bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breastfeeding Symptom Resolution After Sequential Labial–Lingual Frenectomies: A Case Report
Authors: Tseng Raymond J. , Altemara Jessica , Smart Sharon 
Published: December 2024

Background: Breastfeeding is vital for infant nutrition, bonding, and overall health. However, challenges can arise with the presence of tethered oral tissues, commonly known as labial (lip) tie or lingual (tongue) tie, otherwise known as ankyloglossia. This case study explores the differential resolution of breastfeeding symptoms in a one‐month‐old infant with both labial and lingual ties. It outlines the diagnostic process, surgical interventions, and postoperative care, emphasizing the importance of detailed characterization of symptom resolution associated with a lingual and labial frenectomy.Case Presentation: The one‐month‐old male presented with 11 symptoms of feeding difficulties. Sequential surgical releases were performed for the labial and lingual ties, with a ranula also addressed. Detailed symptom assessments were conducted at one, two, and 4 weeks postsurgery, revealing differential responses to labial and lingual releases.Results: The results show that 81.8% of symptoms resolved after labial and lingual surgeries, with some symptoms responding specifically to either labial or lingual release. The study suggests that surgical intervention can significantly improve breastfeeding outcomes, including for patients who may not have access to sufficient lactation counseling resources.Conclusion: This single case study provides a valuable starting point for the exploration of which dysfunctional breastfeeding symptoms are associated with a labial tie versus lingual tie. Further research with larger samples is warranted to explore optimal treatment strategies for diverse parent–baby dyads experiencing breastfeeding difficulties, or whose access to lactation support services is limited.
In Search of the Persianate Tradition of Taking Minutes, or How to Transfer Words to Paper
Authors: Jaśkowski Stanisław Adam 
Published: December 2024

Abstract
The present paper investigates the development of taking minutes and record-keeping in Mughal India and Safavid Iran from the early modern period, including protocols taken as the part of legal processes, diplomatic discussions, government administration, and leisurely gatherings, through an analysis of administrative manuals, stylized literary letters (monshaʾāt), narrative sources, and documents. This study also addresses the relationship between official writings and Sufi literature. Even prior to the import of European bureaucratic practices, the tradition of writing reports of assemblies was well established in the Persian language, though the research here demonstrates how some passages found in the chronicles are probably an embellishment of official records. The practices discussed show a commitment to keeping the account of meetings and oral exchanges in the Persianate world.
Patriotic Humanitarianism: Toward an Emotional and Experiential History of Children’s Actions During the First World War
Authors: Olsen Stephanie 
Published: December 2024

Abstract
Children throughout the British Empire were encouraged by schools, organisations and communities to participate in the First World War as future citizens and humanitarians. Their emotions, and their experiences, were cultivated collectively. This broad understanding of humanitarianism was sometimes tied to peace activism, but was more often tied to militarism for the majority of children in the British Empire. Children raised money by holding events and selling handmade things. They visited soldiers in hospital and brought them presents. They collected for the Red Cross, the Belgian and Serbian Relief funds and other causes. In Star City, Saskatchewan, and Mitta Mitta, Victoria, and in villages, towns and cities in between, children wrote essays, drew pictures, and composed letters to officials detailing their thoughts and efforts.
Children, through their numerous everyday humanitarian actions (often non- material and leaving no trace), contributed to the enormous emotional effort of the war. This essay examines these child-directed humanitarian efforts. Why were so many children motivated to contribute in such substantial ways to the war effort? What sort of emotional and experience formation was required in order to stir children to action? And from where was the impetus – social, school, community, family, peer and/or individual?
Recentering the Ming–Qing Transition: beyond the “Seventeenth Century Crisis,” “The Great Divergence,” and “New Qing History”
Authors: Zhao Yifeng , Broughton Michael 
Published: December 2024

