bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Life-Threatening Contralateral Tension Pneumothorax during Video-Assisted Thoracic Surgery in a Patient with Retrosternal Goiter
Authors: Prasad Nimitha , Gaiwal Sucheta S. 
Published: January 2025

ABSTRACT
We report a case of a 74-year-old female with a retrosternal goiter undergoing video-assisted thoracic surgery (VATS) for a left lung lower lobectomy, necessitating one-lung ventilation (OLV). We encountered a highly unusual complication: contralateral tension pneumothorax. Forty-five minutes into the surgical procedure, a sudden cardiovascular collapse occurred. After confirming the correct positioning of the double-lumen tube and excluding mediastinal mass syndrome (MMS), tension pneumothorax was suspected. Immediate needle decompression followed by right chest tube thoracostomy resulted in a successful patient outcome. This case highlights the importance of maintaining a high index of suspicion for contralateral tension pneumothorax in patients with sudden cardiovascular collapse during OLV.
Developing and validating a questionnaire for knowledge and attitude assessment of medical interns toward transfusion medicine
Authors: Nair Revathy , Gnanaraj John , Toora Esha , Basavarajegowda Abhishekh 
Published: January 2025

Abstract

INTRODUCTION:
The knowledge and attitude level of medical professionals is different at different phases of their careers. Since one size does not fit all and there were no questionnaires available specifically designed for the medical interns, we undertook this exercise to design one for them duly considering their curriculum, exposure, and the nature of work they are expected to do with regard to blood transfusion.

METHODOLOGY:
The questionnaire was designed, and the questions were framed considering the type of information that was required, themes and items for inclusion, appropriate wording for comprehension, layout, and presentation of questions by the nominal group technique of subject experts. Piloting of the questionnaire was done to check for feasibility, validation, and reliability.

RESULTS:
The questionnaire on pilot testing displayed acceptable feasibility with a difficulty rating of 63%. The precision of the questionnaire was indicated by reliability, with test–retest responses showing near-perfect agreement for all the questions with a kappa value between 0.8 and 0.99 (P = 0.008). The value of Cronbach’s alpha for the cumulative score of the test–retest of the pilot population (n = 11) was also good (α = 0.806).

CONCLUSION:
The questionnaire prepared for assessing the knowledge and attitudes of the interns was reliable and was validated with acceptable contents and repeatability. The procedure may be adopted easily by others who intend to prepare their questionnaire.
A whistleblower direct antiglobulin test in chronic kidney disease: An interesting case of occult autoimmune hemolytic anemia in an undiagnosed lymphoma with pure red cell aplasia
Authors: Setia Rasika Dhawan , Dogra Mitu , Jain Kunal 
Published: January 2025

Abstract
A 67-year-old male, presented with urosepsis, severe anemia, advancing azotemia requiring blood transfusion. Patient grouped as O RhD positive. Antibody screening was pan-positive (4+). Similar strong pan-positivity seen on antibody identification with extended cell panel. DAT was 4+ positive for IgG and negative for complement C3. Repeated identification with eluate also showed pan-positive (4+) reaction. Serum haptoglobin markedly reduced. Bone marrow aspirate suggested pure red cell aplasia with suspicion of parvovirus-related changes. Bone marrow biopsy suggested T-cell lymphoproliferative disorder. Immunophenotyping elucidated a suspicious clone of CD7-negative T-cells with CD4 restriction. Histopathological examination revealed angioimmunoblastic T-cell lymphoma (AITL) with bystander Epstein–Barr virus-driven large B-cells. Owing to rarity and nonspecific symptoms, diagnosis of AITL is often challenging. Antibody screen acted as a whistleblower for an undiagnosed aggressive lymphoma. Thus, it will be prudent to look beyond the obvious in complex cases, and a detailed workup will help put together all parts of the jigsaw puzzle.
Predicting interactome networks of up/down regulated proteins and drug-gene interaction analysis associated with peri-implantitis
Authors: Asadzadeh Azizeh , Moattar Fatemeh Shams , Moshfegh Azam 
Published: January 2025

ABSTRACT

Background:
Peri-implantitis is implant-associated inflammation that leads to irreversible loss of surrounding bone. Early diagnosis increases the success of peri-implantitis treatment. Despite various studies associated with this most common complication, early detection of the onset of peri-implantitis remains a major challenge. Molecular biomarkers are applicable detectors for the early detection of numerous diseases and monitoring their development. The present study aimed to predict interactome networks of up/down regulated proteins and analyze drug-gene interaction in peri-implantitis to identify the diagnostic and druggable genes.

