bluuebunny/crossref_metadata_2025 huggingface dataset:
O emprego do lheísmo em textos escritos por brasileiros no século XIX
Authors: Gibrail Alba Verôna Brito
Published: December 2024

O objetivo deste artigo é apresentar o resultado da pesquisa do uso de lheísmo em textos escritos por brasileiros no século XIX, com os dados levantados junto ao Corpus Tycho Brahe das “Cartas Brasileiras para vários destinatários” e “Atas dos Brasileiros”. O resultado da pesquisa mostra a ocorrência desse fenômeno com o clítico lhe nos paradigmas 2SG e 3SG, havendo frequência maior de ocorrência nas cartas escritas a partir de 1850, com o pronome você como forma de tratamento. Em nossa análise, o emprego do clítico lhe dativo na função de objeto direto na escrita de brasileiros do século XIX é uma das formas de manifestação da marcação diferencial do objeto, com objeto pronominal, em concordância com a proposta de Bossong (1991), adotada por Flores e Melis (2007) para o uso do lheísmo no espanhol, e defendida por Oliveira (2003) para a ocorrência desse fenômeno no Português Brasileiro contemporâneo.
A trollagem na política brasileira: efeitos de humor no discurso da extrema direita sobre a comunidade LGBTQIA+
Authors: Nascimento Myllena , Piovezani Carlos
Published: December 2024

Este trabalho pretende analisar alguns aspectos do funcionamento da trollagem no discurso político da extrema direita brasileira sobre a comunidade LGBTQIA+. Para tanto, em razão de sua ampla repercussão e de sua condição de amostra bastante ilustrativa do fenômeno pelo qual nos interessamos, elegemos como objeto de nossa análise um pronunciamento do deputado federal Nikolas Ferreira (Partido Liberal), realizado sintomaticamente no dia 08 de março de 2023. Considerando sua inscrição em certo limiar entre o humor e o discurso de ódio e sua circulação digital, buscaremos identificar, descrever, categorizar e interpretar importantes propriedades da prática da trollagem direcionada à comunidade LGBTQIA+, a produção de seus efeitos e a materialização de seus afetos. Além disso, indicaremos algumas das possíveis mutações discursivas que a trollagem parece promover em modos de dizer do discurso de ódio no campo político. Com vistas a alcançar esses objetivos, nosso trabalho se fundamentará nos postulados, noções e procedimentos da Análise do discurso de linha francesa e em aportes do pensamento de Michel Foucault sobre a ordem do discurso.
Análise dialógica de um enunciado de Poetry Slam: “Coisa de Clayton”, de Tawane Theodoro
Authors: Oliveira Simony Alves de , Marchezan Renata Coelho
Published: December 2024

Este artigo tem por objetivo principal analisar o vídeo da gravação do poema “Coisa de Clayton”, de Tawane Theodoro, declamado e consagrado campeão na final do Slam da Guilhermina no ano de 2018. Busca-se considerar, na perspectiva bakhtiniana, quais vozes e valores eclodem nesse enunciado e de que modo essas vozes e esses valores constituem o Poetry Slam no Brasil. Os resultados da análise mostram que o eu que declama no poema fala ora por si, ora por um grupo, e valora, positivamente, temas como a luta antirracista e, negativamente, o racismo; estabelecendo inúmeras relações dialógicas com a cultura hip-hop, a cultura brasileira e com o contexto do “aqui-agora” em que se realiza. O endereçamento do eu aponta tanto para “os seus”, quanto para um outro, antagonista, a quem se opõe. “Coisa de Clayton” revela um discurso da periferia, para a periferia e sobre a periferia.
O engenho didático na gramática brasileira oitocentista
Authors: Polachini Bruna Soares
Published: December 2024

Este artigo tem como objetivo tratar de gramáticas brasileiras oitocentistas que abordaram a língua portuguesa visando o ensino por meio de diferentes estratégias didáticas. Selecionamos 26 gramáticas que consideramos efetivamente pedagógicas, pois tinham um destes elementos: gênero textual tradicional de ensino; recursos mnemônicos; método intuitivo; relação com sala de aula. Primeiramente, apresentamos os objetivos expressos pelos autores em seus prólogos. Em seguida, investigamos os diferentes recursos didáticos encontrados nesse corpus, a saber: poesia, diálogos, questões conceituais, sínteses de conteúdo, método intuitivo, organização da obra em lições, diretrizes ao professor e, finalmente, exercícios de análise linguística. Com isso, pretendemos dar um panorama geral da inventividade didática na gramática brasileira oitocentista.
Uma nota acerca da matriz repunidade
Authors: Santos Douglas Catulio , Costa Eudes Antonio , Monteiro Francival Santos , Souza Vitor Manoel Alves de
Published: December 2024

O estudo investiga a sequencia repunidade, caracterizados por uma recorrência linear de segunda ordem. Empregando a teoria de Horadam a sequência e a álgebra matricial, elucidamos a sequência, destacando o papel central da matriz geradora na análise de sequência. Os resultados revelam uma profunda inter-relação entre as propriedades da sequência e da matriz. A investigação culmina em um exame meticuloso das propriedades aritméticas e numa interpretação da matriz repunidade. Metodologicamente, integra análises teóricas e matriciais, enraizadas em recorrências e álgebra linear, oferecendo uma visão acadêmica abrangente sobre as complexidades das sequências.
Sobre o lançamento de projéteis
Authors: Silva Ricardo Parreira da
Published: December 2024

