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GReAT:Leveraging Geometric Artery Data to Improve Wall Shear Stress Assessment
No full textLeveraging big data for patient care is promising in many medical fields such as cardiovascular health. For example, hemodynamic biomarkers like wall shear stress could be assessed from patient-specific medical images via machine learning algorithms, bypassing the need for time-intensive computational fluid simulation. However, it is extremely challenging to amass large-enough datasets to effectively train such models. We could address this data scarcity by means of self-supervised pre-training and foundations models given large datasets of geometric artery models. In the context of coronary arteries, leveraging learned representations to improve hemodynamic biomarker assessment has not yet been well studied. In this work, we address this gap by investigating whether a large dataset (8449 shapes) consisting of geometric models of 3D blood vessels can benefit wall shear stress assessment in coronary artery models from a small-scale clinical trial (49 patients). We create a self-supervised target for the 3D blood vessels by computing the heat kernel signature, a quantity obtained via Laplacian eigenvectors, which captures the very essence of the shapes. We show how geometric representations learned from this datasets can boost segmentation of coronary arteries into regions of low, mid and high (time-averaged) wall shear stress even when trained on limited data.</p
Endothelial dysfunction in critically ill patients with sepsis and COVID-19 using the albumin transudation rate:A pilot study
No full textBackground: COVID-19, sepsis, and septic shock are associated with significant endothelial dysfunction and capillary leakage, posing diagnostic and management challenges in critically ill patients. Capillary leakage, as reflected by the albumin transudation rate (ATR), may have implications for fluid dynamics and patient outcomes in these conditions. We sought to describe and compare ATR in these two related pathologies, but clinically distinct conditions. Methods: This study was conducted in 2022 across three ICUs and included 36 patients (18 with COVID-19 and 18 with sepsis). The local ethical committees approved the study. ATR, total blood volume (TBV), red blood cell volume (RBCV), and plasma volume (PV) were measured at multiple time points (Days 1, 2, 3, 7, and 10) using a 131I-albumin tracer. Data were analyzed using the non-parametric Wilcoxon rank-sum test and multivariate linear regression to identify predictors of ATR. Results: ATR was significantly higher in patients with sepsis compared to those with COVID-19 throughout the ICU stay, despite lower admission severity scores in the sepsis group. Clinical assessments of the volume status frequently misclassify TBV in patients with COVID-19 or sepsis. Patients were often deemed hypervolemic when, by objective measures, they were hypovolemic under both conditions. Conclusion: ATR was persistently elevated in critically ill patients with sepsis and COVID-19. Sepsis exhibited significantly higher ATR values, suggesting a more pronounced endothelial dysfunction. There is a frequent inaccuracy in clinical fluid status assessment, which demands more reliable diagnostic tools to better guide fluid therapy in critically ill patients.</p
Het G7-akkoord over Pijler 2 en Europa; van fiscaal multilateralisme naar strategisch realisme
No full textDeze zomer kwam de G7 onder Amerikaanse druk tot een akkoord dat Amerikaanse multinationals vrijstelt van de wereldwijde 15%-minimumbelasting (Pillar Two). Multilateraal fiscaal idealisme wordt ingeruild voor machtspolitiek en strategisch eigenbelang. Europa dreigt als enige vast te houden aan een asymmetrisch speelveld dat eerder verzwakt dan versterkt. Toch kan het momentum worden benut voor een Europees antwoord: een strategisch competitieve winstbelasting – Corporate Tax 2.0 – die fiscale consolidatie, vermogensaftrek en marktgerichte grondslagtoedeling combineert. Stilzitten is geen optie. Europa is aan zet
Wereldwijde minimumbelasting en de VS
No full textOp 30 oktober 2025 stuurde de minister van Financiën de geannoteerde agenda van de vergaderingen van de Eurogroep en Ecofinraad van 12 en 13 november 2025 naar de Tweede Kamer (Kamerbrief nr. 2025-0000493513). Op 12 november 2025 stuurde de minister de Kamer de beantwoording van de Kamervragen uit het schriftelijk overleg van 5 november 2025 inzake deze Eurogroep- en Ecofinraadvergaderingen (Kamerbrief nr. 2025-0000526601).De Kamervragen kwam vanuit de fracties van PVV, VVD en NSC en gaan onder meer over macro-economische ontwikkelingen, de kapitaalmarktunie, de digitale euro, versimpeling (decluttering), regeldruk, de herziening van deenergiebelastingrichtlijn, begrotingsregels, nieuwe eigen middelen, vermogende particulieren, de wereldwijde minimumbelasting (Pijler 2) en de Russische tegoeden en Oekraïne. Hierna bespreek ik de voor de fiscaliteit relevante thema’s, met een nadruk op de directe belastingen