Materials and Methods:
In this in silico study, a suitable gene expression profile related to peri-implantitis was retrieved from Gene Expression Omnibus. Screening differentially expressed genes (DEGs) was carried out based on the cut-off criteria |log2 (fold change)|>2 and P < 0.05. Interactome networks were constructed and analyzed by the STRING database (Version: 12.0) and the Cytoscape software (version: 3.9.1). Finally, to investigate drug-gene interaction, detected hub genes were analyzed by DGIdb (version: 5.0.6).

Results:
A total of 216 genes were identified as DEGs (129 down-regulated and 87 up-regulated genes) in peri-implantitis. Regarding Cytoscape analysis, FCGR3B, CSF3R, AQP9, TREM1, and P2RY13 were the top 5 hub nodes of up-regulated DEGs, and CXCL10, OASL, IFIT1, RSAD2, and ISG15 were the top 5 hub nodes of down-regulated DEGs. Among these key nods, AQP9, CSF3R, CXCL10, IFIT1, ISG15, OASL, and, FCGR3B were therapeutic targets and had approved drugs.

Conclusion:
In this research, seven genes have been identified as druggable genes in peri-implantitis which can be used to treat and diagnose this disease. However, these results and identified genes need to be validated by clinical or experimental methods.
Incidence of healthcare-acquired infections among patients with hematopoietic stem cell transplantation
Authors: Yahia Noura R. M. , Mostafa Manal M. , Samra Mohamed A. , Ahmed Ehsan Y. 
Published: January 2025

Background
Hematopoietic stem cell transplantation (HSCT) is a well-recognized therapeutic modality for the treatment of bone marrow or immune systems that are damaged or defective either because of malignant or nonmalignant causes. Patients receiving HSCT are at high risk for infection for the following reasons: induced suppression of the body’s immune system, administration of massive chemotherapy and immunosuppressive drugs, and use of antibiotic therapy as prophylaxis before and after transplantation.

Aim
This study aimed to assess the incidence of healthcare-acquired infections among patients with HSCT.

Design
A descriptive/exploratory research design was used to carry out this study. It is one of the nonexperimental research designs, which are an efficient means of collecting a large amount of data in a relatively short time. The main purpose of a descriptive research design is to describe, observe, and document in detail some processes, events, risk factors, and outcomes.

Sample
A convenient sample of 62 adult male and female patients after HSCT were recruited to achieve the aim of the study.

Setting
This study was conducted in the Bone Marrow Transplant Unit at Nasser Institute for Research and Treatment in Cairo, Egypt. Tools: data was collected using three tools: Personal and Medical Background Data Form, The adopted Infection Prevention Checklist, and (c) Healthcare-Acquired Infection Checklists.

Results
Study findings denoted that the mean age was 35.5±12.9, and more than half of the study sample was males, revealing that 87.8% of the study participants acquired infection during hospitalization, while 12.2% did not acquire infection. However, 50% of study participants acquired bloodstream infection, 19.4% had pneumonia, 12.9% of them had urinary tract infection, and 1.6% had two types of infection perceptively.

Conclusion
This study concluded that bloodstream infection is the most common and serious healthcare infection among patients with HSCT.

Recommendations
Nurses should follow the guidelines for aseptic technic during implied central venous line care and drug administration to reduce BSI infection within hospitalization, and patients with HSCT should maintain oral care and self-hygiene regularly to reduce the incidence of healthcare-acquired infections. Also, further studies should be conducted to assess different types of infections.
Effect of virtual reality on women’s labor pain perception at Tanta University Hospital
Authors: Abosaleh Enas M. A. , Hameed Azza A.A. , Abdelmonem Amel S. 
Published: January 2025

Background
Normal labor is considered one of the most memorable and painful experiences in a woman’s life. It is ranked high on the pain rating scale when compared to other painful life experiences. The aim of this study is to evaluate the effect of virtual reality on pain perception during the first stage of labor.