Embora o estudo da trajet´oria de proj´eteis, em lançamentos obl´ıquos e sob condiç˜oes ideais, seja um t´opico recorrente durante o per´ıodo que compreende o final do ensino m´edio at´e as disciplinas universit´arias b´asicas de C´alculo e F´ısica, seu tratamento nesse contexto, invariavelmente o apresenta como uma mera aplicac¸˜ao das noç˜oes dos movimentos: uniforme e uniformemente variado em duas dimens˜oes. Assim sendo, propriedades importantes e aplicaç˜oes relevantes s˜ao, em geral, negligenciadas. Neste artigo desenvolvemos a teoria do lanc¸amento obl´ıquo de proj´eteis sob condiç˜oes ideais e destacamos suas principais propriedades. Apresentamos uma s´erie de aplicaç˜oes interessantes e n˜ao triviais, que podem, inclusive, serem estendidas para al´em do escopo deste texto, vide, por exemplo, [1].
The Comparative Efficacy and Safety of Sweet Solutions to Reduce Preterm Infants’ Pain Level: A Systematic Review and Network Meta-analysis
Authors: Efendi Defi , Kang Yi-No , Natalia Regina , Milanti Ariesta , Marsubin Putri M.T. , Kustanti Christina Yeni , Chen Kee-Hsin
Published: December 2024

Background: The efficacy of sweet solutions in alleviating pain for preterm infants has been extensively investigated, yet the most efficacious sweet solutions remain unknown.
Methods: We conducted a search in the CINAHL, MEDLINE, EMBASE, CENTRAL, Scopus, and ProQuest databases for studies. Randomized controlledtrials (RCTs) utilizing glucose, sucrose, or expressed breast milk for managing pain in preterm infants were included in this study. A random-effects frequentist network meta-analysis was conducted to evaluate outcomes in three pain measurement time points. The primary outcome was the pain level in the reactivity phase. The secondary outcomes were pain in the regulation and recovery phases, as well as heart rate, oxygen saturation, respiratory rate, crying time, and adverse events. P-scores and beading plot were utilized to rank the efficacy of the sweet solutions.
Results: Of 10,043 references, 42 RCTs (2,733 newborns) were analyzed. Compared to the controls alone, glucose (standardized mean difference [SMD], -0.72; 95% confidence interval [CI], -1.19 to -0.25]) and sucrose (SMD, -0.56; 95% CI, -1.04 to -0.07]) were associated with lower pain responses in reaction phase. In the regulation and recovery phases, pain reduction was consistently linked to glucose, sucrose, and expressed breast milk. Those interventions were supported by results of P-scores that ranged from 0.877 to 0.917 showing glucose's superiority in the three phases. Glucose was associated with a higher risk of adverse events. Half of the 38 trials had a low risk of bias. Meanwhile, the certainty of the evidence was high to very low.
Conclusions: Our findings indicate that glucose was ranked best for lowering pain in preterm infants, followed by sucrose and expressed breast milk. Future RCTs are expected to investigate the efficacy of sweet solutions, both alone and combined with other pain management methods, as well as the effects of repeated applications.
Systematic review registration: PROSPERO CRD42023389288.
Cost-effectiveness analysis of PD-L1 testing associated with pembrolizumab for first-line treatment of advanced non-small cell lung cancer in China
Authors: Wu Yao , Tao Libo , Liu Chang , Wang Fangxu , Sun Shuang
Published: December 2024

Background: Lung cancer is the leading cause of cancer-related deaths in China, and pembrolizumab shows differential efficacy in advanced non-small cell lung cancer (NSCLC) with different PD-L1 expression levels.
Aim: To assess the cost-effectiveness of PD-L1 testing associated with pembrolizumab for first-line treatment of NSCLC from the perspective of Chinese healthcare system.
Method: Over a lifetime horizon, a three-state partitioned survival model was developed to assess the cost-effectiveness of PD-L1 testing and no PD-L1 testing. In the PD-L1 testing group, patients were stratified by PD-L1 tumor proportion score (TPS) ≥50%, 1-49%, or <1% and received pembrolizumab monotherapy, pembrolizumab plus chemotherapy, or chemotherapy alone, respectively. In the non-PD-L1 testing group, all patients received pembrolizumab plus chemotherapy. Model inputs were obtained from published literature and a healthcare price database, and clinical outcomes from two randomized clinical trials were used. The net monetary benefit (NMB) was estimated for the PD-L1 testing group versus the non-PD-L1 testing group. Deterministic and probabilistic sensitivity analyses, and scenario analyses were conducted to assess robustness of results.
Results: Using PD-L1 testing to guide treatment led to cost savings of $49,392.7 and a reduction in quality-adjusted life years (QALYs) of 0.234, resulting in a positive NMB of $46,421.7 at a willingness-to-pay (WTP) threshold of $12,680.8/QALY (GDP per capita in China, 2023). Findings were robust across sensitivity and scenario analyses.
Conclusion: Using PD-L1 testing to guide first-line pembrolizumab treatment in patients with advanced NSCLC is a cost-effective strategy at a WTP threshold of $12,680.8/QALY for China.
Denosumab Usage in Rare Cemento-Osseous Dysplasia Involves the Whole Mandible, Including the Bilateral Condyle—A Case Report
Authors: Chiang Chieh Ling , Huang Tzu Huan
Published: December 2024

