World Federation Research Articles

Carbon Negative Technologies: Carbon Capture, Sequestration, and Conversion

Abstract Carbon dioxide (CO2) capture and storage are now an essential reality that we are required to adapt to address global climate change concerns. Adapting carbon neutrality or carbon negative processes in mainstream energy generation, manufacturing, and transportation is possible using current technologies, albeit with some limitations. Carbon neutral technologies (CNTs) can be seamlessly integrated with existing systems as well as green technologies to ensure that carbon capture gets a boost. On-land and undersea storage are realistic possibilities since there is immense potential to lock atmospheric CO2 using existing technologies. Thermocatalytic, electrochemical, photo(electro)catalytic, and biological – based approaches do offer promising options, but require optimization of different parameters to ensure commercial viability, scalability, and safety. The role of electrochemical process specifically is examined. New directions for further research in the area of electrochemical – driven applications are identified and opportunities in three areas, viz., electrocatalysts design, pilot scale integrated systems, and simultaneous CO2 capture and conversion, are discussed in detail. The global implementation of any CNTs requires dramatic policy shift, unequivocal support from the world governments, public acceptance, backing from industries, and unwavering financial backing from stakeholders to ensure that there is a real chance to address climate change issues.

World Federation for Medical Education Recognizes 5 International Accrediting Bodies.

World Federation for Medical Education Recognizes 5 International Accrediting Bodies.

The MARVIN Hypothesis: Linking Unhealthy Lifestyles to Intracranial Aneurysm Rupture Risk and Clinical Prognosis

Background and Objectives: The rising incidence of modifiable lifestyle risk factors and cardiovascular diseases, driven by poor diet, inactivity, excessive alcohol use, and smoking, may influence the development and rupture of intracranial aneurysms (IA). This study aimed to examine the impact of lifestyle-related and cardiovascular risk factors on IA rupture and patient outcomes. Materials and Methods: We developed the “MARVIN” (Metabolic and Adverse Risk Factors and Vices Influencing Intracranial Aneurysms) model and conducted a retrospective analysis of 303 patients with 517 IAs, treated between 2007 and 2020. Of these, 225 patients were analyzed for rupture status and 221 for clinical outcomes. The analysis focused on hypertension, diabetes, hypercholesterolemia, vascular diseases, nicotine and alcohol abuse, obesity, aneurysm rupture status, and clinical outcomes. Logistic regression was used to evaluate the impact of these risk factors. Results: Among those with risk factors, 24.9% (56/225) and 25.3% (56/221) had one, 32.0% (72/225) and 30.8% (68/221) had two, 20.0% (45/225) and 20.4% (45/221) had three, 12.0% (27/225) and 12.2% (27/221) had four, 4.0% (9/225) and 4.1% (9/221) had five, 0.9% (2/225) had six in both groups, and 0.4% (1/225) and 0.5% (1/221) had seven risk factors, respectively. Strong relationships were found between lifestyle-related vascular risk factors, indicating multiple comorbidities in patients with unhealthy habits. Smokers with ruptured aneurysms had higher WFNS (World Federation of Neurosurgical Societies) scores, but nicotine abuse did not affect long-term outcomes. The most significant predictors for poor outcomes were WFNS score and age, while age and a history of vascular diseases were protective against rupture. Despite the high prevalence of modifiable risk factors, they did not significantly influence rupture risk. Conclusions: The findings suggest a need for multifactorial risk assessment strategies in managing IA patients. Future studies with larger cohorts are required to confirm these results and better understand IA progression.

Clinical Characteristics and Outcomes in Patients with Ruptured Middle Cerebral Artery Aneurysms: A Multicenter Study in Northern China.