Design
A quasi-experimental design (pretest–posttest nonequivalent control group design) was adopted in this study to obtain the stated aim.

Sample
A purposive sample of 300 laboring women was recruited for this study and categorized into two groups: the study group consisted of 150 laboring women who received the virtual reality intervention and routine hospital care, and the control group consisted of 150 laboring women who received routine hospital care only.

Setting
The current study was conducted at the labor and delivery ward at Tanta University Hospital. Tools: four tools were utilized: (a) Structured Interviewing Questionnaire Schedule, (b) visual analog pain intensity scale, (c) Wong-Baker faces pain rating scale, and (4) laboring women satisfaction tool.

Result
The study findings showed that there was a statistically significant decrease in labor pain perception in the study group using the visual analog scale after the first application of virtual reality with a mean of 7.23±0.99 and 3.87±1.74 in control group and study group, respectively (P=0.001). Moreover, after the third application of virtual reality with a mean of 8.79±0.88 and 3.47±2.37 in control group and study group, respectively (P=0.001). While using Wong Baker face rating scale the labor pain perception statistically significantly decreased in the study group after using the first application of virtual reality with a mean of 3.35±0.56 and 2.17±0.88 in the control group and study group, respectively (P=0.001). Moreover, 86% of the study group were satisfied regarding virtual reality application.

Conclusion
Based on the findings of this study, virtual reality has a positive effect in decreasing pain perception during the first stage of labor. It also achieved satisfaction of laboring women with using it during labor.

Recommendation
Apply virtual reality technique as a non-pharmacological therapy in labor pain management.
Undergraduate nursing students’ perception of quality of managing objective structured clinical examinations and its relation to their exam stressors and achievement
Authors: Mahmoud Eman A. , Al Fattah Magda A.A.H.A. , Gaber Shereen 
Published: January 2025

Background
An objective structured clinical examination (OSCE) is one of the most important instruments for assessing clinical skills at the undergraduate level of nursing education. During their clinical exams, nursing students frequently encounter a range of stressors, which may either directly or indirectly affect how well they perform.

Purpose
This study aimed to investigate undergraduate nursing students’ perceptions of the quality of managing objective structured clinical exams and their relation to their exam stress and achievement.

Methods
A quantitative descriptive correlational design was utilized. Four tools of data collection were used from a solicited sample of 705 students from undergraduate Nursing students embroiled in various Nursing specialties, and levels that completed the OSCE exams within a certain semester at the Faculty of Nursing, Cairo University.

Result
The main findings revealed that nursing students had overall positive mean score perception to word OSCE performance, organization, attributes, and total quality of managing OSCE exams. The overall mean score of incidence of stress was moderate to high at different educational levels. There was highly statistically significant relationship between students, grade point average (GPA) and total quality of managing OSCE, also between GPA and Perceived OSCE exam stress among the students at the second educational level only.

Conclusion
Accordingly, it can be concluded that, the perceived quality of managing OSCE affects OSCE exam stress level and total GPA.

Recommendations
The study recommended that more practice sessions/mock exams with adequate feedback for better prepare for OSCE exams. Redesigning for OSCE laboratories for money-efficient, effective conduction of OSCE exams. determine contributing factors causing stress during OSCE exams for better preparation of OSCE exams without stress. Further studies are required before recommending OSCE as a formative evaluation tool in undergraduate nursing students.
Phytochemical screening and cytotoxic activities of <i>Enhalus acoroides</i> (L.f.) Royle and <i>Halimeda macroloba</i> Decaisne on cervical cancer cell lines
Authors: Navakanitworakul Raphatphorn , Nittayaboon Kesara , Chumkaew Parinuch , Phetcharat Sinjai , Mayakun Jaruwan 
Published: January 2025