Background
Cemento-osseous dysplasia is the most common type of apical radiopaque lesion in the tooth-bearing area. However, large destructive lesions are rare. We report a case in which the lesion extended to the bilateral condyle and whole mandible and was managed with denosumab instead of surgical resection.
Case Presentation:
A 45-year-old woman with destructive progressing large cemento-osseous dysplasia involve the whole mandible, including the bilateral condyle and bony expansion, which led to facial deformity and malocclusion. She was hesitant about the surgical option of resection of the whole mandible and turned to the off-label use of denosumab. After 9 months of administration, rapid ossification of the osteolytic lesion was observed, but there was no obvious change in volume. A bone scan with SPE-CT revealed stable disease with no progression.
Conclusion:
Denosumab may be considered a potential medical treatment option to prevent the progression of severe destructive cemento-osseous dysplasia in patients with limited surgical options.
Comparative Study of a Reinforced Concrete Frame Design Based on American Concrete Institute (ACI-318) and British Standards (EN 1992)
Authors: Sebahire Felicien , Nsanzimfura Theoneste , Imanaturikumwe Cyprien , Hafashimana Felix
Published: December 2024

The level of development of a country is generally perceived in its infrastructures that create good working conditions. The availability of decent infrastructure such as houses, roads, airports, dams, etc. not only increases the national revenues but also brings good humor to the population. In most developing countries, civil engineers, architects, and building constructors have to refer to the standards already created from the developed countries, like the United States of America (USA) and Canada with their American Concrete Institute (ACI-318) standard, and the United Kingdom (UK) with its British Standards (EN 1992). The construction of stable and safe infrastructures is based on design before, to check their workability during the exploitation and serviceability. During the design of any structure, standard codes of practice are directly involved because they give an extent to which the design engineer must refer, thus speeding up the task. In this research, EN 1992 and ACI-318 codes were used to compare the results from the design of a reinforced concrete (RC) frame of a commercial building according to the recommendations from both standards. This paper mainly consists of a double note of calculus done on every structural member, such as a panel slab, a continuous beam, a column, and a pad footing. The design was done at Ultimate Limit States (ULS) and Serviceability Limit States (SLS) in both cases. ArchiCAD and LINPRO softwares have been used, respectively, to produce the figures and calculate the shears and moments in structural members. The results showed that the use of BS code needs more time to reach the same final answer as that of ACI, but it provides fewer sectional areas of the main steel reinforcements. Concerning the structural safety and serviceability of the element to be designed, the calculations done on BS code gave much bending moments and axial internal loads in all performed cases. In this study, other researchers and design engineers are invited to conduct similar work by comparing other codes of practice so that developing countries have their own codes of practice.
Remote Sensing Image Super-Resolution Reconstruction by Fusing Multi-Scale Receptive Fields and Hybrid Transformer
Authors: Liu Denghui , Zhong Lin , Wu Haiyang , Li Songyang , Li Yida
Published: December 2024

To enhance high-frequency perceptual information and texture details in remote sensing images and address the challenges of super-resolution reconstruction algorithms during training, particularly the issue of missing details, this paper proposes an improved remote sensing image super-resolution reconstruction model. The generator network of the model employs multi-scale convolutional kernels to extract image features and utilizes a multi-head self-attention mechanism to dynamically fuse these features, significantly improving the ability to capture both fine details and global information in remote sensing images. Additionally, the model introduces a multi-stage Hybrid Transformer structure, which processes features at different resolutions progressively, from low resolution to high resolution, substantially enhancing reconstruction quality and detail recovery. The discriminator combines multi-scale convolution, global Transformer, and hierarchical feature discriminators, providing a comprehensive and refined evaluation of image quality. Finally, the model incorporates a Charbonnier loss function and total variation (TV) loss function, which significantly improve training stability and accelerate convergence. Experimental results demonstrate that the proposed method, compared to the SRGAN algorithm, achieves average improvements of approximately 3.61 dB in Peak Signal-to-Noise Ratio (PSNR), 0.070 (8.2%) in Structural Similarity Index (SSIM), and 0.030 (3.1%) in Feature Similarity Index (FSIM) across multiple datasets, showing significant performance gains.
Towards Equitable Maternal Care in Obstetric Anal Sphincter Injuries (OASI): Co- developing strategies for reducing risks and improving the lived experience of women and families of ethnically diverse origin
Authors: Olakotan Olufisayo , Lim Jennifer , Bhavsar Mina , Siddiqui Farah , Ayaz Rabina , Henry Gillian O’Brady , Sudhakar Vedhapriya , Pillay Tilly
Published: December 2024