Wetsvoorstel Tweede wet aanpassing Wet minimumbelasting 2024
No full textHet wetsvoorstel Tweede wet aanpassing Wet minimumbelasting 2024 maakt deel uit van de Belastingplanstukken die het kabinet-Schoof op Prinsjesdag, 16 september 2025 presenteerde. Op vergelijkbare wijze als vorig jaar bij de Wet aanpassing Wet minimumbelasting 2024 voert ook dit wetsvoorstel enige technische wijzigingen door in de Wet minimumbelasting 2024 (Pijler 2). Het wetsvoorstel incorporeert daarnaast op vergelijkbare wijze als vorig jaar aanvullende regels uit de administratieve richtsnoeren van het Inclusive Framework on Base Erosion and Profit Shifting (IF). Dit, voor zover de richtsnoeren niet enkel verduidelijken en een wettelijke grondslag vergen, en deze niet al eerder in de Nederlandse Pijler 2-implementatiewetgeving zijn opgenomen. Een deel van de richtsnoeren was al in de wetgeving opgenomen, bij de initiële implementatie in 2023 dan wel via de aanpassingen in 2024. De IF-richtsnoeren die nu in wetgeving worden omgezet, komen uit december 2023, juni 2024 en januari 2025
Rewarding the Right Way: The Effects of Forced Rating Systems on Creative Performance in Groups
No full textSubjective performance evaluation (SPE) has become a prevalent method for assessing employee performance in creative group tasks. However, the role of intragroup competition in SPE remains unclear. This study experimentally examines how SPE frameworks impact performance in creative tasks by varying levels of intragroup competition through a forced rating system (FRS), which reflects higher competition, and an unrestricted rating system (URS), which reflects lower competition. Our findings demonstrate that groups operating under an FRS achieve higher creative performance than those under a URS, outperforming them in both idea generation and idea selection. A post-experimental video analysis of collaborative behaviors indicates that heightened competition, as facilitated by an FRS, reduces free riding and increases speaking time and verbal interruptions, thus promoting a more dynamic and productive idea generation and selection process
Assessment of the content validity of the Oswestry Disability Index (ODI) in patients with Degenerative Disc Disease (DDD):a qualitative study
No full textBackgroundDegenerative disc disease (DDD) is a common disorder that can lead to chronic lower back pain (CLBP). The Oswestry Disability Index (ODI) is a well-established instrument for diseases of the lumbar spine and lower back pain (LBP), covering pain intensity and pain-related disability. This study evaluated the content validity of the modified electronic ODI among patients with DDD and CLBP in the United States (US).MethodCognitive interviews were conducted with 12 participants from the US diagnosed with DDD and CLBP using a semi-structured interview guide to assess the comprehension and relevance of the ODI. Concept saturation was achieved by the 12th interview.ResultsTwelve participants (mean age 40 years old, standard deviation 11 years) including 11 females provided interpretations of the instructions and for each section that were aligned with the intended meanings (11–12/12, ≥ 92%). Sections were relevant to participants’ experience (11–12/12, ≥ 92%), with the sex life section being less relevant (9/12, 75%). Response options were easy to understand. Participants’ interpretations aligned with response options’ intended meanings in 7/10 sections, with less alignment in the lifting, social life, sex life sections due to perceived similarities in ≥ 2 response options. Participants used different recall periods across sections, which was often related to the absence of experiencing the activity at the time of the interview. Most (7/9, 78%) preferred the use of a one-week recall period.ConclusionsThis study confirms the content validity of the ODI in patients with DDD. The ODI with a seven-day recall period would be more appropriate for use in this population to evaluate patient outcomes in a clinical trial
Atherosclerosis after pre-eclampsia:systematic review and meta-analysis
