bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Preoperative Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio Associate with Clinic-pathological Characteristics in Papillary Carcinoma of Thyroid
Authors: Shrestha B. L. , KC A. K. , Rajbhandari P. , Dhakal A. , Shrestha K. S. 
Published: November 2022

Background Thyroid cancer is associated with local and systemic inflammatory activities. Many systemic inflammatory markers including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) had shown credible and independent prognostic biomarkers in different malignant conditions. These markers are easy to reproduce, measure and inexpensive also. So, the preoperative evaluation of NLR and PLR is helpful in evaluating tumor growth and prognosis of papillary carcinoma of thyroid.
Objective To evaluate the association of pre-operative NLR and PLR with clinic-pathological characteristic in papillary carcinoma of thyroid.
Method This was a retrospective study performed in thirty one patients with the diagnosis of papillary carcinoma of thyroid. Preoperative NLR and PLR values were correlated with the clinical parameters like age, gender, lymph node metastasis, tumor size and pathological features (e.g., multifocality, bilaterality, extrathyroidal spread).
Result There were thirty one patients, amongst which 13 were male and 18 were female. Similarly, the age distribution ranges from 27-68 years. The value of NLR was 2.37±1.09, and the value of PLR was 96.69±49.53.The increase in NLR was associated with increase in tumor size with statistically significant results. Similarly, increase in PLR was associated with increase in tumor size and multifocality with statistically significant results.
Conclusion Increase NLR and PLR is associated with lymph node metastasis, extra thyroidal extension, multifocality of tumor and also bilaterality, so the risk can be stratified beforehand with measurement of NLR and PLR.
Whole Genome Sequence Analysis to Identify SARS-CoV-2 Variant in Nepal
Authors: Shrestha R. , Katuwal N. , Adhikari N. , Vanaerschot M. , Tamrakar D. , Dhimal M. , Gyanwali P. , Bhattarai S. , Madhup S. K. , Devkota B. 
Published: November 2022

Background The spread of SARS-CoV-2 has become a global public health crisis. Nepal is facing the second wave of COVID-19 pandemic but, there is still a limited data on the genomic sequence of SARS-CoV-2 variants circulating in Nepal.
Objective The objective of this study is to sequence the whole genome of SARS-CoV-2 in Nepal to detect possible mutation profiles and phylogenetic lineages of circulating SARSCoV- 2 variants.
Method In this study, swab samples tested positive for SARS-CoV-2 were investigated. After RNA extraction, the investigation was performed through real-time PCR followed by whole genome sequencing. The consensus genome sequences were, then, analyzed with appropriate bioinformatics tools.
Result Sequence analysis of two SARS-CoV-2 genomes from patient without travel history (Patient A1 and A2) were found to be of lineage B.1.1. Similarly, among other four samples from subjects returning from the United Kingdom, genomes of two samples were of lineage B.1.36, and the other two were of lineage B.1.1.7 (Alpha Variant). The mutations in the consensus genomes contained the defining mutations of the respective lineages of SARS-CoV-2.
Conclusion We confirmed two genomic sequences of variant of concern VOC-202012/01 in Nepal. Our study provides the concise genomic evidence for spread of different lineages of SARS-CoV-2 – B.1.1, B.1.36 and B.1.1.7 of SARS-CoV-2 in Nepal.
Prevalence of Prediabetes in Patients with Acute Coronary Syndrome: A Descriptive Cross-Sectional Study
Authors: Karki Biplave , Ghimire Jeet , Nepal Bikash , Mahaseth Aditya , Sah Ajit , Pandit Swapnil , Pandey Naveen , Shah Prashant , Karki Prahlad 
Published: November 2022