Background: Women from minority ethnic groups are found to have the highest prevalence for obstetric anal sphincter injuries (OASI) or third and fourth degree occurring during childbirth. Co-producing strategies with the target individuals/community is key to producing care and services that will meet their needs, resulting in higher chances of effectiveness. Incorporating the voice of mothers experiencing higher risk of OASI to develop strategies to improve OASI care are required.
Aim: To co-develop, with women and families at high risk for and with lived experience of OASI, strategies aimed at improving their care and well-being.
Methodology: Women and families at high risk of, and with lived experience of OASI in Leicester, UK, were invited, through our local maternity and neonatal voices partnership, to participate in a virtual focus group discussion (FCD). Seven women of diverse ethnic background with lived experience of third- and fourth-degree perineal tear between 1 to 5 years, participated in the study. The discussion was recorded and transcribed. The data was analysed using the five-step thematic analysis approach by Braun and Clarke.
Results: The group of women identified strategies that would provide culturally appropriate OASI care, namely: linguistically accessible prenatal resources, comprehensive midwifery training, updated prenatal education, standardized postpartum care, and the inclusion of fathers in prenatal education, empathetic care, and trust, as well as community engagement and education.
Conclusion: This highlights the important role of co-developed care in improving maternal healthcare for women with OASI from diverse ethnic backgrounds. Integrating the voices of women directly affected by OASI can offer valuable insights for the development of culturally sensitive policy and practice in maternal care.
Shadow Economy and Economic Growth Nexus in Developing Countries: What is the Role of Financial Inclusion?
Authors: Waqar Ahmad , Babar Hussain , Khalid Muhammad Waqas , Lambarraa-Lehnhardt Fatima , Umair Muhammad
Published: December 2024

Shadow economy (SE) creates a significant barrier to economic progress in developing economies, whereas financial inclusion (FINI) plays a crucial role in boosting economic performance. This study examines the impact of the SE on economic growth (ECOG) and explores how this relationship is moderated by FINI. We use two key dimensions of FINI including financial market development (FMD) and financial institution development (FID). We apply system GMM and difference GMM techniques on a dataset of 120 selected developing economies worldwide, spanning the years 2002 to 2020. The estimation results reveal that a sizeable SE significantly hampers ECOG, while higher levels of FINI improve it. Additionally, financial inclusion, particularly through the development of financial markets and institutions, moderates the adverse effects of the SE on ECOG, suggesting a significant substitutability between the SE and FINI. This indicates that increasing FINI can reduce the shadow economy's size and mitigate its harmful effect on ECOG. These results remain robust when using an alternative measure of the SE. Based on the findings; we recommend that governments promote financial inclusion initiatives, such as expanding banking services, advancing mobile banking, and increasing financial literacy.
Analysis of Gene mutation types and clinical characteristics of patients with familial hypercholesterolemia in Shijiazhuang
Authors: Hu Xitian , Wei Zeqian , Geng Shuchen , Wang Shuo , Chen Liyuan
Published: December 2024

Objective This study aimed to investigate the incidence, types of gene mutations, and clinical characteristics of familial hypercholesterolemia (FH) in Shijiazhuang, while evaluating the effectiveness of targeted sequencing combined with high-risk population screening for FH. Methods A cross-sectional study was conducted involving 941 randomly selected normal individuals and 83 high-risk individuals. All participants underwent targeted sequencing for Low Density Lipoprotein Receptor (LDLR), Proprotein Convertase Subtilisin/kexin Type 9 (PCSK9), and Apolipoprotein B (APOB). Logistic regression and ROC curves were used to analyze predictive factors for gene mutations. Results The mutation rate of LDLR in the general population is 0.318%, while the mutation rate of PCSK9 is 0.106%. In contrast, among high-risk groups, the LDLR mutation rate increases significantly to 18.072%, and the mutation rate of APOB is 1.204%. Predictive factors for carrying mutated genes were TG (odds ratio [OR] = 0.328, 95% confidence interval [CI] = 0.164–0.893, p = 0.026), incidence of fatty liver (OR = 0.274, 95%, CI = 0.081–0.924, p = 0.037), body mass index (BMI) (OR = 0.775, 95% CI = 0.637–0.944, p = 0.011), incidence of fatty corneal arch (OR = 3.375, 95% CI = 1.124–10.131, p = 0.030), DLCN score (OR = 2.075, 95% CI = 1.433–2.951, p < 0.050), respectively. The areas under the ROC curves of TG, DLCN scores, and BMI were 0.757 (cutoff value, 1.420), 0.854 (cutoff value, 5.500), and 0.734 (cutoff value, 24.950) respectively. Conclusions Targeted sequencing of LDLR, PCSK9, and APOB effectively identifies FH-related mutations, especially in high-risk populations, enhancing detection rates while reducing costs.
Identification and Validation of a Novel Machine Learning Model for Predicting Severe Pelvic Endometriosis: A Retrospective Study
Authors: Cao Siqi , Li Xingzhe , Zheng Xin , Zhang Jiaxin , Ji Ziyao , liu yanjun
Published: December 2024

