bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deviation in Robert Browning's My Last Duchess: A Stylistic Study
Authors: Shihab Teeba , Afrawi Shouq Ali 
Published: December 2024

This paper deals with the effects of deviation as a Stylistic device on the discourse of poetry by making it complex and ambiguous.
This study aims at providing a theoretical side about deviation and its types.
As well as providing, a practical side about an analysis of Robert Browning's My Last Duchess. It is hypothesized that Robert Browning poetry is affected by a set of deviations in order to make it unique and ambiguous.
It is hoped that the paper will be valuable to both stylistic researchers end English language learners.
The paper consists of an abstract and three chapters. The first chapter contains the procedure and the general framework that the paper is built on such as the problem, the hypothesis, the aimsand the model etc… .
As for the second chapter it is devoted to discuss the literature review and to elaborate the model of analysis. Moreover, Chapter three is dedicated to the analysis of the paper. The paper ends withsome conclusions, an appendix and a bibliography.
It is concluded that poetry discourse is full of deviation and that kind of deviation marks it as difficult to be understandable straightforwardly. Furthermore, Robert Browning's Poetry is an exemplification of that type of deviation.
Dynamics of Weakness and Strength: Confronting Difficulties in The Bamboo Stalk.
Authors: Yasir Maha 
Published: December 2024

This paper will critically discuss the Dynamics of Weakness and Strength with and overcomes the problems that naturally paper from being of Kuwaiti-Filipino heritage. The study aims to portray the dynamics of weakness and strength in Confronting and to show how they have an impact on his identity development and the sense of belonging Difficulties in "The Bambo Stalk" by Saud Alsanousi. Being revealed in such a way are intricate dynamics of weakness and strength along José's trajectory, and the study adds to discourses of cultural identity, resilience, and the complexities of multiculturalism in literature, which have lots to give for understanding the struggle of individuals with mixed heritage in today's societies. The analysis points out that In the novel "The Bamboo Stalk," Saud Alsanousi tells José's coming-of-age story against the backdrop of societal prejudice and cultural clashes, evidencing both his strength and times of weakness. Through this narrative, he reveals man's struggle for acceptance and belonging. José's story becomes, therefore, an intense search for identity in a world ruled by social norms and biases at the end.
Increased in vitro antimicrobial resistance of Mycoplasma pneumoniae isolates obtained from children in Beijing, China, in 2023
Authors: Jia Xinyu , Chen Yujie , Gao Yagang , Ren Xue , Du Bing , Zhao Hanqing , Feng Yanling , Xue Guanhua , Cui Jinghua , Gan Lin , Feng Junxia , Fan Zheng , Fu Tongtong , Xu Ziying , Yu Zihui , Yang Yang , Zhao Shuo , Huang Lijuan , Ke Yuehua , Liu Chuanhe , Yan Chao , Yuan Jing 
Published: December 2024

IntroductionMycoplasma pneumoniae (M. pneumoniae), a common pathogen of community-acquired pneumonia in school-age children and adolescents, can cause epidemics worldwide. In late 2023, the incidence of M. pneumoniae infection among children reached a high level.MethodsWe investigated the in vitro antimicrobial susceptibility of 62 M. pneumoniae isolates obtained from children with pneumonia in Beijing between 2021 and 2023, and analyzed the correlation of antimicrobial susceptibility with molecular characteristics of isolates and clinical manifestations of patients.ResultsThe resistance rates of M. pneumoniae isolates against erythromycin and azithromycin were both 100% (62/62). The minimum inhibitory concentration (MIC) of acetylspiramycin (16-membered macrolides) was lower than that of erythromycin and azithromycin. The MIC of azithromycin in 2023 was notably higher compared to 2021 and 2022. No resistance to tetracycline and levofloxacin was observed. Genotypes P1 type 1 and P1 type 2 were identified in 74.2% and 25.8% of isolates, and M4-5-7-2 (61.3%) and M3-5-6-2 (22.6%) were predominant multi-locus variable-number tandem-repeat analysis (MLVA) types. The A2063G mutation was present in all isolates (100%). Among the patients, 45/59 cases (76.3%) had severe M. pneumoniae pneumonia, and 14/59 cases (23.7%) presented co-infection. The duration of fever was 12 days (1-30 days) and the fever duration after initiation of macrolide antibiotics treatment was 8 days (1-22 days).DiscussionOur study showed that macrolide-resistant M. pneumoniae (MRMP) with high in vitro antimicrobial resistance level may be the causative factor of the M. pneumoniae epidemic in late 2023 in Beijing, China. It is urgent to pay more attention to MRMP and the antibiotics choose.
Ramulus Mori (Sangzhi) alkaloids ameliorate high-fat diet induced obesity in rats by modulating gut microbiota and bile acid metabolism
Authors: Shang Xin , Fu Yu , Wang Ying , Yan Shuxun 
Published: December 2024