Purpose: To determine the cytotoxic effects of phytochemical compounds in Enhalus acoroides and Halimeda macroloba crude extracts on cervical carcinoma and normal kidney tissue cells.
Methods: Dried Enhalus acoroides and Halimeda macroloba were macerated in ethanol. Then, phytochemical screening was done using thin-layer chromatography (TLC). The cytotoxic activities of extracts against HeLa and SiHa cervical cancer cells were performed using MTT assay.
Results: The H. macroloba extract was highly active against SiHa cells, with an IC50 of 17.22 ± 3.93 μg/mL, and moderately active against HeLa cells, with an IC50 of 36.57 ± 7.26 μg/mL. The E. acoroides extract was moderately active against both HeLa and SiHa cells. Moreover, both extracts exhibited lower toxicity against HEK293 normal kidney cells, with IC50 values of > 80 μg/mL.
Conclusion: These results suggest that E. acoroides and H. macroloba exert potent cytotoxic activity on cervical cancer cells. The mode of action associated with the cytotoxicity of these extracts, and the effect of the combination of the extracts with chemotherapy, should be investigated in subsequent studies.
Antioxidant and α-glucosidase inhibitory activities of phytochemicals extracted from leaves, branches and roots of native and hybrid Thai mulberry (Morus alba, Linn.) cultivars
Authors: Katisart Teeraporn , Magnussen Kanitsara , Konsue Ampa , Butkhup Luchai , Butiman Chirapha 
Published: January 2025

Purpose: To determine the phytochemical compounds, in leaves, branches and roots of two mulberry cultivars, Monnoi and Buriram 60 (Br.60).
Methods: Both cultivars were grown under organic conditions. Extraction of plant parts was done using either distilled water (autoclave), 50 % ethanol or 95 % ethanol and the proximate chemical analysis including 1-Deoxynojirimycin (DNJ) content, total flavonoid (TFC) and total phenolic contents (TPC), antioxidant and α-glucosidase inhibitory properties of the plant extracts were analyzed.
Results: The proximate analysis showed that both cultivars had high protein content in leaves (21 – 25 %) compared to branches and roots. The carbohydrate content was high in all parts of both cultivars (32 – 50 %) and the DNJ content of all parts using 50 % ethanol extraction was higher compared to the other two methods, ranging from 10 – 17 mg/g Ext. Total phenolic content (TPC) in Monnoi branches extracted with distilled water (autoclave) was 13.45 ± 0.26 mg GE/g Ext while Br.60 roots with distilled water extraction (autoclave) showed the highest total flavonoid content (TFC) at 1.55 ± 0.02 mg QE/g Ext. Antioxidant activities of the extract on FRAP, DPPH radical and ABTS were high for both cultivars but the IC50 value was higher and significantly different (p < 0.05) compared to two standards used as controls (Trolox and Ascorbic acid). The α-glucosidase assay showed that the leaves and branches of Monnoi had IC50 values of 2.21 ± 0.09 and 2.45 ± 0.1, respectively, with the potential to reduce enzymatic activity but less than the standard substance Acarbose with an IC50 of 0.31 ± 0.01.
Conclusion: Two mulberry cultivars, Monnoi and Br.60, show high potential for diabetes treatment owing to their bioactive compounds. Extraction with 50 % ethanol gives the highest yield. Further isolation and characterization and possible mechanism of action of phytoactive constituents such as 1- deoxynojirimycin (DNJ) would be necessary.
Evaluation of awareness, perceptions and opinions of artificial intelligence (AI) among healthcare students – A cross-sectional study in Saudi Arabia
Authors: Fadil Haifa , Alahmadi Yaser 
Published: January 2025