Background and Aims: Diabetes mellitus is a well recognized risk factor for cardiovascular disease and acute coronary syndrome. It is becoming increasingly clear that pre-diabetic state is also associated with adverse clinical outcomes. However, evidence is limited regarding the prognostic value of 'prediabetes' on the clinical outcome of acute coronary syndrome. So, we aimed to assess the prevalence of prediabetes in acute coronary syndrome patients and its clinical outcome
Methods: This was a single center descriptive cross-sectional study to know the prevalence of prediabetes in 115 patients consisting of 71 males and 44 females, admitted with acute coronary syndrome in the Department of Cardiology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, between August 2020 to July 2021.
Results: Based on the definition of 2020 American Diabetic Association, 35 (30.4%) patients were newly diagnosed diabetic, 46 (40%) patients were prediabetic and 34(29.6%) were non-diabetic. Based on HbA1c alone, 26.1% patients were classified as newly diagnosed diabetic patients, 38.3% patients were classified as prediabetic and 35.7% as non-diabetic. Compared with patients without diabetes, patients with prediabetes tended to have a longer hospital stay (p=0.04), higher creatine level (p=0.01) and higher incidence of heart failure (p=0.046).
Conclusion: Prediabetes is common in patients presenting with acute coronary syndrome who are not previously known to have diabetes. Further multi-center studies with long term clinical follow-up are needed to draw a firm conclusion regarding the impact of prediabetes on clinical outcome
TRANSLATION STRATEGIES IN REPRODUCING THE EXPRESSIVE MEANS OF PUBLIC POLITICAL SPEECH: PECULIARITIES AND TECHNIQUES
Authors: Vasylenko Oksana M. , Khyzhun Yaroslava V. 
Published: November 2022

The paper considers the peculiarities of the application of translation strategies in reproducing the expressive potential of modern samples of the political speech genre in their specific national and linguistic variants. Political speech, which aims at embodying a certain ideological influence, will be effective if it combines rational and emotional elements. Speeches by politicians are usually expressive. Expressive political speech produces the most intended effect on the audience, its purpose is to increase the influence of what is said by the speaker and the presence of expressive function in political speeches is almost mandatory. When translating speeches of well-known politicians, the translator is interested in a certain choice of language means because the taget text should influence the foreign audience in the same way as the original own. Metaphorical utterances and phraseological units are important elements of a political speech that cause difficulties in translation. In order to transfer the expressive function in the translation of metaphors, the translator resorts to a number of stylistic modifications, transformations in which instead of the units belonging to one stylistic register, the units belonging to another one are used. Expressiveness in the speeches of the English-speaking politicians is also achieved through the use of not only metaphor but also metonymy, antithesis, epithet, hyperbole, litotes and lexical repetition. Among the types of lexical repetition anadiplosis, anaphora, epiphora and symploce are considered in the paper. When choosing a translation strategy, it is necessary to take into account the linguistic and cultural features of American rhetoric, the reaction of recipients, as well as the political situation in the country.
METAPHORICAL MODEL GOD IS THE NEED IN ENGLISH AND UKRAINIAN BIBLICAL DISCOURSE
Authors: Izyumtseva Ganna V. 
Published: November 2022

The paper considers the critical problem of contrastive analysis of conceptual metaphors underlying the conceptualization of Biblical (the Pentateuch) realia in English and Ukrainian discourse within the cognitive- discoursive framework. The complex methodology used in the research is based on the procedures of the contrastive analysis of conceptual metaphors developed in works of A. Barcelona, E. V. Budaiev, and A. P. Chudynov. It allowed, first, establishing and systematizing (based on the source-domain) the main shared models of metaphorical conceptualization, namely: anthropomorphic, nature-morphic, phitomorphic, zoomorphic, sociomorphic, artifact, military, temporal, and economic metaphors; second, reconstruction and contrastive cognitive-semantic analysis of the metaphorical model GOD IS THE NEED / БОГ Є ПОТРЕБА pertinent for the English and Ukrainian, but at the same time not elaborated in the Pentateuch. The heuristic and axiological potential of the model was established. The frame-slot conceptual domain THE NEED serves as a source-domain for the target-domain GOD thereby uncovering the cognitive meanings related to the most important spheres of experience of English-speaking and Ukrainian respondents. The obtained results account for some subtle contrasts in metaphorical conceptualization of Biblical (the Pentateuch) realia by present-day representatives of English and Ukrainian linguocultures, and demonstrate the ethnocultural specificity of the national mentality against the background of the universal and shared in the process of the figurative interpretation of the world. In addition, it was found that in contrasted discourses, the concept of GOD figuratively represents the collective idea of the highest spiritual value.
FORMATION OF VALUABLE ATTITUDES TO NATURAL OBJECTS IN CHILDREN: THEORETICAL FOUNDATIONS OF THE PROBLEM
Authors: Pustovit Hryhoriy 
Published: November 2022