The long-term prognosis of ruptured middle cerebral artery aneurysms (MCAAs) in northern China remains unclear. The aim of this study is to analyze the epidemiological characteristics and long-term outcomes of ruptured MCAAs in northern China. We included patients who were consecutively admitted for ruptured MCAAs to 12 tertiary care centers in northern China from January 2017 to December 2020. Kaplan‒Meier curves were used to compare survival in hazard strata. The Cox proportional hazards model was used to analyze risk factors and mortality risk, whereas logistic regression was used to identify factors influencing 2-year survival. Subgroup analyses were performed to verify the robustness of the results. Data on 959 patients with ruptured MCAAs were analyzed; 16.4% of these patients had ruptured intracranial aneurysms (RIAs) and were registered in the Chinese cerebral aneurysm database. The mean follow-up duration was 3.0years (range 0-6.2years). The 3-month and 2-year mortality rates were 15.5% and 18.2%, respectively. The risk factors for mortality were identified via Cox regression and were as follows: age > 70years, previous stroke, combined intracerebral hemorrhage (ICH)/intraventricular hemorrhage (IVH), poor Hunt and Hess grade, multiple aneurysms, and conservative treatment (CT). The positive association between the risk of death and CT was consistent across subgroups. According to logistic regression, hypertension, previous stroke, combined ICH/IVH, Hunt and Hess grade, and WFNS (World Federation of Neurological Surgeons) score were identified as factors negatively influencing 2-year survival. We detail the epidemiologic characteristics and long-term outcomes of MCAAs. The risk factors for mortality included age > 70years, previous stroke, combined ICH/IVH, poor Hunt and Hess grade, and multiple aneurysms. Compared with microsurgical treatment (MST), CT is associated with an increased risk of mortality, while the risk of mortality associated with endovascular treatment (EVT) is not significantly different. Two-year survival was associated with hypertension, previous stroke, ICH/IVH, and poor grades at admission.

Integrating endovascular techniques into established open neurosurgery practice: a temporal analysis of treatment evolution in a dual-trained neurosurgical unit

ObjetiveIn Europe, units with Dual-trained Neurovascular Surgeons (DTNS) skilled in both open neurosurgery (ON) and endovascular neurosurgery (EN) are scarce. For instance, in Spain, our unit is unique within the public health system, where all neurovascular procedures are carried out by DTNS. Our study aims to evaluate the evolution in treating ruptured intracranial aneurysms (rICAs) and assess the impact of this evolution on clinical outcomes. MethodsA retrospective cohort study was performed on rICAs treated in our unit from October 2012 to June 2023. We reviewed clinical and radiological data to analyze the evolution of ON and EN over time, as well as their impact on patient outcomes. Univariate, multivariate, and mixed-effects models were utilized to discern temporal changes. ResultsThe modified Fisher Scale (mFS) and the modified World Federation of Neurological Surgeons scale (mWFNS) showed strong correlation with the outcome at 6 months outcomes, both with p < 0.00001. However, the surgical intervention method, ON versus EN, did not significantly affect outcomes (p > 0.85). In adjusted multivariate logistic regression, mFS (−1.579, p: 0.011) and mWFNS (−0.872, p < 0.001) maintained their significance. rICAs location was significant when comparing ON to EN p = 0.0001. A significant temporal trend favored the selection of EN p = 0.0058). Mixed-effects time series modeling indicated that while patient characteristics and rICA specifics did not predict treatment choice, the year of treatment was significantly correlated (0.161, p = 0.002). Logistic regression with interaction terms for time and treatment type did not produce significant results. ConclusionOur findings suggest that despite an increased adoption of EN techniques, there has been no change in patient outcomes. Even with the rise of EN, our unit continues to perform ON for a higher proportion of rICAs than most national hospitals. We propose that a “dual approach” offers advantages in a patient individualized treatment decision protocol in the European context.

The 1st World Congress of Nuclear Medicine and Biology held in Japan: a historical review with personal reminiscences.

The 1st World Congress of Nuclear Medicine and Biologywas held from September 30 to October 4 1974 in Japan. This was an epoch-making event in the history of Nuclear Medicine in Japan as well as in the World. The huge success of the meeting contributed a lot to the rapid and remarkable progress of nuclear medicine thereafter. The author served as a secretary of the local organizing committee for the Congress. The author would like to record the event summarizing the publications made by the local organization committee. The author would like to share with nuclear medicine professionals of younger generations the unforgettable experiences which he has kept in memory for the past half a century. The author believes this historical review will help to pave the future way of nuclear medicine by recalling how the World Federation and Congress was started with the great efforts of the excellent minds of predecessors.