Purpose: To ascertain the views, knowledge and opinions of healthcare students (HCs) regarding artificial intelligence (AI).
Methods: The cross-sectional survey designed to assess awareness, perceptions and opinions of HCs towards AI was conducted between April to June 2023. A pre-tested, validated structured questionnaire was distributed electronically to HCs across different universities in Saudi Arabia. Responses were compiled using a 5-point Likert scale. Cronbach's alpha score of 0.80 was used to establish the reliability of the questionnaire. Mean scores were determined by calculating each item in the perceptions compiled.
Results: Majority of HCs had a positive perception towards AI in healthcare and agreed that AI could improve diagnostic accuracy (73.4 %), reduce errors in medical practice (65.2 %) and facilitate patient education (70.8 %). However, some concerns were expressed that AI has a harmful impact on healthcare practitioners' relationships with patients and potential ethical implications (44.3 %) and also allows patients to increase control over their health (51 %). Most students (85 %) believe that if AI is integrated into healthcare, there is a risk of losing jobs. The analysis of multiple linear regression shows that course of study (B = 0.311; SE = 0.132; t = 2.360; p = 0.019; CI = 0.052 to 0.570), awareness of AI (B = -1.822; SE = 0.785; t = -2.320; p = 0.021; CI = - 3.366 to -0.279) were predictors of perception score of AI.
Conclusion: Healthcare students show positive perceptions towards AI and agree that AI helps in various aspects of healthcare. However, students revealed some concerns about AI. Therefore, addressing concerns related to ethics, workforce impact and patient privacy is crucial for successful AI implementation in the healthcare sector.
Therapeutic and clinico-biological significance of CREB3L4 expression in primary prostate cancer
Authors: Alfahed Abdulaziz 
Published: January 2025

Purpose: To investigate the therapeutic, clinicopathological and biological relevancy of CREB3L4 expression in primary prostate cancer (PCa) and to determine the mechanisms underlying the deregulation of CREB3L4 expression in PCa.
Methods: The therapeutic, clinicopathological and biological significance of CREB3L4 expressions in two cohorts of PCa, and the mechanisms of deregulation of CREB3L4 expression using TCGA data were determined using integrative computational analyses of the clinico-genomic data of the cancer genome atlas (TCGA) and Deutsches Krebsforschungszentrum (DFKZ).
Result: Gene set enrichment analyses (GSEA) demonstrated enrichment of gene sets that predict biological responses to a range of approved inhibitors in the PCa subsets with low CREB3L4 expression, and at nominal and false discovery rates of p < 0.05 and p < 0.25, respectively. In addition, lower CREB3L4 expression in TCGA PCa cohort showed poorer outcomes following androgen deprivation therapy. Furthermore, GSEA demonstrated that cell proliferation, epithelial-mesenchymal transition, angiogenesis, inflammatory response and apoptosis gene sets were enriched in PCa subsets with low CREB3L4 expressions. Low CREB3L4 expression was associated with adverse clinicopathological features of PCa at adjusted p < 0.05. Multiple regression analysis of the methylation, microRNA expression and copy number data of CREB3L4 identified the methylation loci and miRNA expression which independently predicted the expression of CREB3L4 in PCa.
Conclusion: This study demonstrates the potential therapeutic relevance and clinico-biological significance of CREB3L4 expression in primary PCa.
Mechanistic insight into the cholinergic, muscarinic and antagonistic effects of Khat (Catha edulis) on native nicotinic acetylcholine receptors
Authors: Abdelwahab Siddig , Sidahmed Heyam , Alfaifi Hassan , Albadawi Dina , Alzahrani Amal 
Published: January 2025

Purpose: To investigate the cholinergic, muscarinic and antagonistic effects of Khat (Catha edulis) on native nicotinic acetylcholine receptors (nAChR) and understand its associated mechanism.Methods: Fresh leaves of Catha edulis (50 g) were pulverized and subjected to extraction using 200mL of methanol and filtered. The filtrate was reconstituted with 0.02 N sulfuric acid, and then chloroform extraction. Properties of the crude alkaloid extract of khat (CAEK) were assessed in skeletal muscles isolated from frog rectus abdominis. In silico analysis of the effects of cathine (CAT) and cathinone (CATO) on muscle-type nicotinic acetylcholine receptors (nAChRs) and molecular docking to predict their potential binding sites on nAChR subunits were carried out.Results: Pre-treatment of isolated muscles with CAEK inhibited carbachol-induced contractility in a dose-dependent manner. At 10, 20, 40 and 80 mg/mL concentrations of CAEK, inhibition percentages were 74.4, 85.2, 95.4 and 99.5 %, respectively. Molecular docking studies show that CAT and CATO modulate the function of nAChRs through competitive antagonism.Conclusion: These results reveal that khat consumption could contribute to the development of skeletal muscle-associated ailments; hence, detailed studies emphasizing cardiac complications and muscular toxicity mechanisms should be conducted.