ObjectiveThe objective of this study is to investigate the ability of Ramulus Mori (Sangzhi) alkaloid tablets (SZ-A) to ameliorate obesity and lipid metabolism disorders in rats subjected to a high-fat diet (HFD) through metagenomics, untargeted lipidomics, targeted metabolism of bile acid (BA), and BA pathways, providing a novel perspective on the management of metabolic disorders.MethodsIn this research, HFD-fed rats were concurrently administered SZ-A orally. We measured changes in body weight (BW), blood lipid profiles, and liver function to assess therapeutic effects. Liver lipid status was visualized through H&amp;E and Oil Red O. Gut microbiota composition was elucidated using metagenomics. The LC-MS-targeted metabolomics approach was utilized to define the fecal BA profiles. Furthermore, the lipid metabolomics of adipose tissue samples was investigated using an LC-MS analysis platform. The expression levels of the BA receptor were determined by western blotting. Additionally, serum insulin (INS), glucagon-like peptide-1 (GLP-1), and inflammatory cytokines were quantified using an ELISA kit. The integrity of the colonic epithelial barrier was assessed using immunofluorescence.ResultsSZ-A notably decreased BW and blood lipid levels in obese rats while also alleviating liver injury. Additionally, SZ-A reduced the serum levels of leptin (LEP), INS, and GLP-1, indicating its potential to modulate key metabolic hormones. Most notably, SZ-A substantially improved gut microbiota composition. Specifically, it reshaped the gut microbiota structure in HFD-fed rats by increasing the relative abundance of beneficial bacteria, such as Bacteroides, while decreasing the populations of potentially harmful bacteria, such as Dorea and Blautia. At the BA level, SZ-A decreased the levels of harmful BAs, including hyodeoxycholic acid (HDCA), deoxycholic acid (DCA), 12-keto lithocholic acid (12-KLCA), lithocholic acid (LCA), and muricholic acid (MDCA). Between the model group and SZ-A, 258 differentially abundant metabolites were detected, with 72 upregulated and 186 downregulated. Furthermore, these BAs are implicated in the activation of the FXR-FGF15 and TGR5-GLP-1 pathways in the intestine. This activation helps to alleviate HFD-fed intestinal inflammation and restore intestinal barrier damage by modulating inflammatory cytokines and bolstering the intestinal barrier’s capabilities.ConclusionsOur findings indicate that SZ-A effectively modulates BW, serum lipid profiles, and liver function in HFD-fed rats. Moreover, SZ-A exerts a positive influence on inflammatory cytokines, thereby mitigating inflammation and promoting the restoration of the intestinal barrier. Significantly, our research indicates that adjusting the gut microbiome and BA levels could serve as an effective approach for both preventing and treating obesity and related metabolic dyslipidemia.
Characterization of the hepatic flora and metabolome in nonalcoholic fatty liver disease
Authors: Jiang Hua , Wang Hui , Guo Yangfan , Zhu Yankun , Dai Hui , Liang Chenchen , Gao Jianpeng 
Published: December 2024

Background/aimThe purpose of this study was to examine the hepatic bacterial composition and metabolome characteristics of patients with NAFLD using 16S rDNA sequencing and metabolomics. The results of the study revealed substantial differences in hepatic bacterial composition and metabolites between the NAFLD group and the control group. These differences were used to identify potential biomarkers that could be employed to diagnose NAFLD.Subjects/methodsLiver tissues from 13 patients in the NAFLD group and 12 patients in the control group were collected for microbiota examination.ResultsThe bacterial DNA profiles of the liver were significantly different between NAFLD patients and controls. NAFLD patients exhibited an enrichment of Enterobacterales, Mycobacteriales, Pseudomonadales, Flavobacteriales and Xanthomonadales, Sphingomonadales, Lysobact, which was characterised by a lack of erales. At the genus level, the abundance values of Escherichia-Shigella, Rhodococcus, and Chryseobacterium in the NAFLD group were significantly elevated, while the abundance values of Stenotrophomonas, Lawsonella and Sphingobium were significantly reduced. A total of 402 distinct metabolites were identified between the two groups, with 78 metabolites that were up-regulated and 14 metabolites that were down-regulated. The enrichment of metabolic pathways indicated that linoleic acid metabolism was the most significant contributor to the metabolic differences, and lipid metabolism was substantially differentiated. The hepatic metabolite levels were substantially correlated with the changes in hepatic microflora, as demonstrated by the correlation analysis.ConclusionDifferences in pathogenesis and host physiological function of NAFLD may be attributed to the hepatic flora and metabolomic characteristics. In the future, this presents new opportunities for the investigation of prospective diagnostic and therapeutic targets for NAFLD.
hvEEGNet: a novel deep learning model for high-fidelity EEG reconstruction
Authors: Cisotto Giulia , Zancanaro Alberto , Zoppis Italo F. , Manzoni Sara L. 
Published: December 2024

