Webster University

Ransomware poses a growing threat to healthcare systems, compromising patient safety, operational continuity, and financial stability. Although machine learning techniques have been widely used for intrusion detection, most approaches do not support real-time, cost-sensitive response planning. In this paper, we propose a hybrid framework that integrates deep learning with quantum optimization to both predict the severity of ransomware infection and recommend optimal recovery strategies. The system employs a multilayer perceptron (MLP) trained on structured ransomware incident data to forecast infection rates, followed by a quantum post-processing module using the Quantum Approximate Optimization Algorithm (QAOA) to minimize operational and financial costs through discrete response decisions. We evaluated the framework on a realistic healthcare ransomware dataset consisting of 5,000 simulated attack scenarios. Our approach achieves a root mean squared error (RMSE) of 0.073 in the prediction of infection rates and demonstrates up to 25% cost savings over classical heuristics in recovery decisions. Extensive experiments confirm the generalizability of the model to unseen attack types, the scalability across data volumes, and the stability of the decision in risk contexts. The proposed method represents a step toward intelligent real-time ransomware mitigation systems for high-risk environments such as healthcare.

The study examines the Japanese school sports festival (undōkai) as a cultural and educational practice aimed at the comprehensive development of children—physically, socially, emotionally, and morally. The work answers the research question of what educational values undōkai promotes, based on an analysis of sources and the results of a questionnaire survey.

Abstract Background Maintenance of sinus rhythm is challenging in patients with longstanding persistent atrial fibrillation (PeAF). Minimally invasive surgical AF ablation may improve outcomes when combined with catheter ablation (the hybrid convergent ablation). This real world data series evaluates the safety and efficacy of the convergent procedure in longstanding PeAF. Methods 91 consecutive patients with longstanding PeAF underwent subxiphoid endoscopic ablation of the posterior left atrium followed by catheter ablation from 2013 to 2022 at a single tertiary within the dedicated hybrid theatre. Median age was 64.4 years with a BMI of 30.3kg/m2. Median duration of AF was 50.4 months with an LA diameter of 45.7mm. The primary outcome was AF-free survival at 12 months; secondary outcomes included change in EHRA class, echocardiographic data, procedural complications, freedom from anti-arrhythmic drugs (AADs), and long term arrhythmia-free survival. All patients underwent 72 Holter monitoring at 3 months and then 12 months post procedure with an echocardiogram at baseline and then at 12 months. Holter monitoring at 6 months was dependant on clinical status. Results After 12 months, the convergent procedure was associated with increased AF-free survival on AADs (65.3%) and off AADs (43.5%). Allowing for multiple procedures, after 32.3 ± 12.7 months' follow-up the convergent procedure was associated with arrhythmia-free survival on AADs (48.4%) and off AADs (33.7%). Complication rates were 4.3% until 2018 over the first 5 year data outcomes, followed by 1.2% with no major complications over the next 5 years following a change from subdiaphragmatic access to subxiphoid access and increased operator experience. Conclusions In longstanding Persistent AF, the convergent procedure is associated with improved arrhythmia-free survival. Complication rates over time have improved due to changes in the access and operator experience.

The study explores the significance of translation studies in the internationalization of the Uzbek language. In the context of globalization, translation serves not only as a linguistic bridge but also as a cultural mediator that shapes perceptions of Uzbek identity abroad. This article analyzes theoretical and practical aspects of how translation contributes to promoting Uzbek literature, academic discourse, and intercultural communication. Special attention is given to the challenges of ensuring accuracy, stylistic adequacy, and cultural adaptation when Uzbek texts are translated into world languages. The research also highlights strategies for strengthening international cooperation in translation projects and academic exchange.

Purpose This paper aims to investigate the evolution of family representations in children’s literature, focusing on the rise of queer narratives and the critical role of chosen families in shaping children’s understanding of familial relationships. Design/methodology/approach Via counter-storytelling, the authors of this work critique limitations embedded throughout traditional family portrayals as well as the implications of these narratives for queer children’s socialization and identity formation. This critique argues that traditional family structures often reinforce heteronormative ideals, whereas, in contrast, an inclusion of queer counter-narratives and chosen families in children’s literature serves to validate diverse experiences and promote inclusivity among young readers. Throughout this piece, the authors use counter-storytelling – as both a method and as an analytic lens, while drawing from critical race theory (Ladson-Billings and Tate, 1995) and queer of color critique (Ferguson, 2004) to center marginalized familial narratives. Together, these critical frameworks function as pedagogical tools for illuminating the lived realities of various individuals outside of dominant norms. Findings The findings showcase how the traditional, nuclear family model depictions often marginalize those who fail to adhere to or fit its limiting structures, thereby leading to feelings of exclusion. In contrast, the inclusion of queer narratives and chosen families in literature fosters acceptance and understanding, providing essential validation for queer youth. This work contributes to existing literature by highlighting chosen families and queer representation in children’s literature as essential in advocating for greater understanding of family dynamics that transcends traditional nuclear model to include chosen families. Originality/value The work presented in this paper is our own. Neither artificial intelligence nor large language models) were used to produce any of the research, findings or writing.