Impact of age on surgical outcomes for world federation of neurosurgical societies grade I and II aneurysmal subarachnoid haemorrhage: a novel prognostic model using recursive partitioning analysis

This study aimed to evaluate age as a prognostic factor and develop a comprehensive prognostic model for patients undergoing clipping surgery for World Federation of Neurosurgical Societies (WFNS) grade I/II aneurysmal subarachnoid haemorrhage (SAH). We retrospectively investigated 188 patients with WFNS grade I/II SAH who underwent microsurgical clipping at our institute between December 2010 and January 2020. The data of 176 patients (75 with grade I and 101 with grade II) were analysed. Data on patient demographics, aneurysm characteristics, SAH factors, surgical details, and clinical outcomes were collected. Prognostic factors were assessed using bivariate and multivariable logistic regression analyses, and recursive partitioning analysis. Favourable outcomes (mRS 0–2) were observed in 76% of patients. Age, a significant negative prognostic factor in multivariable analysis (odds ratio 0.55, 95% confidence interval 0.40–0.76, p < 0.001), was cutoff at 70 years by the receiver operating characteristic curve. Patients aged ≤ 70 years had significantly better outcomes than those aged > 70 years (84% vs. 46%, respectively; p < 0.001). Epileptic seizures were significantly associated with poor outcomes in older adults (p < 0.001). A prognostic model (favourable, intermediate, and poor) based on age and postoperative adverse events showed significantly different outcomes between age groups (p < 0.001). Age was a stronger prognostic factor than WFNS grading for patients with grade I/II SAH undergoing microsurgical clipping. For patients aged ≤ 70 years, precise microsurgeries with fewer complications were associated with favourable outcomes beyond WFNS grade. For older patients, postoperative intensive seizure management may prevent poor outcomes.

Research on the Development Trend of New Energy Electric Vehicles in China based on Mathematical Model

As the global economic development moves closer to the direction of green sustainability, the international automobile market pays more and more attention to the development of new energy vehicles. New energy electric vehicle (NEV), as a kind of new energy vehicles, has developed rapidly in recent years due to its characteristics of low pollution, low energy consumption, peak power consumption and adjustment capacity, and has been welcomed by global consumers and governments. The Chinese government conforms to the development of The Times and actively promotes the development of its industry. This paper aims to study the development trend of China's new energy electric vehicles in China, through the establishment of multiple linear regression equation model analysis of different factors of new energy electric vehicles, and using the stochastic comparison model compared the influence of new energy electric vehicles on the traditional energy vehicle industry, and establish the influence factor model, analyze the international policy influence on the development of new energy electric vehicles, in the whole research process to test and the advantages and disadvantages analysis.

Knowledge gaps in diagnosing chronic polyneuropathy: Review of national guidelines.

The prevalence of chronic polyneuropathy will increase due to the aging population, and therefore, it becomes ever so important to optimize the diagnostic process. However, it is uncertain which blood tests are required and when nerve conduction studies (NCS) should be done in the workup of chronic polyneuropathy. We aimed to investigate the methodology used to develop national polyneuropathy guidelines and to provide an overview and strength of evidence of the recommendations. We searched PubMed and websites of national neurological associations as listed on the website of the World Federation of Neurology to identify national guidelines pertaining to the workup of chronic polyneuropathy by neurologists in an outpatient clinic setting. We identified three national guidelines in the United States and seven national guidelines in Denmark, France, Germany, the Netherlands, Norway, Spain, and Turkey. The methodology used to develop the guidelines differed greatly. All guidelines recommend a series of blood tests. Some guidelines advise to conduct NCS in all patients, while other guidelines advise to conduct NCS when certain symptoms are present. There is variation in recommendations about the extensiveness of NCS, but all mention measuring the sural nerve and the motor peroneal nerve. The evidence for the recommendations is graded as low. Despite some overlap, there are disparities between guidelines regarding the workup that is advised to do in patients with chronic polyneuropathy. It remains unclear which combination of blood tests are to be strongly recommended. Furthermore, it is undetermined whether NCS are always necessary.