IntroductionModeling multi-channel electroencephalographic (EEG) time-series is a challenging tasks, even for the most recent deep learning approaches. Particularly, in this work, we targeted our efforts to the high-fidelity reconstruction of this type of data, as this is of key relevance for several applications such as classification, anomaly detection, automatic labeling, and brain-computer interfaces.MethodsWe analyzed the most recent works finding that high-fidelity reconstruction is seriously challenged by the complex dynamics of the EEG signals and the large inter-subject variability. So far, previous works provided good results in either high-fidelity reconstruction of single-channel signals, or poor-quality reconstruction of multi-channel datasets. Therefore, in this paper, we present a novel deep learning model, called hvEEGNet, designed as a hierarchical variational autoencoder and trained with a new loss function. We tested it on the benchmark Dataset 2a (including 22-channel EEG data from 9 subjects).ResultsWe show that it is able to reconstruct all EEG channels with high-fidelity, fastly (in a few tens of epochs), and with high consistency across different subjects. We also investigated the relationship between reconstruction fidelity and the training duration and, using hvEEGNet as an anomaly detector, we spotted some data in the benchmark dataset that are corrupted and never highlighted before.DiscussionThus, hvEEGNet could be very useful in several applications where automatic labeling of large EEG dataset is needed and time-consuming. At the same time, this work opens new fundamental research questions about (1) the effectiveness of deep learning models training (for EEG data) and (2) the need for a systematic characterization of the input EEG data to ensure robust modeling.
Myopenia and body fat distribution in hospitalized ulcerative colitis patients: correlations with clinical characteristics and response to vedolizumab
Authors: Wei Wei , Yan Pengguang , Zhang Yan , Wang Qiong , Kang Junren , Liu Pengju , Fu Jin , Li Jingnan , Yu Kang 
Published: December 2024

BackgroundUlcerative colitis (UC) patients often suffer from impaired nutritional conditions. However, there are few studies focused on muscle loss in UC patients as well as its impact on therapeutic response. This study aimed to investigate the prevalence of myopenia in hospitalized patients with active UC, analyze the relationship between body composition including both skeletal muscle and fat with clinical characteristics, and explore the association between body composition and clinical response to vedolizumab.MethodsA retrospective cohort study was conducted in hospitalized patients with active UC in Peking Union Medical College Hospital from November 2014 to October 2022. Computed tomography (CT) scans were used to measure skeletal muscle area, visceral fat area (VFA), subcutaneous fat area (SFA), and intramuscular fat infiltration at the third lumbar vertebrae (L3) level. These measurements were standardized by height (m) squared. Myopenia was defined as a skeletal muscle index (SMI) &lt; 44.77 cm2/m2 for males and &lt;32.50 cm2/m2 for females. The VFA/SFA ratio (VSR) served as an indicator of visceral obesity, while intramuscular fat infiltration was evaluated using the mean Hounsfield Unit (HU) value of the L3 skeletal muscle section.ResultsA total of 457 patients were enrolled. The prevalence of myopenia was 49.7% in this cohort. Female patients had significantly higher levels of subcutaneous fat and intramuscular fat but a lower level of visceral fat than male patients. SMI and mean HU showed positive correlations with serum albumin (ALB) and negative correlations with serum high-sensitivity C-reactive protein (hsCRP), whereas VSR showed the opposite trend. Among the 92 patients who received vedolizumab treatment, myopenia was significantly associated with a lower clinical response rate, and this association remained significant after adjusting for vedolizumab duration, ALB, and hsCRP (OR = 3.458, 95% CI 1.238–9.659, p = 0.018). Visceral obesity, defined as VSR ≥ 75th centile of gender-specific VSR, tended to diminish the clinical response rate but did not reach statistical significance.ConclusionThis study underscores the significance of assessing body composition in UC patients. Optimizing body composition should be considered an integral component of managing UC patients in the future.
Artificial intelligence model predicts M2 macrophage levels and HCC prognosis with only globally labeled pathological images
Authors: Tian Huiyuan , Tian Yongshao , Li Dujuan , Zhao Minfan , Luo Qiankun , Kong Lingfei , Qin Tao 
Published: December 2024