Background
Severe endometriosis significantly impacts the quality of life, particularly in women of reproductive age. Though numerous studies have conducted predictive models with preoperative clinical data for endometriosis, most risk models focus on diagnosis rather than disease staging. This study aimed to explore potential factors for endometriosis severity and to develop a classification model to assess the accuracy of predicting the risk of severe endometriosis.
Methods
A total of 308 patients with endometriosis were retrospectively analyzed. The stage of endometriosis was classified according to the scoring system of the revised American Society for Reproductive Medicine (rASRM) system, through surgical visualization,which is the most widely used staging system globally. All patients underwent preoperative transabdominal and transvaginal ultrasound, based on four steps screening approach proposed by The International Deep Endometriosis Analysis (IDEA) consensus. We randomly divided these data into training and testing datasets at a ratio of 8:2. Least absolute shrinkage and selection operator (LASSO) was performed to identify the potential risk factors for severe endometriosis. Then, we used 7 machine learning(ML) models to construct the predictive models. The area under the receiver-operating-characteristics curve (AUC) and accuracy were used to evaluate and determine the most effective model. Finally, SHapley Additive exPlanations (SHAP) interpretation was calculated to evaluate each parameter's contribution to risk prediction.
Results
In this retrospective study, about 59.2% (183/308) of endometriosis patients were diagnosed with severe endometriosis. The predictors of severe endometriosis occurrence were found to be compliance of 18 factors such as the negative sliding sign, pelvic fluid, bilateral OE, serum CA125 level and severe dysmenorrhea according to LASSO. The random forest (RF) model performed best in discriminative ability among the 7 ML models. After reducing features according to feature importance rank, an explainable final RF model was established with 6 features. The final model could accurately predict severe endometriosis with the area under curve (AUC) of 0.744 and an accuracy of 0.667 in the test set. From the SHAP map, it was found that the negative sliding sign had the greatest impact on the diagnostic performance of the RF model.
Conclusions
We constructed a predictive model based on the ML model, and the RF model showed a better performance. we also provided a personalized risk assessment for the development of stage IV in endometriosis patients explained by SHAP. This can help clinicians to treat severe endometriosis.
Prediction of Epileptic Seizure Using Deep Learning Techniques
Authors: Krosuri Lakshmi Revathi , Gundam Siddartha Reddy , Datti Mounika Lakshmi
Published: December 2024

Epilepsy, a widespread neurological condition affecting more than 65 million individuals globally, poses a significant challenge for over 30% of cases resistant to conventional medical or surgical interventions. This addresses the need for effective seizure prediction to counter the consequences of epilepsy through early detection of seizures. They occur in four primary states: the preictal phase, signaling occurrence of seizures earlier; ictal, the active seizure period; postictal state ensues after the seizure; and interictal, the baseline between seizure. In this proposal, a novel deep learning based epileptic seizure prediction approach using EEG signals has been introduced. It begins with the preprocessing of scalp EEG signals, followed by the automated extraction of features utilizing convolutional neural networks. Utilizing Bi-LSTM facilitates the classification process in the proposed methodology. The classification process is facilitated by Bi-LSTM, achieving a remarkable accuracy of 99.61% and specificity of 0.9961. This approach holds promise for improving quality of life by effectively mitigating the impact of seizures through timely intervention and accurate classification.
Comparison of three different protocols for the preparation of dental implant drilling sequences (Conventional, Undersized surgical technique and Expander-osteotome): Ex-vivo study
Authors: Ferreira Anderson Jara , Cáceres-Barreno Andrés , Gaêta-Araujo Hugo , Haiter-Neto Francisco , Guimarães Camila Coelho , Dias-Ribeiro Eduardo , Asprino Luciana
Published: December 2024

Objective: To compare the effect of three types of surgical site preparation protocols on the primary stability of dental implants installed in poor quality bone. Material and methods: After analysis by X-ray microtomography, thirty bone blocks with poor bone quality were chosen and divided into three groups (N = 10). Control: Conventional; Undersized surgical technique and Expander-osteotome. The final insertion torque and the implant stability quotient were recorded. Statistical analysis included the Shapiro-Wilk test, One-way ANOVA, with Tukey's post-hoc and Pearson's correlation coefficient with a significance level of 5%. Results: The undersized surgical technique obtained higher final insertion torque values (p <0.05) and better results in terms of resonance frequency analysis values (p <0.05). Pearson's correlation test showed a strong correlation between the variables (p < 0.05). Conclusions: According to the methodology used, the undersized surgical technique proved to be more advantageous in regions of low bone quality.
Comprehensive analysis of the nasopharyngeal microbiome and host transcriptome in children with varying severity of respiratory syncytial virus infection
Authors: Wang leying , Li Haiyan , Liu Zhenwei , Weng tingting , chen Xiaofang , Liu Peining , Dong lin
Published: December 2024

Background: The majority of children hospitalized with severe respiratory syncytial virus (RSV) infection do not exhibit conventional identifiable risk factors. The composition of the respiratory microbiota, in conjunction with host factors, significantly influences the initiation and progression of respiratory tract infections. We hypothesized that the severity of RSV infection in children is influenced by the interplay between host immune response regulation and the respiratory microbiota.
Methods: 16S rRNA sequencing was conducted on nasopharyngeal aspirate samples from pediatric RSV-infected patients (n = 129) and healthy controls (HCs; n = 21). Leukocyte transcriptomics was conducted using whole blood samples from 75 RSV-infected children and 40 age-matched HCs. Patients were grouped by severity of illness. To identify pathologic regulatory mechanisms, advanced computational methods were employed to analyze and integrate these datasets.
Results: Compared with HCs, RSV-infected children exhibited decreased microbial diversity, and higher relative abundances of the genera Pseudomonas, Achromobacter, and Variovorax that were positively correlated with the severity of infection. Transcriptomics uncovered 1,016 differentially expressed genes (DEGs) in the mild-, moderate-, and severe-infection groups versus the HC group. Of these, the 169 DEGs were common to all three infection groups were mainly enriched in processes related to hydrogen peroxide catabolic precursors, host entry mechanisms, response to lipopolysaccharide, and receptor-mediated endocytosis of viruses by host cells.Integrated microbiome and transcriptome analyses revealed strong correlations between two characteristic genera and two genes.
Conclusions: The respiratory microbiota is useful to distinguish severity of infection. Specifically, interactions between RSV and nasal microbes may regulate the host immune response, potentially affecting the severity of clinical diseases.
Impact of Lipid-Lowering Therapy on Pancreatic Health: Insights from Mendelian Randomization
Authors: Yang Ge , Feng Yizhuo , Ou Yanjiao , Zhang Hong , Tang Can-E , Chen Yongchuan
Published: December 2024