The article analyzes the psychological-pedagogical problem of forming a valuable attitude to nature and its individual objects in children, which is relevant to the national education system. The theoretical foundations and conceptual provisions for solving this problem in the 20th and at the beginning of the 21st centuries are revealed. The issue of the creative implementation of Vasyl Sukhomlynskyi's pedagogical heritage in relation to solving this important problem has been updated.The understanding of the specified problem in modern pedagogical science and practice in the context of reforming the national education system and implementing the Concept of the New Ukrainian School is characterized.Four psychological levels of children's knowledge of the environment and the formation of appropriate value attitudes towards it in the creative educational environment of a modern educational institution are defined and substantiated (awareness of the environment or its individual objects based on sensory perception of the realities of reality; awareness of one's place and role in the environment as a single integral socio-natural system; formation of concern for the state of the environment; awareness of the direct influence of the environment as a whole or the state of individual natural objects on the formation of a child as a personality)/
The stages of forming a child's subjective attitude towards nature or its individual objects as a value category are characterized, such as the accumulation of elementary knowledge and experience of interaction with the surrounding world or its individual objects; determination of the totality and content of own needs, their hierarchy in the mind of the child; determining the nature or individual objects (sets of objects) or phenomena of the natural (socio-natural) environment, which, according to the child's belief, can satisfy his needs; the child's awareness of objective connections between objects of nature and their own needs; analysis of the effectiveness of the results of one's own behavior or activity in the environment to satisfy one's own needs.
Effect of Ascorbic acid on Serum Calcium Levels in Hyperparathyroid and Euparathyroid Individuals with and without Physical Activity
Authors: Nargis Hayder Kakar  , Hina Sadaf  , Mutayyaba Majeed  , Roheen Shakeel  , Zobiah Hafeez  , Asma Hussain  , Zunera Tanveer  
Published: November 2022

Introduction: In end-stage renal disease, there is a high incidence of secondary hyperparathyroidism. It is proposed that increasing vitamin C levels by dietary supplementation results in a decrease of parathyroid hormone (PTH) in vitamin C-deficient hemodialysis patients with secondary hyperparathyroidism. The aim of this study was the evaluation of vitamin C administration for reduction of serum PTH level in hemodialysis patients.
Participant-Reported Effects of Armed Conflict and Displacement on Behaviour and Attitudes in Malakand District of Pakistan
Authors: Rubina Salma Yasmin  , Asfandiyar  , Farzand Iqbal  , Muhammad Iqbal  , Salahud Din  
Published: November 2022

This study was carried out in Malakand District, to identify conflict related loss of family members and affect on livelihood as reported by study participants, to assess participant-reported perceived changes in human behaviour and attitude towards revenge due to armed conflict and displacement. For this cross-sectional study, convenient sampling was done among residents at the time of conflict and thereafter. Four hundred and thirty-five residents of Malakand District were included in the study. Two hundred and sixty-six (61%) of the participants were displaced from their hometown and 23% had one or more of their family members injured during the conflict. One hundred and sixty-five (38%) participants believed that they have the right to take revenge by whatever means necessary and 287 (66%) reported an increase in the incidence of domestic violence and abuse. Increase in abductions and robberies were reported by 292 (67%) and 182 (41.8%) participants respectively. Those displaced were more likely to report a family member killed (p = 0.044) or injured in the conflict (p <0.05), earnings affected (p <0.05), increase in robberies (p = 0.006) and increase in abductions (p = 0.003) compared to those who were not displaced in the conflict. Substantial loss of family members, displacement and loss of livelihood were reported by the participants due to armed conflict as well as an increase in various criminal activities. Health professionals in areas of conflict should consider focusing on domestic violence, mental health and social history.
Detection of Japanese Encephalitis Virus & West Nile Virus in Suspected Population in Pakistan
Authors: Darakhshan Guhar  , Najeeb Ullah  , Shoukat Jahan Talpur  , Muhammad Kamran Akhtar  , Owais Quadri  , Yasmeen  , Gulzar Ahmed Channa  , Saifullah Khan  
Published: November 2022