Background and aimsThe levels of M2 macrophages are significantly associated with the prognosis of hepatocellular carcinoma (HCC), however, current detection methods in clinical settings remain challenging. Our study aims to develop a weakly supervised artificial intelligence model using globally labeled histological images, to predict M2 macrophage levels and forecast the prognosis of HCC patients by integrating clinical features.MethodsCIBERSORTx was used to calculate M2 macrophage abundance. We developed a slide-level, weakly-supervised clustering method for Whole Slide Images (WSIs) by integrating Masked Autoencoders (MAE) with ResNet-32t to predict M2 macrophage abundance.ResultsWe developed an MAE-ResNet model to predict M2 macrophage levels using WSIs. In the testing dataset, the area under the curve (AUC) (95% CI) was 0.73 (0.59-0.87). We constructed a Cox regression model showing that the predicted probabilities of M2 macrophage abundance were negatively associated with the prognosis of HCC (HR=1.89, p=0.031). Furthermore, we incorporated clinical data, screened variables using Lasso regression, and built the comprehensive prediction model that better predicted prognosis. (HR=2.359, p=0.001).ConclusionOur models effectively predicted M2 macrophage levels and HCC prognosis. The findings suggest that our models offer a novel method for determining biomarker levels and forecasting prognosis, eliminating additional clinical tests, thereby delivering substantial clinical benefits.
Achievements, priorities and strategies in pediatric nephrology in Europe: need for unifying approaches or acceptance of differences?
Authors: Ehrich Jochen , Tasic Velibor , Edvardsson Vidar O. , Preka Evgenia , Prikhodina Larisa , Stefanidis Constantinos J. , Topaloglu Rezan , Shtiza Diamant , Sarkissian Ashot , Mueller-Sacherer Thomas , Fataliyeva Rena , Kazyra Ina , Levtchenko Elena , Pokrajac Danka , Roussinov Dimitar , Milošević Danko , Elia Avraam , Seeman Tomas , Faerch Mia , Vainumae Inga , Kataja Janne , Tsimaratos Michel , Rtskhiladze Irakli , Hoyer Peter F. , Reusz George , Awan Atif , Lotan Danny , Peruzzi Licia , Nigmatullina Nazym , Beishebaeva Nasira , Jeruma Edite , Jankauskiene Augustina , Niel Olivier , Said-Conti Valerie , Ciuntu Angela , Pavićević Snežana , Oosterveld Michiel , Bjerre Anna , Tkaczyk Marcin , Teixeira Ana , Lungu Adrian C. , Tsygin Alexey , Stojanović Vesna , Podracka Ludmila , Levart Tanja Kersnik , Espino-Hernández Mar , Brandström Per , Sparta Giuseppina , Alpay Harika , Ivanov Dmytro , Dudley Jan , Khamzaev Komiljon , Haffner Dieter 
Published: December 2024

BackgroundThere is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.MethodsIn 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children.ResultsThe reported three most important priorities in the care of children with kidney diseases were better training of staff, more incentives for physicians to reduce staff shortages, and more hospital beds. Positive achievements in the field of pediatric nephrology included the establishment of new specialized pediatric nephrology centers, facilities for pediatric dialysis and transplant units in 18, 16, and 12 countries, respectively. The most common problems included no access to any type of dialysis (12), inadequate transplant programs for all ages of children (12), lack of well-trained physicians and dialysis nurses (12), inadequate reimbursement of hospitals for expensive therapies (10), and lack of multidisciplinary care by psychologists, dieticians, physiotherapists, social workers and vocational counsellors (6). Twenty-five of 48 countries (52%) expected to have a shortage of pediatric nephrologists in the year 2025, 63% of clinical nurses and 56% of dialysis nurses. All three groups of health care professionals were expected to be lacking in 38% of countries. Prenatal assessment and postnatal management of renal malformations by a multidisciplinary team including obstetricians, geneticists, pediatricians, and pediatric surgeons was available in one third of countries.ConclusionsOur study shows that there are still very marked differences in pediatric health care systems across the European countries and highlights the need need for appropriate services for children with kidney disease in all European countries.
Cost-effectiveness analysis of first-line combination chemotherapy regimens for metastatic pancreatic cancer and evidence-based pricing strategy of liposomal irinotecan in China
Authors: Xiang Zuojuan , Ma Ling , Li Zhengxiong , Fu Yingzhou , Pan Yong 
Published: December 2024