Pancreatic diseases, usually including various pancreatitis, pancreatic cancer and pancreatic cysts, present great challenges to the global health care system. Abnormal lipid profiles are common in these pancreatic diseases, suggesting the lipid-lowering medications may have potential effects on them. However, given the current evidence, the effects of lipid-lowering drugs on pancreatic diseases are inconsistent. Therefore, this study employs drug-targeted Mendelian randomization to investigate the causal relationships between hypocholesterolemic drugs (statins, ezetimibe and PCSK9 inhibitors) and various pancreatic diseases. The findings of our results indicate significant associations between the genetically proxied inhibition of HMGCR and decreased risks of chronic pancreatitis and pancreatic cysts, while PCSK9 inhibition is associated with an increased risk of alcoholic chronic pancreatitis. In addition, NPC1L1 inhibition is linked to an increased risk of pancreatic cysts and benign pancreatic tumors. These results provide insights for screening personalized medications for pancreatic diseases, highlighting the potential benefits of statins in pancreatitis and its complication and the need for caution when prescribing specific lipid-lowering drugs to patients predisposed to pancreatic conditions.
Assessment of Submandibular Fossa Depth and Diameter of Mandibular Canal Using Cone Beam Computed Tomography: A Comparative Study
Authors: Livingstone Shilpa , . Shivaprasad , Ayoob Aneesa , Shetty Devika , M Shruthi
Published: December 2024

Introduction
The submandibular fossa (SF) is a depression on the lingual surface of the mandible, extending from the distal of the mental foramen to the mandibular third molars. It houses the submandibular salivary gland, influencing its depth and shape. Accurate knowledge of SF and mandibular canal (MC) anatomy is crucial for preventing complications during oral surgeries, such as dental implant placement and extractions. This study aims to assess the SF depth, MC diameter, and concavity angles between males and females.
Methodology
The study included 160 patients (80 females and 80 males) aged 18–35 years who underwent CBCT imaging of the mandible. The images were analysed using NNT viewer software, focusing on the interradicular regions of the first and second molars. SF depth was categorized into three types: Type I (< 2 mm), Type II (2–3 mm), and Type III (> 3 mm). Measurements of MC diameter and concavity angles were also taken. Statistical analysis was performed using the unpaired t-test and Chi-square test, with significance set at p < 0.05.
Results
Type I SF depth was the most prevalent in both genders, with 70% of females and 60% of males exhibiting this type. However, males generally exhibited greater SF depth, averaging 2.0 mm compared to 1.7 mm in females, and larger concavity angles, with an average of 39° in males and 35° in females. Significant gender differences were observed in MC diameter, which was larger in males, averaging 2.9 mm compared to 2.7 mm in females, particularly on the right side. The SF depth was greater on the left side for both genders, with an average of 1.8 mm on the left side compared to 1.6 mm on the right side.
Conclusion
This study emphasizes the significance of anatomical variations, highlighting the necessity of detailed preoperative imaging for dental implant placement. Such imaging ensures an accurate assessment of bone morphology and dimensions, thereby minimizing surgical risks and improving patient outcomes.
Nonlinear association of the visceral adiposity index with migraine among the U.S adults from NHANES: a cross-sectional study
Authors: Lan Yang , Zijian Tang , Chen Qiwei , Yang Lu , Junqiang Chen.
Published: December 2024

Background
As a primary headache disorder impacting the neurovascular system, migraine has been linked to a higher risk in obese individuals relative to those with normal weight. Nonetheless, data regarding the association between central obesity and migraine are limited. The Visceral Adiposity Index (VAI) serves as an indicator of abdominal fat distribution and the functionality of adipose tissue. This study aims to examine the association between VAI and the risk of migraine in the adult U.S. population.
Methods
This research utilized data gathered from adult subjects during the 1999–2004 phase of the NHANES. Weighted multivariable logistic regression and smoothed curve fitting analyses were conducted to explore the potential associations between VAI and migraine. In addition, two-piecewise logistics regression models were used to calculate inflection points, we also conducted subgroup analysis, interaction tests to determine the consistency of findings.
Results
A total of 4503 participants(weighted mean age 46.35 years; 49.28% male) in this study, 868(19.28%) had a self-reported history of migraine. In the fully adjusted model, there is a 19% increased chance of getting migraine for every unit increase in the VAI after ln transformation(OR = 1.19, 95%CI:1.04–1.36). When VAI was converted from continuous variable into tertiles, participants in the highest VAI tertiles(T3) had a significantly 32% increased risk of migraine compared with those in the lowest tertile (OR = 1.32, 95%CI: 1.02–1.71). Furthermore,the multivariate smooth splines analysis demonstrated a non-linear relationship between VAI after Ln transformation and migraine (P for nonlinearity < 0.05), with an inflection point of roughly 0.64. The subgroup analyses, adjusted for all covariates, were in line with the overall population findings, and also revealed interactions between stroke and the outcome within the subgroups.
Conclusion
The study revealed a non-linear relationship, suggesting that VAI, being a noninvasive measure of visceral adiposity, might be utilized for a straightforward assessment of migraine risk, thereby serving as an innovative marker.
Estimation of Informal Economy in Pakistan Through Monetary Approach
Authors: Jehan Yasir , Khan Rohina
Published: December 2024