<h3>Introduction/Purpose</h3> Headache is a nearly universal and often disabling symptom in the acute phase of aneurysmal subarachnoid hemorrhage (aSAH), yet it remains inadequately managed, often requiring high-dose opioids. Emerging evidence suggests that meningeal inflammation and dural nociceptor activation contribute significantly to this pain. As the middle meningeal artery (MMA) supplies the pain-sensitive dura, it offers a potential route for targeted therapy. We evaluated whether dural infusion of lidocaine—with or without dexamethasone—via the MMA during aneurysm embolization could provide effective, opioid-sparing pain relief. <h3>Materials and Methods</h3> In this prospective pilot study, nine patients with Hunt and Hess grade 1-2 aSAH and severe headaches (VAS ≥7) were randomized to one of three groups (n=3 each): (1) Lidocaine + Dexamethasone (L+D), (2) Lidocaine alone (L), or (3) No treatment (Control). Treatment was administered during endovascular embolization via selective MMA infusion bilaterally (50 mg of Lidocaine each side ± 10 mg dexamethasone). Pain scores were measured at baseline, multiple intervals in the first 24 hours, 7 days and 1 month. Primary outcomes were pain relief and opioid use (oral morphine equivalents, OME). A responder was defined as ≥50% reduction in VAS at 24 h. Safety was assessed by a composite endpoint of stroke or cranial neuropathy. <h3>Results</h3> Post-procedure VAS scores were significantly reduced in L+D (median 2) and L (4) compared to Control (6; p=0.038 each), but there was no difference between the L+D and L groups. First-day cumulative VAS scores were significantly lower in treated groups (16 vs 31; p=0.012). Subacute (24h-7d) cumulative VAS, 1-month (7d-1mo) cumulative VAS, and total (post-op to 1mo) cumulative VAS remained significantly lower in the treated groups. All L+D patients, two of three L patients, and no controls achieved a ≥50% immediate VAS reduction. Opioid use was substantially lower in treated groups compared to controls (median oral morphine equivalents [OME]: L+D = 5.6 mg, L = 0 mg, Control = 16.7 mg; combined treated vs Control, p = 0.16).. No adverse events occurred. <h3>Conclusion</h3> Targeted dural therapy via the MMA during aneurysm embolization appears safe and may offer meaningful, sustained pain relief after aSAH. Patients receiving lidocaine, with or without dexamethasone, experienced significant reductions in pain and opioid use. These encouraging results support further investigation into this novel therapeutic strategy to improve post-aSAH recovery and reduce reliance on opioids. <h3>Disclosures</h3> <b>M. Costa:</b> None. <b>T. Zhang:</b> None. <b>P. Kan:</b> None. <b>T. Hong:</b> None.

This applied research case study investigates whether the pre-service teachers use Instruction Checking Questions (ICQs) and Concept Checking Questions (CCQs) to improve their instructional clarity in the microteaching of the practicum course. According to the study, 24 out of 26 pre-service teachers (92.31 %) did not apply ICQs, and no one effectively used CCQs. Even though they had passed the instructional methods, teaching English to Young learners, and lesson planning courses, the participants of this study failed to give clear instructions and check students' understanding of grammar and vocabulary in the classroom. The author used qualitative applied research with basic descriptive statistics. The observations and analyses were conducted on the recordings of the practicum microteaching course. The findings represent that overuse of teacher talk, lack of instructional scaffolding, and no application of conceptual understanding are the essential issues. The gaps found in the literature also align with the findings from the studies on pre-service educator practices. In conclusion, there is a need for more experiential and practice-oriented courses in higher educational institutions in Uzbekistan. The research advocates for a structured reflective approach, explicit modeling, clear demonstration, reduction of Teacher Talking Time (TTT), and feedback sessions. The article suggests that the curriculum should incorporate more practical topics on ICQs, CCQs, a discussion of the reflective approach, modeling technique, the use of TTT, constructive feedback, and as well as critical pedagogy.