients with positive primary ER lesions but negative ER expression in metastatic disease. 18F-FES PET offers an opportunity to answer this question. Objectives: This study aimed to characterize the primary ER-positive patients with advanced-stage FES negativity and investigate the real-world treatment decisions made by physicians subsequently, and compare the efficacy between different regimens. Design: This observational cohort study was conducted at Fudan University Shanghai Cancer Center, enrolling breast cancer patients with ER-positive primary tumors who showed advanced-stage FES negativity. Methods: Descriptive statistics were used in clinicopathologic characteristics and compared with a chi-square test or t-test. In addition, progression-free survival (PFS) was estimated by the Kaplan-Meier method and compared by log-rank test. Results: 16.6% (52/314) of patients with an ER-positive primary tumor had negative ER expression assessed by 18F-FES for MBC prior to receiving first-line systemic therapy, among whom adjuvant endocrine therapy was prevalently utilized (86.5%, 45/52). The rate of FES negativity in the advanced stage was negatively correlated with levels of ER expression of primary tumors. Chemotherapy (83.3%, 40/48) was the most common treatment strategy afterward, among which capecitabine monotherapy (62.5%, 25/40) was a dominant alternative. PFS was significantly prolonged with capecitabine alone versus other chemotherapy (median PFS: 13.14 versus 6.21 months, p = 0.029). Conclusion: Negative conversion of ER in MBC detected by 18F-FES occurred frequently. Patients with lower ER expression in the primary lesion were more likely to have negative ER expression in the metastasis. In real-world clinical practice, most physicians primarily opted for chemotherapy, with capecitabine monotherapy being a commonly selected regimen. Trial registration: ClinicalTrials.gov identifier: NCT05797987.
Utility of an Artificial Intelligence Language Model for Post-Operative Patient Instructions Following Facial Trauma
Authors: Mohan Suresh , Souza Spenser , Fakurnejad Shayan , Knott P. Daniel 
Published: December 2023

Study Design Qualitative Descriptive Study. Objective To evaluate the utility of post-operative instructions (POIs) for facial trauma provided by the language model ChatGPT as compared to those from electronic medical record (EMR) templates and Google search engine. Methods POIs for four common facial trauma procedures (mandibular fracture, maxillary fracture, nasal fracture, and facial laceration) were generated by ChatGPT, extracted from EMR templates, or obtained from Google search engine. The POIs were evaluated by a panel of surgeons using the Patient Education Materials Assessment Tool (PEMAT-P). Results Average PEMAT-P understandability scores across all 3 sources ranged from 55% to 94%. Actionability scores ranged from 33% to 94%, and procedure-specific scores ranged from 50% to 92%. ChatGPT-generated POIs ranged from 82% to 88% for understandability, 60% to 80% for actionability, and 50% to 75% for procedure-specific items. Conclusions ChatGPT has great potential to be a useful adjunct in providing post-operative instructions for patients undergoing facial trauma procedures. Detailed and patient-specific prompts are necessary to output tailored instructions that are accurate, understandable, and actionable.
Understanding, readiness, and response of healthcare professionals in combating falsified medical products in Eritrea: a population-based survey
Authors: Fitsum Yodit , Werede Azania , Mahmud Saleh Abubeker , Tesfamariam Eyasu H. , Magombo Francis , Misghina Freminatos , Yemane Hermella , Bahta Iyassu , Abraham Liya , Bahta Merhawi , Debesai Merhawi , Tesfagaber Meron , Ghirmai Michael , Tesfamariam Sirak , Russom Mulugeta 
Published: December 2023

Background: The circulation of falsified medical products is a global threat and is expected to be higher in low- and middle-income countries. Objective: This study was conducted to assess the understanding, readiness, and response of Eritrea’s healthcare professionals (HCPs), and identify potential areas of intervention to combat circulation of falsified medical products. Design: This was a nationwide population-based cross-sectional survey, conducted in December 2021. Methods: This study enrolled representative samples of HCPs working in public and private health facilities. Two-stage stratified cluster sampling was used to select study participants and data were collected through face-to-face interviews. Descriptive statistics, Mann–Whitney U test, Kruskal–Wallis test along with their post hoc tests, Jonckheere-Terpstra, and logistic regression analyses were performed as appropriate. Results: The study enrolled 707 HCPs, and 96.6% were successfully surveyed. The majority of the participants (62.5%) encountered products with suspected quality defects and 63.8% claimed that they had reported the incident(s) at least once. About 85% reported that complaints should be submitted to the Eritrean Pharmacovigilance Centre and 74.0% indicated that it should be reported at the earliest time possible even if the reporter lacks details. The standard reporting form for suspected product quality issues was correctly recognized by 13.8%. Overall, the median knowledge and attitude scores were found to be 9 out of 17 (interquartile range, IQR: 4.0) and 30 out of 35 (IQR: 4.0), respectively. Not knowing how to report (55.6%) and what to report (34.9%), no/delayed feedback from the regulatory authority (30.0%), and unavailability of reporting forms (29.0%) were the frequently reported barriers to reporting. In addition, profession ( p = 0.027), no/delayed feedback (adjusted odds ratio [AOR]: 4.70; 95% CI: 2.17–10.18; p < 0.001), and not knowing how to report (AOR: 0.12; 95% CI: 0.05–0.28; p < 0.001) were found to be determinants of reporting suspected product quality defects. Conclusion: The readiness and response of Eritrea’s HCPs in detecting and reporting falsified medical products seems promising, although a significant knowledge gap was observed.