No full textObjective: Pre-eclampsia complicates up to 8% of pregnancies and is associated with increased risk of ischemic cardiac and cerebral disease, which may be prevented through management of cardiovascular risk when early disease stages are detected. This meta-analysis aimed to determine the prevalence of clinical and subclinical atherosclerosis in women after pre-eclamptic vs non-pre-eclamptic pregnancy with advancing maternal age.Methods: A systematic search of the literature was conducted in PubMed, Embase and Web of Science for studies reporting on the prevalence of atherosclerosis in women with a previous pre-eclamptic pregnancy and those with a previous uncomplicated pregnancy. Any systemic atherosclerosis documented using ultrasound or computed tomography was included. Random-effects meta-analysis was used to compute the odds ratio (OR) with 95% CI for the association between pre-eclampsia and the presence of atherosclerosis. Subgroup analysis was conducted according to average maternal age at evaluation. Results: A total of 11 articles were included (13 217 participants). The average maternal age at evaluation ranged from 32 to 60 years. Within this age range, the pooled OR for the presence of atherosclerotic plaque after pre-eclampsia was 1.57 (95% CI, 1.39–1.78). The pooled OR of developing atherosclerotic plaque after a pre-eclamptic vs non-pre-eclamptic pregnancy increased gradually with advancing maternal age. The OR was not significant in the 30–39-year-old group (0.64 (95% CI, 0.10–4.15)), but the odds of finding an atherosclerotic plaque were significantly increased after pre-eclamptic pregnancy in the 40–49-year-old group (OR, 1.59 (95% CI, 1.34–1.89)) and 50–60-year-old group (OR, 2.00 (95% CI, 1.30–3.08)). At any given age, the percentage plaque prevalence in formerly pre-eclamptic women was roughly equal to that seen 10 years later in women with a previous non-pre-eclamptic pregnancy.Conclusions: Women with a previous pre-eclamptic pregnancy exhibit atherosclerosis more frequently and approximately 10 years earlier compared with women with a previous non-pre-eclamptic pregnancy. Targeted primary prevention is required to reduce morbidity and mortality from premature cardiovascular disease in women after pre-eclampsia.</p
Labor market dynamics in a highly competitive industry
No full textWe study labor market dynamics of workers in a highly competitive industry with a highly competitive labor market. We focus on the relationship between workers’ age, wages, and productivity. Our analysis uncovers an inverse U-shaped relationship. While some wage adjustments occur within the current firm, job mobility plays a crucial role in shaping wage trajectories. There is assortative matching with highly productive workers moving to highly productive firms, while less productive workers gravitate towards less productive firms. Our findings suggest that both in-firm wage progression and wage growth via job mobility contribute to a close alignment between wages and productivity throughout workers’ careers.</p
Dynamics of participation in utilization of local value chain services:assessing barriers and enablers in Uganda
No full textIntegrating smallholders into agri-food value chains has become a widely endorsed strategy for transforming food systems and reducing poverty in agrarian communities. However, value chain development initiatives are increasingly criticized for their lack of inclusiveness—benefits tend to accrue to resource-rich households, while marginalized communities are often left behind, exacerbating social inequality. There is no clear consensus on the factors driving disparities in participation and utilization of value chain services. Using panel data from soybean smallholders in Uganda, we trace the evolution of participation in value chain service use. We employ a multinomial logit model to (a) identify the drivers and barriers to participation in value chain (VC) service utilization and (b) examine the determinants of variation in service uptake—specifically, the types and number of services used. While the Multinomial Logit Model is also used to analyse variation in service types, a Two-Part Model is applied to assess participation intensity. Our findings show that barriers such as insecure land tenure, limited education, poor access to credit, and distance from service points hinder inclusive participation. Value chain service delivery appears to operate as a mechanism for selecting more viable participants, suggesting that value chain service providers might be adopting risk-averse strategies that (whether intentionally or unintentionally) can exclude resource-poor households from accessing services. Moreover, exclusion tends to persist even after initial participation in farm-level training, limiting subsequent engagement with input and output market services. We discuss the implications of these findings for fostering more inclusive and resilient food systems.</p