Abstract
The Ming–Qing transition – the final dynastic change in Imperial China – followed the cyclical patterns of rise and fall that had characterized previous dynastic shifts throughout Chinese history. However, its occurrence in the mid-seventeenth century positions it within a broader context of significant transformations in Europe and the Americas. This transition’s most profound impact lay in the culmination of the long-term centralizing processes within Chinese civilization. In its aftermath, the imperial system continued, for a time, to grow stronger, while the economy experienced sustained prosperity driven by both agriculture and commerce. When viewed holistically, this period in Chinese history, while interconnected with European developments, followed a distinct trajectory. Recent scholarship, influenced by the framework of world history, has deepened our understanding of the Ming–Qing transition’s role in broader global changes. However, this approach has sometimes led to an overemphasis on international factors, potentially diminishing the transition’s significance as a particular phase in China’s long-term historical progression. Analyses that predominantly focus on ethnic Manchu–Han dynamics often fail to capture the full historical context. A more nuanced understanding emerges when we examine this period through the lens of the long-term centering process within Chinese civilization. Differences between Chinese and European civilizations extend far beyond comparisons of productive forces. Therefore, discourse around concepts like “convergence” or “divergence” can be misleading without clearly defined comparative frameworks and metrics.
Free-living marine nematodes of the genus Richtersia Steiner, 1916 (Desmodorida: Richtersiidae) from the Sea of Japan
Authors: REVKOVA TATIANA N. , SERGEEVA NELLI G. 
Published: December 2024

Two new species Richtersia japonica sp. nov. and Richtersia amurica sp. nov. are described from the shallow water of the Sea of Japan. Both new species are characterized by the presence of multispiral amphidial fovea 3.5 turns in males and one turn in females; two unequal spicules and gubernaculum with anterior apophyses. R. japonica sp. nov. is most similar to R. beibuwanensis Fu, Cai, Boucher, Cao & Wu, 2013 and R. staresensis Soetaert & Vincx, 1987 in having arrangement of longitudinal rows of spines and presence of anterior apophyses on gubernaculum, but differs from them by the length of the spicules and in de Man a value in males. R. amurica sp. nov. is most similar to R. coomansi Soetaert & Vincx, 1987 and R. inaequalis Riemann, 1966 in having arrangement of longitudinal spine rows beginning at the level of the amphidial fovea and in long hairy spines on the tail of females. But it differs from them by presence of anterior apophyses on gubernaculum and length of the spicules. Data on the geographic and bathymetric distribution of all valid Richtersia species are provided.
Chest Pain Risk Stratification in the Emergency Department and Prediction of Major Adverse Cardiac Events Using HEART Score
Authors: Rajesh R  , Amith Kumar CS  , Reddy Sankarapu Narendra 
Published: December 2024

Introduction: Acute coronary syndrome (ACS) should be identified from various cardiac and noncardiac causes of chest pain. Non-ST segment elevation (NSTE-ACS) diagnosis can be done immediately in the case of typical changes in the electrocardiogram (ECG) and/or increased levels of myocardial markers, the absence of such variation does not always exclude NSTE-ACS. NSTE-ACS in its early stages difficult to diagnose. To stratify the risk of chest pain, aid early diagnosis, and prediction of outcome HEART score was designed. Components of the HEART score are history, ECG, age, risk factors, and troponin. The objectives of the study are risk stratification of chest pain in ED, prediction of MACE, validate the HEART Score in risk stratification of chest pain, and deciding on the discharge of patients. Materials and methods: This was a hospital-based, prospective study involving 220 patients who were admitted and discharged according to risk stratification using the HEART score. Patients are followed up over six weeks for prediction of MACE. MACE includes AMI, PCI, CABG, or death. The collected data were analysed with SPSS version 26.0, IBM Corp, Chicago, Illinois, USA. P value ≤.05 is considered as significant. Results: Out of 220 patients, 51 reached MACE. Low-risk HEART scores were seen in 25% of patients and No MACE occurred in these patients. Intermediate risk HEART scores were seen in 53% of patients and MACE occurred in 9.3% of patients. High-risk HEART scores were seen in 22% of patients and MACE occurred in 83% of patients. Conclusion: HEART score is helpful in risk stratification of chest pain in our study. It also aids in early diagnosis of intermediate and high-risk groups. HEART score also helps in decision-making to discharge patients. Thus, HEART score provides a quick and reliable prediction of outcomes in chest pain and should be used in ED.
Clinical Profile and Outcomes of Patients Presenting with H1N1 Pneumonia and Respiratory Failure at a Tertiary Care Centre of Central India
Authors: Agrawal Shailesh , Bajpai Pranay , Kodape Anay , Agrawal Palash , Avashia Sanjay , Bhargava Salil , Bansal Deepak 
Published: December 2024