This study purposes to estimate Pakistan’s informal economy by monetary methods. The other objective of the study is to find that if tax evasion is playing a major role in the informal economy. Ordinary least square is used for estimation. From the monetary approach, we conclude that informal economy is increasing. In our study, particular implications of the informal economy are identified and conferred to accomplish and achieve the goal of continuous growth and progression of a country. The estimated result shows that informal economy grew rapidly to 13541.4 billion in 2017. On the other side, tax evasion grew rapidly from 2005 to 76184.1 billion and increases to 1886700.0 billion. The informal economy plays a main role in income inequality and reducing the poverty. It limits the implementation of the operative public policy. The government should make such policies to control the informal economy and increase tax evasion.
Challenges of getting to B (Briefing / Preoperative goal setting) in the BID model
Authors: Poola V. Prasad , Boehler Margaret , Roberts Nicole K
Published: December 2024

Purpose:
Implementing effective operative teaching models such as Briefing, Intra-operative teaching, and De- briefing (BID model) begins with establishing pre-operative teaching goals. However, the practice of setting pre-operative teaching goals is not widespread. This study aims to investigate the benefits, barriers, and facilitators of pre-operative goal setting as perceived by faculty surgeons.
Methods:
This qualitative study involved interviews with faculty members from our general surgery residency program, utilizing a standardized questionnaire. The interviews were recorded and transcribed. Qualitative analysis software (ATLAS.ti.9) was used to analyze the transcripts. We report the themes and relational networks.
Results:
All eight participants agreed that preoperative goal setting enhances teaching and improves resident satisfaction. However, individual and systemic barriers prevent this from being routinely practiced. These barriers include a belief that non-deliberate teaching is effective, administrative burdens that lead to organizational challenges and faculty burnout, workflow designs that hinder the alignment of faculty and residents for operative teaching, and a lack of clear expectations. Facilitators of incorporating preoperative goal setting into routine teaching practice include educating both faculty and residents, establishing realistic expectations, and aligning educational goals in the operating room. Faculty should be able to express their preferences for how and when to set preoperative goals. Cultivating a culture that considers preoperative goal setting as integral to operative teaching is essential for sustaining this practice.
Conclusions:
Despite recognizing its benefits, preoperative goal setting is not consistently practiced. This study identifies both individual and systemic barriers, as well as facilitators, that can guide efforts to promote and enhance the practice of preoperative goal setting.
Inflections in Learner Sentiment on the Culture of Surgery
Authors: Wagner Justin P. , Huang Ivy A. , Chen Formosa , Wu James , Tillou Areti , MacQueen Ian T. , Chen David C. , Rogers David A.
Published: December 2024

Purpose
Students’ preconceptions about workplace culture may influence the learning environment in the Surgery clerkship; however, the time at which students develop these sentiments is unclear. We aimed to identify inflections in students’ preconceptions of the culture of surgery, which are relevant to the timing of interventions targeting the surgical learning environment.
Methods
Cohorts of students at multiple levels received surveys between July 2021-September 2023 soliciting words associated with, “Culture of Surgery.” We analyzed entries using a Bag-of-Words method, with each word representing a unique token, and determined the most prevalent words. In sentiment analysis, 2 raters independently assigned a positive, neutral, or negative valence to each word, and valence agreement was assessed. We compared proportions of valences and rater agreement among cohorts with Fisher exact tests and determined inflections in sentiment along the learning continuum.
Results
Participants included 50 undergraduates, 111 first-year medical students, and 216 clerks beginning Surgery rotations. “Intense” was the most common word associated with “Culture of Surgery” at all levels. Sentiment analysis comparing pre-medical undergraduate students and first-year medical students revealed profound differences in proportions of words with positive (58.9 vs 13.3%, p<0.001) and negative (20.0 vs 57.0%, p<0.001) valences. Non-pre-medical undergraduate students’ word valences were even more frequently positive (71.6%) and less frequently negative (7.1%). Sentiments did not change appreciably among medical students at all levels. The range of rater agreements was 62.3-78.6%.
Conclusions
Prior to medical school, students have predominantly positive sentiments about surgical culture, while negative preconceptions predominate early in medical school and persist into clerkships. Interventions should be designed to encourage surgeons’ contributions to all aspects of undergraduate medical education culture.
Anti-GluK2 Antibody-Positive Autoimmune Encephalitis Concurrent with Multiple Myeloma: A Case Report
Authors: Cheng Zheng ping , Song Yang , Zhao Shuqi , Sui Xiaowen , Xie Lili , Zhao Hongling , Pan Xin , Cui Li , Huang Xinran , Ma Shubei
Published: December 2024