BackgroundThe phase III NAPOLI-3 trial, which upgraded FOLFIRINOX (leucovorin, fluorouracil, irinotecan and oxaliplatin) to NALIRIFOX (liposomal irinotecan, oxaliplatin, leucovorin, and fluorouracil), demonstrated the superiority of NALIRIFOX over GEMNABP (gemcitabine and nab-paclitaxel) as the first-line treatment for metastatic pancreatic ductal adenocarcinoma. The purpose of this study was to assess the cost-effectiveness of NALIRIFOX, FOLFIRINOX, and GEMNABP, and to simulate the price of liposomal irinotecan at which NALIRIFOX could achieve cost-effectiveness.MethodsA partitioned survival model was performed to evaluate the cost-effectiveness of NALIRIFOX, FOLFIRINOX and GEMNABP from the perspective of the Chinese healthcare system. Survival data was obtained from a recently published network meta-analysis (NMA). Drug prices were collected from the database of the Hunan Province Drug and Medical Consumables Procurement Management Subsystem. Other cost and utility values were sourced from established literature. Cumulative costs, LYs (life-years), quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), net monetary benefits (NMBs) and incremental net monetary benefits (INMBs) were the main outputs. Furthermore, the variations in ICER were analyzed as the price of liposomal irinotecan gradually decreased when comparing NALIRIFOX with FOLFIRINOX or GEMNABP. The robustness of the model was assessed by sensitivity analysis and scenario analysis.ResultsAt the willingness-to-pay (WTP) threshold of $38,223.34, GEMNABP was the favored treatment. NALIRIFOX was associated with the highest LYs, QALYs, and cost. The cost-effectiveness of NALIRIFOX would be obtained if the price of liposomal irinotecan was less than $3.36/mg and $2.08/mg compared to FOLFIRINOX and GEMNABP, respectively, without considering the patient assistance program (PAP). Sensitivity analysis and scenario analysis revealed that the results of the model were stable.ConclusionFrom an economic standpoint, GEMNABP represents the favored choice in the prevailing market conditions among these three first-line combination chemotherapy regimens. The price simulation of liposomal irinotecan conducted in this study could provide valuable evidence for healthcare decision-making. Further evidence regarding the budget impact is still needed.
Factors influencing the quality of life among women with cancer in Vietnam
Authors: Nguyen Huyen Thi Hoa , Giap Tinh Thi Thanh , Tran Tran Ngoc , Nguyen Anh Chau , Truong Trung Quang , Bui Linh Khanh , Tran Quang Duc , Anderson Debra J. 
Published: December 2024

BackgroundCancer and its treatments significantly affect the quality of life (QoL) of patients. This remains understudied among Vietnamese women with cancer.ObjectivesThis study explored the QoL of Vietnamese women with cancer and identified key influencing factors.MethodIn 2022, this study analyzed 214 Vietnamese women with cancer from four hospitals, assessing pain levels (Visualized Pain Scale), functional capacity (Karnofsky Performance Status Scale), and QoL (SF12). Analyses used SPSS 26.0, including t-tests, ANOVA, and hierarchical linear regression models.ResultsSF12-PCS and SF12-MCS scores were 46.61 ± 9.70 and 46.96 ± 9.06. Pain score (β = −0.304, p &lt; 0.001) and symptoms number (β = −0.311, p &lt; 0.001) were key predictors of physical health. For mental health, functional status (β = 0.259, p &lt; 0.001) and symptoms number (β = −0.311, p &lt; 0.001) were significant. PCS was negatively correlated with age (r = −0.165, p = 0.016), number of symptoms (r = −0.220, p = 0.001), and pain (r = −0.444, p &lt; 0.001). Mental health (MCS) was negatively correlated with the length of cancer diagnosis (r = −0.156, p = 0.036) and the number of symptoms (r = −0.362, p &lt; 0.001). Both PCS and MCS positively correlated with functional status (r = 0.222, p = 0.001) and (r = 0.281, p &lt; 0.001), respectively.ConclusionCulturally sensitive care, pain management, and tailored support programs addressing physical, psychological, spiritual, and social aspects can enhance QoL for these women.