Background and Aims: Influenza, a lethal disease presenting with acute respiratory illness (ARI), has taken its toll on mankind through successive epidemics and pandemics. This study was conducted amidst the H1N1 influenza outbreak that struck central India in the latter half of 2022. Materials and Methods: Records of all patients admitted from 1 August 2022 to 7 September 2022 at a tertiary care centre of central India were reviewed and all patients admitted with acute respiratory failure who were suspected and tested for H1N1 influenza were included. Results: Thirty-two patients with respiratory failure were included in the study. They had a median age of 46 years, among which 50% patients were males. The median duration of illness was 6.8 (+/– 4.0) days, in which majority of patients were having fever (90.62%) and dyspnoea (93.75%). The median duration of hospital stay was nine days. Overall, 37.5% of the individuals had comorbidities, with diabetes mellitus (21.87%) and systemic hypertension (18.75%) being the most common. About 28.13% patients were confirmed positive for H1N1. The median oxygen saturation (SpO2) at presentation was 83% (with 13 patients having a saturation below 80% at room air) with a median respiratory rate of 25 breaths per minute. In 31 (96.8%) patients, chest imaging revealed an involvement in at least two zones. Eighteen (56.25%) patients had severe acute respiratory distress syndrome (ARDS). Overall mortality among the patients was 31.25%. All patients received full course oseltamivir. Conclusion: Our study H1N1 influenza virus-associated ARDS had a mortality rate of 31.25% with diabetes being a significant risk factor for severe disease and mortality.
Why Portable Handheld Cardiac Ultrasound Devices Ought to Incorporate 3-lead Electrocardiographs: A Mini-narrative Review
Authors: Okechukwu Chidiebere Emmanuel 
Published: December 2024

Introduction: Transthoracic echocardiography is a non-invasive diagnostic test used to assess the structure and function of the heart in real-time. An examination of the heart's electrical activity is done non-invasively through electrocardiography (ECG). The ECG is primarily used during an echocardiography procedure to assess the heart's rhythm and to synchronise the cardiac cycles with echocardiographic image acquisition; this enables the echocardiographer to acquire images at specific phases of the cardiac cycle. A handheld echocardiograph is not connected to the electrocardiogram, which is a clinical limitation for the point-of-care ultrasound procedure. The objectives of this review are to highlight the reasons why 3-lead electrocardiography should be incorporated into pocket-sized handheld echocardiographs to support clinicians in conducting and reporting complete cardiac investigations. Methods: An in-depth search was made on the PubMed database to find experimental and review studies that assessed the importance of 3-lead ECG in the acquisition of hand-held echocardiographic data. Four related studies were selected for this review. Results: The study found that integrating cardiac point-of-care ultrasound into primary healthcare practices such as family medicine or general practitioners’ practices and training clinicians to accurately perform the procedure can expedite cardiovascular disease diagnosis and treatment in critical and non-critical scenarios. Secondly, recent hand-held cardiac ultrasound examination outcomes are as accurate and precise as standard transthoracic echocardiography and cardiac magnetic resonance imaging. Conclusion: Furthermore, medical device companies should consider integrating and producing new hand-held echocardiographs with configured 3-lead electrocardiographs that are artificial intelligence-enhanced to assist clinicians in precise point-of-care cardiac assessments.
Dignity in Practice: Navigating Humanitarian Response and the Right to Stay Amid Lebanon’s Multiple Migrations
Authors: Petro Michael 
Published: December 2024