7.O. Skills building seminar: Initiating change: Mainstreaming equity and diversity in public health

Abstract Background Consideration of the increasing population cultural and ethnic diversity and the widening of social gaps is essential for narrowing health inequities. While tailored and targeted measures for populations at risk of social disadvantage are needed, mainstreaming and integration of diversity and inclusion perspectives in all public health measures are required. To our knowledge, the EU Joint Action for Cardiovascular diseases and diabetes (JACARDI) is the first large-scale program to apply a systematic and harmonized approach for integrating equity and diversity perspectives. Objectives The main objective of the workshop is skills building in integration of equity and diversity perspectives in practice through: 1) Introducing the key requirements for achieving EU-wide programme change, drawing from several decades of experience in projects conducted in over 30 countries, including those partnered with the World Health Organization, governments and industry. 2) Outlining a practical tool in the format of an equity and diversity matrix designed for integrating equity and diversity perspectives developed within the JACARDI project to support implementation of 142 sub-projects in 21 partner countries. 3) A practical participatory group work based on the JACARDI equity and diversity maturity matrix, followed by a moderated discussion. The workshop acts as a valuable platform for sharing and building collaborative knowledge across European countries and empowering participants as initiators for sustainable, more equitable, and diversity inclusive public health actions. It provides practical and concrete skills on equity and diversity that participants can apply in their work and disseminate within their organizations. The presentations will build knowledge, while group work and the moderated discussion will build skills among participants on the workshop topic. Format of the workshop Two presentations followed by participatory group work and a moderated discussion among workshop participants and presenters. Key messages • Population diversity should be systematically mainstreamed in public health to effectively and sustainably narrow persisting health inequities. • An equity and diversity maturity matrix can be used as a practical tool for systematic integration and monitoring of diversity perspectives in practice.

Key requirements for achieving EU-wide programme change

Abstract Issue Across the world, thousands of projects aim for equitable improvement in health for people who are experiencing ongoing avoidable stigma, discrimination and disadvantage however very little change is often achieved. Description of the problem In this presentation we explore key requirements for project-level change to ensure EU-wide programme change is achieved. Results The two most common causes of project failure are a) the innovation is not suitable, needed or wanted (also called theory failure) or b) implementation failure. This presentation shares strategies to mitigate risks of project failure through co-design processes and communication, drawing from 30 years of experience from the entire implementation process from ideation to scale up. These experiences include projects from over 30 countries, including partnerships with the World Health Organization, governments and industry focused on health literacy, self-management, care pathways, workplace health, hospital services redesign, First Nations health and migrant health. Common success factors include balancing top-down needs with co-designed inputs and with previous preferred or good practice (which may have come from controlled trial evidence generated in different contexts). The intervention must co-implemented to serve stakeholder’s needs at all levels, from citizens to decision makers. Lessons The United Nations (UN) and private sector apply system-wide approaches to affect large scale change. This knowledge is valuable for large public health programmes aiming to integrate equity and diversity in project processes to minimize implementation failure.

International survey of young adults’ opinions on tobacco endgame measures &amp; e-cigarette regulations

Abstract In the last decade, while tobacco consumption has decreased, there has been a significant rise in e-cigarette usage particularly among young people. Tobacco-free generations and other endgame strategies are being considered in several countries, moving from tobacco control towards ending the tobacco epidemic. This online survey of 18-34-year-olds evaluated opinions on potential endgame measures and e-cigarette regulations, to generate evidence to inform policy decisions. The survey was developed with input from the World Federation of Public Health Associations and Tobacco-Free Ireland, asking participants about support (yes/no) for 20 endgame measures in 4 domains and attitudes towards e-cigarettes. Utilising convenience sampling, the survey was distributed through international networks. Of 295 responses in 34 countries, 72% were never smokers and 56% were never e-cigarette users. 31% were aware of tobacco endgame. 68% supported increasing tobacco purchasing age to 21. 70% supported restricting tobacco sales to a limited number of licenced shops. 73% supported reducing nicotine content in cigarettes. 74% supported tobacco companies having to pay for health costs from smoking. 73% would like to see tobacco-free generation legislation in their country, but only 31% expected it would be successful. Regarding e-cigarettes, they were judged as more desirable than cigarettes mostly due to different flavours and visual appearance (both 74%). They were perceived to be an important health risk (82%) and as or more addictive than cigarettes (78%). 65% believed overall harms from e-cigarettes outweigh benefits for society. 86% felt they should be subjected to the same advertising restrictions as cigarettes and 66% supported increasing their cost. There was strong support for various tobacco endgame measures and tobacco-free generation legislation in this 18-34-year-old cohort. The majority recognised health risks of e-cigarettes and favoured stricter regulation of these products. Key messages • An international survey of 295 young adults in 34 countries demonstrated strong support for various tobacco endgame measures including tobacco-free generation legislation. • For e-cigarettes, there was wide acknowledgement of addictiveness and health risk, and support for increased education and warnings, lower nicotine content and reduced advertising and availability.