Objectives: To investigate the presence of IgM and IgG in the sera of patients screened for Dengue and Chikungunya during Dengue outbreak 2015-2019 in Karachi, Pakistan.
Methods: Japanese encephalitis virus (JEV) and West Nile virus (WNV) are two neglected viral infections in Pakistan. A sero-survey was conducted to assess the exposure of the population to JEV and WNV in Pakistan. The patients screened negative for Dengue and Chikungunya but had acute undifferentiated febrile illness during Dengue outbreak 2015-19 in Karachi, Pakistan were included in the study. Total 115 human sera were subjected to ELISA for detection of IgM and IgG antibodies produced in response to West Nile virus and Japanese Encephalitis virus.
Results: Our results highlighted that the overall prevalence of Japanese Encephalitis and West Nile Virus in screened population was 76.52%. The sero-positivity for Japanese encephalitis virus was found in 50 samples whereas; the prevalence of West Nile virus (WNV) was detected in 38 samples. However, 21 samples with co-circulation were indicated in our results.
Conclusion: In conclusion, this is an alert for physicians to suspect WNV and JEV infection in patients with a dengue-like illness especially those patients who are dwelling or traveling to and from Pakistan. Therefore, there is a need of standardized diagnostic facilities and surveillance system at national level to avoid misdiagnosis and rule out the actual prevalence rate in Pakistan.
Susceptibility Pattern of E. coli Isolates from Urinary Tract Infections, in Quetta
Authors: Mengal Hasina Mengal 
Published: November 2022

Globally Urinary tract infections (UTIs) are the serious health problem affecting about 150 million people per year. The most common cause of UTI is Gram negative bacteria that Belong to the family Enterobacteriaceae. Members of these families include Escherichia Coli, Klebsiella, Enterobacter and Proteus. Mid stream urine was collected in a sterile container from suspected case of UTI. The urine was inoculated by 1mm loop, on Mac Conkey agar and EMB agar, incubated at 37c, for 24 hours in aerobic atmosphere. After 24 the colony was examined for colony morphology, gram staining motility test. Biochemical test like Indole, Methyl red, Voges – Proskaur Citrate inoculated in related test media to identify the E. coli strains. Susceptibility pattern was done by disk diffusion method. Total 40 isolates of E. coli were included in this study. Out of them 22 were female and 18 were male patients. The age ranges from 4 less than 14 years 10 patients, 15-29 years, 12 patients from 30 -44 years,7 patients of 45-59 years. 7 more than 60 years age. The Antibiotic susceptibility was Imipenem 96.66%, Nitrofurantoin 96.15%, Amikacin 85%, Meropenem 71.42%, Fosfomycin 66.66%, Ceftazidime 27.27%, Pipemidic Acid 26%, Ceftriaxone 24.24%, Ciprofloxacin 14.81%, Nalidixic Acid 12.5%.E. coli is becoming resistant to routine urinary antibiotics like Nalidixic Acid Pipemidic Acid and Quinolones like ciprofloxacin. Cephalosporins are also loosing sensitivity against E. coli. Imipenem, Nitrofurantoin and Amikacin has good susceptibility against E. coli in urinary isolates
Prevalence of Rounded Shoulder in Computer Users. A cross-sectional survey
Authors: Arif Abeera 
Published: November 2022

Background and aim: The study's goal is to determine the prevalence of rounded shoulder in computer users. Computer technology have become very important part of our lives. It impacts significantly on our health, daily life and work and also upper extremity of our body including shoulder, neck arms and hands.
METHODOLOGY: The research is based on observation. The study enlisted the participation of 377 people in total. Both male and female were included. A demographic questionnaire of Age, BMI etc was used and VAS was also added in survey. The participants were observed and shoulder were measured by different tools using goniometer/flexibe scale and wall stand test. Data were collected according to working hours/screen time also.
Results: The results show 62.6% participants with rounded shoulder. Mostly users were of young age and they spent different hours at computer but minimum were 3 hours. There were 62.1% users for more than a year and 41.6% participants use computer or laptop for more than 5 hours per day. The use of computer for long time without proper posture can cause rounded shoulder.
Conclusion: It is concluded that poor, long and sustained posture can cause rounded shoulder. It is also observed that use of technology for long time without healthy lifestyle is also cause of pain in individuals but all have their own experience.
Keywords: Computer users, Rounded Shoulder, Shoulder Pain, Neck Pain, Forward Shoulder
Spontaneous obliteration of brain arteriovenous malformations: illustrative cases
Authors: Agyemang Kevin , Rose Anna , Olukoya Olatomiwa , Brown Jennifer , St George Edward Jerome 
Published: November 2022