Executive Summary This piece will examine the complexities of the “right to stay” within the overlapping and multiple migratory contexts of Lebanon. I argue that standard right to stay frameworks fall short in addressing the complex interplay of Lebanon’s local context, the role of humanitarian response, and the importance of agency and control in the lives of those affected by forced displacement. Based on the work of the Jesuit Refugee Service (JRS) in Lebanon with Syrian refugees, local Lebanese residents, and diverse populations of migrant workers, I offer several lessons learned for humanitarian work on the right to stay in similar contexts. First, based on our engagement with Syrian refugees, I argue that, in practice, JRS understands the right to stay as a control right which is grounded in human dignity and the subjective importance of control of intimate space. I argue that understanding this right as continuous with the migratory vision of Pope Francis, which places free choice, control, and agency at the core of a person’s choice to migrate, offers humanitarian actors pathways for response, even in contexts of actual and ongoing displacement. Altogether, this framework enables JRS programming focused on fostering spaces of intimate control, mental health, and psychosocial support for those whose dignity has been violated, and facilitating agency within the limits of the Lebanese context. Second, based on JRS’s growing engagement with local Lebanese populations, I describe how this dignity framework requires broad inclusion in programming. At the same time, Lebanon’s overlapping migratory flows necessitate greater attention to the dynamics between ongoing displacements in Lebanon in order to navigate tensions around aid access. Finally, drawing from JRS and Jesuit work with migrant domestic workers in Lebanon, I describe how our work engages the complexity of migrants’ temporary displacements and their link with home countries, highlighting questions of agency and attention. Ultimately, I argue that humanitarian organizations need to pay closer attention to these spaces of multiple migrations, engaging the actuality of many migrants’ mobility, and grounding work for the right to stay in more expansive visions of human dignity through support for migrants’ control and agency. Governments, particularly the government of Lebanon, must reduce violations of this basic control by ceasing programs of involuntary return and long-term migrant detention.
Therapeutic drug monitoring vs. pharmacogenetic testing in the context of elevated olanzapine concentrations and prior clozapine intolerability: a case study
Authors: Khorassani Farah , Azevedo Ricardo , Farokhpay Reza 
Published: December 2024

Abstract
Background
Strong evidence for therapeutic drug monitoring exists for olanzapine and clozapine, however, olanzapine therapeutic drug monitoring is often underutilized. Evidence for pharmacogenomic-guided dosing of antipsychotics is not as robust, especially for cytochrome P450 1A2 metabolized agents such as olanzapine and clozapine. Herein, we present a case involving a patient suspected of having poor CYP1A2 metabolism. Therapeutic drug monitoring of olanzapine was employed to guide the titration of clozapine following olanzapine failure. Despite pursuing pharmacogenetic testing, no meaningful results were obtained due to the omission of CYP1A2 variants associated with poor metabolism.

Case presentation
A 32-year-old Caucasian male with schizoaffective disorder-bipolar type, ADHD, and autism spectrum disorder presented with extrapyramidal symptoms due to antipsychotic polypharmacy, resulting in multiple falls. He experienced a partial response to olanzapine 40 mg, thus his dose was increased to 50 mg. Sampling an olanzapine trough revealed a supratherapeutic level of 152 ng/mL. Given his history of EPS and other reported adverse effects from antipsychotics, including clozapine, pharmacogenomic testing was pursued. The patient cross-tapered to clozapine slowly, with the knowledge that the patient would likely exhibit elevated levels of olanzapine. Clozapine was efficacious and tolerated well. As expected, the patient exhibited higher clozapine trough concentrations for someone of his age, ethnicity, and gender. Pharmacogenomic testing yielded no relevant findings relating to olanzapine or clozapine metabolism.

Conclusion
This case highlights the utility of TDM over pharmacogenetic testing for patients on these medications with a suspected alteration in CYP1A2 metabolism. therapeutic drug monitoring emerges as a more practical approach with stronger evidence for its use, particularly in cases of suspected reduced CYP1A2 activity, where suballeles resulting in decreased enzyme function are not readily detectable on standard commercial pharmacogenomic panels.
Serum concentrations of different or multiple vitamins and Sarcopenia risk among US adults: insights from NHANES
Authors: Liu Li , Ding Xueman , Zhang Yue , Li Tingting , Xu Panpan , Ma Yue , Xing Hengrui , Niu Qiang , Keerman Mulatibieke 
Published: December 2024

Abstract
Background
The relationship between serum concentrations of different or multiple vitamins and sarcopenia remains underexplored. This investigation evaluates potential links between serum concentrations of different or multiple vitamins and sarcopenia prevalence among adults in the United States.