Global health

Abstract Global health emphasizes the importance of addressing health challenges that transcend national borders and require strong international collaboration and governance. This concept is grounded in collaborative transnational actions aimed at promoting health for all, reducing disparities, and protecting against threats. Strengthening health systems, public health infrastructure, improving health service delivery, and ensuring equal access to healthcare for all are key focus areas in global health. This plenary will address several major health challenges and critical issues, such as the rising burden of non-communicable diseases, re-emerging pandemics, environmental threats, and the suboptimal responses of national healthcare systems to manage these challenges. The need to focus on vulnerable and marginalized populations, particularly those affected by migration and ethnicity, will be highlighted. The discussion will also showcase the importance of including ethnic minority and Indigenous people’s perspectives in health policy and decision-making processes, as well as addressing the social determinants of health that disproportionately affect these communities. Central to the discussion on global health is the role of global health policy and diplomacy, focusing on how countries can collaborate to address health threats and challenges, shaping international strategies and frameworks. Innovation, including reverse innovation and the development of evidence-informed policies and effective public health strategies that can be implemented globally and is relevant also in resource-constrained contexts, is another critical aspect in addressing the intersection of health and development. Finally, strong public health leadership is needed to shape practices and policies, as well as fostering the next generation of global health leaders. The multifaceted nature of global health calls for a comprehensive approach to health—one that integrates policy, leadership, and equity into the core of public health strategies. The integration of health into all policies at the global level is vital for creating supportive environments, policies, services, and communications that promote better health for all. Moderators Iveta Nagyova President EUPHA Henrique Barros President ASPHER Speakers/Panellists Emma Rawson Te Patu President World Federation of Public Health Associations Charles Agyemang Professor of Global Migration, Ethnicity &amp; Health, University of Amsterdam, Netherlands Agnès Buzyn Former Minister of Health and Social Affairs, France Moredreck Chibi Public Health Innovation Lead, WHO Regional Office for Europe

Why is regulation of the online world urgently needed to protect children’s wellbeing?

Abstract Background The online world affords children many benefits, such as connectivity and access to educational and cultural content. Simultaneously, it increases their likelihood of encountering harmful or distressing web-based content and behaviour, such as marketing for harmful products, violent or discriminatory material, and cyberbullying. Yet, there is a dearth of objective research globally on children’s real-time experiences, with current research relying on self-reports or observations made in experimental conditions. This paper reports on the nature and extent of children’s online world. Methods Kids Online Aotearoa is a cross-sectional observational study of children’s real-time experiences of the online world. A strategic sample of 180 12-year-olds from schools in the Wellington region of Aotearoa, New Zealand, used Zoom video conferencing software to record their online world for four days. Recordings were analysed manually and using AI. Results Children spend most of their time online on their phones, often using TikTok. Children spend 25 % of their online phone time gaming or watching games (game time). They encounter many gambling and gambling-like activities while doing so. Of game time, 16% of the time children are exposed to marketing. Preliminary analysis reveals that children are exposed to marketing for alcohol, junk food, tobacco, vapes and gambling. This is counter to national legislation prohibiting or restricting such marketing to children. Conclusions This novel methodology reveals the actual online experiences of children as they go about their daily lives. This includes engaging in harmful behaviours such as gambling and encountering harmful product marketing. While from New Zealand, this study is likely to be relevant for other countries given the global reach of the online world. The research indicates the urgent need for national and global government regulation of the online world to protect the rights of children and ensure their wellbeing. Key messages • Kids Online Aotearoa reveals the nature and extent of children’s online world, including their exposure to harmful product marketing. • National and global regulation of the online world is urgently needed to protect child rights and wellbeing.

