bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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.
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.
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

Abstract
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

Abstract
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

Abstract
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.
Machine learning models predicting risk of revision or secondary knee injury after anterior cruciate ligament reconstruction demonstrate variable discriminatory and accuracy performance: a systematic review
Authors: Blackman Benjamin , Vivekanantha Prushoth , Mughal Rafay , Pareek Ayoosh , Bozzo Anthony , Samuelsson Kristian , de SA Darren 
Published: January 2025

Abstract
Background
To summarize the statistical performance of machine learning in predicting revision, secondary knee injury, or reoperations following anterior cruciate ligament reconstruction (ACLR), and to provide a general overview of the statistical performance of these models.

Methods
Three online databases (PubMed, MEDLINE, EMBASE) were searched from database inception to February 6, 2024, to identify literature on the use of machine learning to predict revision, secondary knee injury (e.g. anterior cruciate ligament (ACL) or meniscus), or reoperation in ACLR. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Demographic data and machine learning specifics were recorded. Model performance was recorded using discrimination, area under the curve (AUC), concordance, calibration, and Brier score. Factors deemed predictive for revision, secondary injury or reoperation were also extracted. The MINORS criteria were used for methodological quality assessment.

Results
Nine studies comprising 125,427 patients with a mean follow-up of 5.82 (0.08–12.3) years were included in this review. Two of nine (22.2%) studies served as external validation analyses. Five (55.6%) studies reported on mean AUC (strongest model range 0.77–0.997). Four (44.4%) studies reported mean concordance (strongest model range: 0.67–0.713). Two studies reported on Brier score, calibration intercept, and calibration slope, with values ranging from 0.10 to 0.18, 0.0051–0.006, and 0.96–0.97 amongst highest performing models, respectively. Four studies reported calibration error, with all four studies demonstrating significant miscalibration at either two or five-year follow-ups amongst 10 of 14 models assessed.

Conclusion
Machine learning models designed to predict the risk of revision or secondary knee injury demonstrate variable discriminatory performance when evaluated with AUC or concordance metrics. Furthermore, there is variable calibration, with several models demonstrating evidence of miscalibration at two or five-year marks. The lack of external validation of existing models limits the generalizability of these findings. Future research should focus on validating current models in addition to developing new multimodal neural networks to improve accuracy and reliability.
Comparison between relining of ill-fitted maxillary complete denture versus CAD/CAM milling of new one regarding patient satisfaction, denture retention and adaptation
Authors: Kamal Maha Nagy Mohamed 
Published: January 2025

Abstract
Purpose
This study aimed to compare different treatment modalities to correct ill-fitted maxillary complete denture either by the conventional relining method or by scanning the relining impression and digitally construct a new denture regarding patient satisfaction, denture retention, and adaptation.

Materials and methods
Twelve edentulous patients suffering from loose maxillary complete dentures were selected, dentures’ borders and fitting surfaces were prepared, and relining impressions were taken, the impressions were scanned and the STL files were used for CAD/CAM milling ( computer aided designing/ computer aided manufacturing) of new maxillary dentures (Group A), then the relining impression went through the conventional laboratory steps to fabricate (Group B) maxillary dentures. Both groups were evaluated regarding patient satisfaction by a specially designed questionnaire, retention values were measured by a digital force gauge at denture insertion appointment and two weeks later, geomagic software was used to evaluate dentures adaptation to oral tissues.

Results
Both groups (A and B) were completely satisfied with their dentures except regarding esthetics, all group A and 50% of group B were satisfied. Both groups showed a statistically significant increase in retention values at the two-week follow-up period compared to those at denture insertion time, with higher values were for group B. Finally, the relined dentures showed better oral tissue adaptation than digitally constructed dentures.

Conclusion
Relined maxillary dentures showed better retention, esthetics, and denture adaptation with lower cost than digitally constructed maxillary dentures which showed acceptable retention and adaptation, with better time and data saving.

Trial registration
Clinical trials number: NCT06366321. With registration date on ClinicalTrials.gov public website: 13/ 4/ 2024.