Background It is the first reported instance of GluK2 antibody-associated autoimmune encephalitis with involuntary movement.
Case presentation A 60-year-old woman who experienced involuntary movements of her lower limbs and facial muscle for two years，sometimes accompanied with hysterical shouting. Ater the treatment for multiple myeloma, bone marrow examinations showed that the proportion of myeloma cells have a sustained decline which indicated the treatment worked, meanwhile, all the symptoms disappeared and the concentrations of anti-GluK2 antibody IgG decreased sharply.
Conclusions This case revealed that the involuntary movements and the emotion is a new phenotype of Anti-GluK2 Antibody-Positive Autoimmune Encephalitis.
Identification of a Candidate Risk Model Based on Cancer- Associated Fibroblasts-Related Gene Signature Predicting the Prognosis in Hepatocellular Carcinoma
Authors: Dai Bin , Wang Wei , Li Yanan , Zhou Chen , Ran Jun , Shang Runze , Xia Hui
Published: December 2024

Background
Cancer-associated fibroblasts (CAFs) play vital roles in HCC initiation and progression via multicellular, stromal-dependent manners. Despite their acknowledged significance, the comprehensive role of CAFs-related gene signatures in HCC and their prognostic implications remain underexplored. Here, we constructed a prognostic signature based on CAFs-related differentially expressed genes in HCC.
Methods
We conducted a comprehensive analysis using RNA sequencing data from the TCGA database and a validation cohort from the ICGC database. Differential gene expression analysis identified CAF-related genes associated with HCC prognosis. A gene signature was developed using LASSO and Cox regression analyses, and its prognostic value was evaluated through Kaplan-Meier (K-M) survival analyses and receiver operating characteristic curve (ROC) analysis. The signature's association with immune cell infiltration, chemotherapeutic response, and functional enrichment was also investigated.
Results
In total 256 differentially expressed CAFs-related genes were identified between CAFs high and low samples. After systematic analysis, a prognostic signature including 23 genes (MYH11, RAMP3, RCAN2, CLEC3B, KLF2, HTRA3, VCAN, MARVELD1, PRSS23, IL7R, IL33, MSC, SERPINE2, CRYAB, SPINT1, HGFAC, IGLL5, SLC22A1, CTAG2, CXCL8, ADH1C, PEG10, AKR1B10) were constructed. The K-M and ROC analysis demonstrated the robust predictive potential of our risk model for HCC patients. The univariate/multivariate Cox regression analyses furtherly confirmed the risk model was an independent prognostic factor of HCC in both testing and validation cohort. Moreover, the response to chemotherapy and the stromal score were differed significantly between the high- and low-risk groups. Finally, the signaling pathways enriched in high-risk group are mainly associated with HCC progression.
Conclusions
CAFs-related gene signature model shows good predictive potential with respect to prognosis of HCC patients.
Impact of lung-resident Mesenchymal Stem Cells on Epithelial Wound Healing in Idiopathic Pulmonary Fibrosis
Authors: Martin-Medina Aina , Truyols-Vives Joan , Jahn Andreas , Rio Carlos , Montes Ana , Molina-Molina Maria , Elowson Linda , Westergren-Thorsson Gunilla , Mercader-Barceló Josep , Sala-Llinàs Ernest
Published: December 2024

Aberrant repair processes in lung alveolar epithelial cells (AEC) are hallmarks of the initiation and progression of idiopathic pulmonary fibrosis (IPF), a lethal interstitial lung disease with very limited therapeutic options and no current means to reverse or improve lung function. Lung-resident mesenchymal stem cells (LRMSC) are expected to repair and regenerate tissue; however, they have recently been reported to be altered in IPF, thereby promoting disease pathogenesis. Although IPF LRMSC closely interact with alveolar epithelial cells (AEC), the involvement of IPF LRMSC in restoring the epithelial lung barrier has not been studied in detail. Here, we compared the proliferation capacity of LRMSC from IPF patients and control subjects via molecular and functional assays and investigated the induction of in vitro epithelial wound closure in both direct and indirect cell cocultures. All setups were tested under normal and profibrotic conditions upon stimulation of LRMSC with TGF-β. IPF LRMSC were less proliferative than controls under profibrotic conditions. LRMSC enhanced wound closure in direct coculture with AEC, however, the ability of LRMSC to regenerate scratched AEC monolayers through only their secreted factors was reduced in IPF donors. Moreover, profibrotic stimulation of LRMSC with TGF-β further potentiated AEC wound closure, but this effect was delayed in IPF donors compared with controls. This study demonstrated that LRMSC mediate epithelial wound closure under fibrotic conditions; however, their potential is impaired in IPF LRMSC, especially in terms of their paracrine function.
Recurrent Headaches in a Child with Tuberculous Meningitis: Unmasking Slit Ventricle Syndrome
Authors: Li Yiyuan , Zhu YU , Guo Qin
Published: December 2024

Background
Slit ventricle syndrome (SVS) is a severe and potentially life-threatening complication associated with chronic overdrainage of cerebrospinal fluid. However, its clinical manifestations and imaging characteristics are often overlooked due to insufficient awareness among clinicians..
Case Presentation
We report the case of a pediatric patient diagnosed with tuberculous meningitis, who received standard anti-tuberculosis treatment and underwent ventriculoperitoneal shunting for hydrocephalus. Four years after completing treatment, the patient presented with recurrent headaches, which were eventually diagnosed as SVS. The patient's condition improved following an upward adjustment of the shunt valve pressure.
Conclusion
This case highlights the critical need for heightened awareness of SVS among pediatric specialists. Early recognition and timely intervention are crucial for optimizing clinical outcomes in patients with a history of shunt surgery and hydrocephalus.