RETROSPECTIVE ANALYSIS OF DESIGNING ANTI-CORRUPTION ACTS AT DIFFERENT LEVELS OF INTERNATIONAL LEGAL ANTI-CORRUPTION

It has been established that international legal countermeasures against corruption are carried out at three levels: global (by the United Nations, the Organization for Economic Cooperation and Development, the World Bank, etc.); regional integration (Council of Europe, European Union, other integration associations); bilateral intergovernmental and interagency cooperation. There is no coordination of directions and means of combating corruption between them. Therefore, international anti-corruption activities at all three levels developed not only in different directions, but also in many ways spontaneously. It has been proven that the wide participation of international organizations in the fight against corruption and the variety of anti-corruption legal means used by them contribute to the concentration and coordination of the efforts of states in the fight against corruption. Another positive effect of the acts of international organizations is also noted: drawing the attention of civil society to the tasks of combating corruption, they significantly strengthen the potential for their full solution. On the other hand, the variety of subjects and legal forms of international legal anti-corruption often create legal conflicts between acts operating in this area. Such collisions create, for example, different approaches to defining the concept of corruption. It is noted that the concepts of designing anti-corruption acts, based on the ideas and methods of system design of complex technological processes and objects, are more and more widely used in the law-making practice of international organizations and states of the modern world. Their influence on the legal regulation of social relations is increasing, confirming that at the current stage of socio-economic, technological, informational development, the complication of social relations, the rapid increase in their quantitative parameters and indicators, the growing danger of man-made and natural disasters, the introduction of system design becomes impossible. It is gradually displacing the maximally ineffective under such conditions practices of «industry», «fragmentary», «point», «situational» legal regulation. It has been established that the systematic design of anti-corruption acts primarily involves conducting comprehensive studies of law-making initiatives. In the course of such studies, all factors that may affect the intended sphere (object) of legal regulation must be analyzed; the opinions, positions, and evaluations of not only regulatory and control-supervisory state bodies, but also potential participants in the projected legal relations should be taken into account.

Surgical options for metastatic spine tumors: WFNS spine committee recommendations.

Surgical treatments for metastatic spine tumors have evolved tremendously over the last decade. Improvements in immunotherapies and other medical treatments have led to longer life expectancy in cancer patients. This, in turn, has led to an increase in the incidence of metastatic spine tumors. Spine metastases remain the most common type of spine tumor. In this study, we systematically reviewed all available literature on metastatic spine tumors and spinal instability within the last decade. We also performed further systematic reviews on cervical metastatic tumors, thoracolumbar metastatic tumors, and minimally invasive surgery in metastatic spine tumors. Lastly, the results from the systematic reviews were presented to an expert panel at the World Federation of Neurosurgical Societies (WFNS) meeting, and their consensus was also presented.

Internal evaluation of medical programs is more than housework: A scoping review.

The aim of this scoping review was to explore current program evaluation practices across various medical schools. We conducted searches in MEDLINE (Ovid), Embase (Elsevier) and ERIC (ed.gov) for original research and review articles related to medical education evaluation with key words evaluation, program, medical education, pre-registration, framework, curriculum, outcomes, evaluation, quality. We followed Arksey and O'Malley's (2005) process for scoping reviews. Thirty-two articles were included. Studies were primarily concerned with either proving (n = 21) or improving efficacy of their programs (n = 11). No studies aimed at comparing programs. Nine were literature reviews. Others aimed to develop a new evaluation model (n = 7) or apply (n = 12) or validate (n = 4) an existing model (or part thereof). Twenty-two studies explicitly identified an evaluation model they had used or would recommend. Most frequently used models for evaluation were: Context-Input-Process-Product, Kirkpatrick, World Federation Medical Education, and the Standards by Joint Committee on Standards for Educational Evaluation. Overall, evaluations were learner-focused and accreditation driven with a minority considering the broader influences of program success. Program evaluation is fundamental to driving the quality of education delivered to produce workforce-ready healthcare professionals. The focus of current evaluations is on student experience and content delivery with a significant gap in the existing literature on evaluation related to staff, learner/staff well-being, equity, diversity, and meta evaluation.