Methods
Utilizing a cross-sectional design, this research draws from the National Health and Nutrition Examination Survey (NHANES) dataset of 2003–2006, encompassing 5,060 participants with comprehensive serum vitamin A, E, B9, B12, C, and D concentrations, alongside sarcopenia and covariate measurements. Participant stratification into distinct vitamin co-exposure clusters was achieved through K-means clustering. Analytical models, including weighted logistic regression, restricted cubic splines (RCS), weighted quantile sum regression (WQS), quantile g-computation (Q-gcomp), and Bayesian kernel machine regression (BKMR), were employed to evaluate the association between serum concentrations of different or multiple vitamins and sarcopenia risk, with an emphasis on nonlinearity.

Results
In this study, sarcopenia was detected in 681 individuals (13.46%). Logistic regression results did not demonstrate any linear association between individual vitamin levels and sarcopenia risk (PFDR > 0.05). Contrastingly, the RCS model unveiled significant non-linear relationships for vitamins A and D (P_non-linear < 0.05). The K-means clustering results showed that participants in high-level vitamin exposure group had lower sarcopenia risk compared with those in low-level vitamin exposure group (OR (95% CI): 0.582 (0.397, 0.852)). Additionally, higher serum concentrations of different or multiple vitamins correlated inversely with sarcopenia risk (P_trend = 0.002). This inverse association was corroborated by WQS, Q-gcomp, and theBKMR models and remained consistent upon sensitivity analysis.

Conclusions
This study elucidates an inverse correlation between serum concentrations of different or multiple vitamins and sarcopenia risk, emphasizing a non-linear association, particularly with suboptimal vitamin D concentrations. Given the limitations of the NHANES study, further researches are required to clarify the existence of these relationships.
Application of CUSUM analysis in assessing learning curves in robot-assisted sacrocolpopexy performed by experienced gynecologist
Authors: Park Kena , Kwon Ji Young , Yoo Eun-Hee , Lee Seon Hwa , Song Jeong Min , Pyeon Seung Yeon 
Published: December 2024

Abstract
Background
The aim of this study was to assess the learning curve of robotic-assisted sacrocolpopexy by applying CUSUM analysis based on operation time, complication rate and conversion rate to open laparotomy.

Methods
A retrospective study was conducted with 50 consecutive robotic-assisted sacrocolpopexy surgeries performed from June 2018 and June 2023 by a single experienced gynecologist. Baseline patient demographics, intraoperative parameters and postoperative outcomes were collected. Cumulative sum (CUSUM) of robotic-assisted sacrocolpopexy operation time was analyzed to determine breakpoints between learning phases using piecewise linear regression. This allowed the detection of subtle shifts in surgical parameters and ultimately surgeon proficiency and competency. Continuous variables, such as age, length of hospitalization and op time, were reported as mean (standard deviation). One-way analysis of variance was employed to compare continuous variables. Categorical variables were expressed as percentages and analyzed using the chi-square test.

Results
The regression identified breakpoints at case 8.47 (95% CI 8.0, 9.0) and case 34.41 (95% CI 32.7, 36.1), with an R2 value of 0.87, which agrees with that of the second-order polynomial equation. The breakpoints were rounded to the next whole number at case 9 and 35. The Learning, Proficiency, and Competency phases consisted of 9, 26, and 15 cases, respectively in this consecutive series. This suggests that the surgeon achieved proficiency after the first 9 cases and competency after 35 cases. There were no intraoperative nor short-term post-operative complications during the span of this study. Furthermore, there were no conversions to open laparotomy. CUSUM analysis based on complication and conversion rate, therefore, was not available.

Conclusion
According to CUSUM analysis, surgical proficiency of robotic-assisted sacrocolpopexy was attained after the first 9 cases, and stabilization of operation time was achieved after 35 cases. This statistical tool has proven to be useful in objectively assessing learning curves for new surgical techniques, and the transition from laparoscopic sacrocolpopexy to robotic-assisted sacrocolpopexy seems achievable. This, however, may vary with each surgeon’s manual dexterity and experience level. Further investigation with several surgeons and institutions is needed to define a more accurate and generalized learning curve of robotic-assisted sacrocolpopexy.