BACKGROUND
Spontaneous angiographic obliteration of a brain arteriovenous malformation (AVM) is considered a rare outcome, with most cases in the literature related to prior hemorrhage in small brain AVMs. The authors present a prospective, single center, consecutive case series. The clinical course and radiographic features of four cases with spontaneous obliteration of brain AVM were analyzed.

OBSERVATIONS
The median age of patients in this series was 47.6 years, with an equal gender split. The median maximum brain AVM diameter was 2 cm. The median time to spontaneous obliteration was 26 months, with hemorrhage preceding this in three out of four cases and a prolonged latency in the only case with a nidus size larger than 3 cm and no hemorrhage.

LESSONS
The present study provides additional information to allow clinicians to counsel patients about the rare outcomes of conservative management. This work extends our understanding of when this phenomenon can occur by reporting on the differences associated with spontaneous obliteration of larger AVMs.
Direct intralesional n-butyl-cyanoacrylate embolization for intractable vertebral hemangioma bleeding: a salvage technique. Illustrative case
Authors: Kenworthy Matthew K. , Bakmeedeniya Roshitha , Narula Soni , Wong George 
Published: November 2022

BACKGROUND
Surgical resection of vertebral hemangiomas in the setting of cord compression can be technically difficult and has the potential for life-threatening hemorrhage. The authors report a case of intraoperative direct intralesional n-butyl-cyanoacrylate embolization for intractable vertebral hemangioma bleeding.

OBSERVATIONS
A 53-year-old woman presented for repeat surgery of a residual vertebral hemangioma after a previous debulking, laminectomy, and fixation that were without problems with bleeding. The second surgery was complicated by intractable hemorrhage. Bleeding was controlled with direct intralesional n-butyl-cyanoacrylate embolization after fluoroscopy without accompanying endovascular embolization.

LESSONS
Aggressive vertebral hemangiomas should ideally be managed in centers where transarterial embolization is available. If such centers are not available or there is still intractable intraoperative bleeding despite preoperative embolization, direct intralesional embolization may be considered as a potential salvage technique.
Paraparesis caused by intradural thoracic spinal granuloma secondary to organizing hematoma: illustrative case
Authors: Yue John K. , Lee Young M. , Quintana Daniel , Aabedi Alexander A. , Krishnan Nishanth , Wozny Thomas A. , Andrews John P. , Huang Michael C. 
Published: November 2022

BACKGROUND
Spinal granulomas form from infectious or noninfectious inflammatory processes and are rarely present intradurally. Intradural granulomas secondary to hematoma are unreported in the literature and present diagnostic and management challenges.

OBSERVATIONS
A 70-year-old man receiving aspirin presented with encephalopathy, subacute malaise, and right lower extremity weakness and was diagnosed with polysubstance withdrawal and refractory hypertension requiring extended treatment. Seven days after admission, he reported increased bilateral lower extremity (BLE) weakness. Magnetic resonance imaging showed T2–3 and T7–8 masses abutting the pia, with spinal cord compression at T2–3. He was transferred to the authors’ institution, and work-up showed no vascular shunting or malignancy. He underwent T2–3 laminectomies for biopsy/resection. A firm, xanthochromic mass was resected en bloc. Pathology showed organizing hematoma without infection, vascular malformation, or malignancy. Subsequent coagulopathy work-up was unremarkable. His BLE strength significantly improved, and he declined resection of the inferior mass. He completed physical therapy and was cleared for placement in a skilled nursing facility.

LESSONS
Spinal granulomas can mimic vascular lesions and malignancy. The authors present the first report of paraparesis caused by intradural granuloma secondary to organizing hematoma, preceded by severe refractory hypertension. Tissue diagnosis is critical, and resection is curative. These findings can inform the vigilant clinician for expeditious treatment.