Identifying Patients at Increased Risk for Poor Outcomes Among Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients: The IPOGRO Risk Model

Background: A subarachnoid hemorrhage due to an aneurysmal rupture (aSAH) is a serious condition with severe neurological consequences. The World Federation of Neurosurgical Societies (WFNS) classification is a reliable predictor of death and long-term disability in patients with aSAH. Poor-grade neurological conditions on admission in aSAH (PG-aSAH) are often linked to high mortality rates and unfavorable outcomes. However, more than one-third of patients with PG-aSAH may recover and have good functional outcomes if aggressive treatment is provided. We developed a risk model called Identifying POor GRade Outcomes (IPOGRO) to predict 6-month mRS outcomes in PG-aSAH patients as a secondary analysis of a previously published study. Methods: All consecutive patients in poor-grade neurological conditions (WFNS IV-V) admitted to our institute from 2010 to 2020 due to aSAH were considered. Clinical and neuroradiological parameters were employed in the univariable analysis to evaluate the relationship with a 6-month modified Rankin Scale (mRS). Then, a multivariable multinomial regression model was performed to predict 6-month outcomes. Results: 149 patients with PG-aSAH were included. Most patients were surgically treated, with only 33.6% being endovascularly treated. The 6-month mRS score was significantly associated with clinical parameters on admission, such as lowered Glasgow Coma Scale (GCS), leukocytosis, hyperglycemia, raised Systolic Blood Pressure (SBP), greater Simplified Acute Physiology Score (SAPS II score), increased initial serum Lactic Acid (LA) levels, and the need for Norepinephrine (NE) administration. Neuroradiological parameters on the initial CT scan showed a significant association with a worsening 6-month mRS. The IPOGRO risk model analysis showed an association between a WFNS V on admission and a poor outcome (mRS 4-5), while raised SBP was associated with mortality. Conclusions: Our IPOGRO risk model indicates that PG-aSAH patients with higher SBP at admission had an increased risk of death at 6-month follow-up, whereas patients with WFNS grade V at admission had an increased risk of poor outcome but not mortality.

The Rise of Green Trade Policy and Its Impact on the International Market

With the increasing severity of global environmental issues, governments and international organizations are gradually recognizing the key role of green trade policies in promoting environmental sustainability. Green trade policies aim to facilitate a green transition in global trade through the formulation and implementation of environmental protection measures. These policies include carbon pricing mechanisms, green tariffs, environmental subsidies, and international coordination of environmental standards. This paper systematically analyzes the definition and development of green trade policies and explores their impact on the international market. The main content covers the reshaping of international trade flows and patterns, changes in global competitive dynamics, and the optimization and adjustment of global supply chains. The study reveals that green trade policies not only drive increased demand for eco-friendly products and technologies in the international market but also reshape global competitive dynamics and promote the greening and smart transformation of global supply chains. In the future, with the further refinement of green trade policies and strengthened international cooperation, the global economy is expected to achieve more sustainable development.

The effects of university badminton class on health and well-being in untrained college students

This study investigated the effects of a 6-week activity course on health and well-being in untrained college students. Twenty-two participants (ages 18–23) engaged in either badminton or soccer twice a week. Using Badminton World Federation (BWF) Shuttle Time Lesson Plans, both groups showed significant improvements in the quadrant jump and standing long jump tests, with badminton participants demonstrating greater gains in the quadrant jump. In addition, Resilience levels increased in both groups and exercise self-efficacy saw a larger rise in the soccer class. The data suggested that badminton might improve agility more due to the need for rapid direction changes in a smaller court. Further, university activity classes could enhance both physical and mental well-being, though prior soccer experience and limited badminton court access may boost self-efficacy more in soccer participants. Lastly, BWF Shuttle Time Lesson Plans proved effective for introducing badminton to beginners.