bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tubercular Meningoencephalitis with  Longitudinal Extensive Transverse Myelitis  (LETM): A Clinical Dilemma
Authors: Pandit Sanjay , Dharra Gaurav , Kumar Kishore , Khan Ulma , Aggarwal Rupal , Garg Sagar 
Published: January 2025

Tuberculosis remains a significant global health challenge with various clinical presentations. In this case, we present a rare occurrence of disseminated tuberculosis with meningoencephalitis with longitudinally extensive transverse myelitis (LETM) in an immunocompetent person, which illustrates its complex clinical course and the challenges associated with diagnosis. A 24-year-old male patient presented with progressive weakness in the proximal lower limbs which was associated with acute urinary retention, followed by fever, headache, neck pain, and projectile vomiting. Neurological examination revealed neck rigidity, decreased sensations, paraparesis, and absent deep tendon reflexes. Cerebrospinal fluid analysis indicated lymphocytic pleocytosis and elevated protein levels. Radiological findings confirmed the presence of meningoencephalitis with LETM. However, the magnetic resonance imaging (MRI) findings in the brain and LETM in the spinal cord were suggestive of an autoimmune association, and neuromyelitis optica spectrum disorder (NMOSD) could not be ruled out. Based on the clinical, laboratory, and radiological evidence, a diagnosis of disseminated tuberculosis was established. The patient was promptly initiated on steroids and antitubercular treatment. This case serves as a reminder of the diverse clinical spectrum associated with tuberculosis, highlighting the importance of considering unusual presentations. Early diagnosis is an important predictor for prognosis which prevents complications and improves patient outcomes.
Community Engagement in the BE SAGE Project: Reducing COVID-19 in Hispanic and Low-Income Preschoolers via Testing and Open-Air Garden-Based Education
Authors: Valdez Hector J. , Santana Michelle , Genis Sandra , Gonzalez Edny , Kramer Joanna L. , Lee Rebecca E. 
Published: January 2025

Objective Back to Early Care and Education Safely With Sustainability via Active Garden Education (BE SAGE) involved COVID-19 testing and a free garden-based physical activity and nutrition program at early care and education centers with primarily Hispanic/Latino enrollment. This article describes the project community engagement plan, process, and outcomes focusing on deliberate and intentional staffing, an extensive online presence, and focused outreach. Methods BE SAGE purposefully hired bilingual (English/Spanish) and bicultural staff; developed and maintained a large bilingual online presence (website, newsletters, social media), and fostered community partnerships with community health workers (CHWs) and dedicated staff. Hiring records, online internet records, staff calendars, and field notes were coded and tabulated. Results 84% of the 13-member research team and all CHWs identified as Hispanic or Latino. Predominantly US users accessed the website ( N = 3,108), 36.9% of received electronic newsletters were opened, and 1126 followed social media across four platforms. The Outreach Specialist fostered existing relationships and created new partnerships. With the help of CHWs, 562 research participants completed at least one COVID-19 test. Conclusions By prioritizing representative staffing hires, expending substantial resources on an online presence, and establishing and nurturing our community partnerships, our BE SAGE community engagement approach helped to achieve study aims and create lasting community impact. Community engagement and partnerships to forward research requires ample funding and dedicated representative hiring polices to cultivate and maintain community relationships with asset-driven outcomes. Policy Implications Funding agencies must prioritize community engagement in research outcomes to ensure robust, meaningful scientific discovery and innovation.
The evolution of treatment-free remission
Authors: Hughes Timothy P. , Yong Agnes S. M. , Ross David M. 
Published: January 2025

Abstract
One of the most remarkable achievements of the tyrosine kinase inhibitor (TKI) era has been the capacity to induce deep molecular remissions that are sustainable off therapy in patients with chronic myeloid leukemia (CML), that is, treatment-free remission (TFR). TFR was first described in a handful of patients within 3 to 4 years of imatinib approval. In 2004, TFR was tested in a small French pilot study, followed soon after by the French STIM and Australasian TWISTER studies. These early trials demonstrated that TFR was achievable but also showed that rapid relapse was equally likely. Perhaps the most critical observation was that relapsing patients could be rapidly and safely returned to deep molecular remission after restarting therapy, minimizing the risk associated with TFR attempts. Consensus criteria for TFR eligibility were established soon after those studies were reported. Over the past decade, TFR criteria have been broadened, key predictive markers of success identified, and overall safety of TFR in the wider clinical community confirmed. Despite this progress, TFR is still only achieved in a fraction of patients with CML globally. Over the next decade, the focus will be making TFR the mainstream pathway for as many patients as possible as well as scaling back the duration of therapy required. More potent, better targeted TKIs, and immune modulation will likely have a significant impact. Predictive assays should enable most patients who attempt TFR to do so with a high probability of success. Ultimately TFR should be seen as the first step on an ambitious pathway toward cure for patients with CML.
Systematic and comprehensive insights into HIF-1 stabilization under normoxic conditions: implications for cellular adaptation and therapeutic strategies in cancer
Authors: Zhang Jiayi , Yao Mingxuan , Xia Shiting , Zeng Fancai , Liu Qiuyu 
Published: January 2025

AbstractHypoxia-inducible factors (HIFs) are essential transcription factors that orchestrate cellular responses to oxygen deprivation. HIF-1α, as an unstable subunit of HIF-1, is usually hydroxylated by prolyl hydroxylase domain enzymes under normoxic conditions, leading to ubiquitination and proteasomal degradation, thereby keeping low levels. Instead of hypoxia, sometimes even in normoxia, HIF-1α translocates into the nucleus, dimerizes with HIF-1β to generate HIF-1, and then activates genes involved in adaptive responses such as angiogenesis, metabolic reprogramming, and cellular survival, which presents new challenges and insights into its role in cellular processes. Thus, the review delves into the mechanisms by which HIF-1 maintains its stability under normoxia including but not limited to giving insights into transcriptional, translational, as well as posttranslational regulation to underscore the pivotal role of HIF-1 in cellular adaptation and malignancy. Moreover, HIF-1 is extensively involved in cancer and cardiovascular diseases and potentially serves as a bridge between them. An overview of HIF-1-related drugs that are approved or in clinical trials is summarized, highlighting their potential capacity for targeting HIF-1 in cancer and cardiovascular toxicity related to cancer treatment. The review provides a comprehensive insight into HIF-1’s regulatory mechanism and paves the way for future research and therapeutic development.
Potential mutagenicity of aflatoxin B1 in Egyptian spices
Authors: Geoshi Basma El , El-Akabawy Gehan , Metwally Mohammed El , Soliman Magda I. 
Published: January 2025

AbstractThe current study aimed to detect the mutagenic impacts of aflatoxin B1 (AFB1), which is produced by Aspergillus group fungi, via a high-plant genotoxicity test. Different durations of treatment (3 h, 6 h, and 12 h) were used to treat the Vicia faba root tips with varying concentrations of Aflatoxin B1 (AFB1) following the approved protocol for plant assays published by the International Program on Chemical Safety (IPCS) and the World Health Organization (WHO). The data obtained indicated that AFB1 not only has the ability to induce various alterations in the process of mitosis, ranging from increasing to decreasing mitotic and phase indices but also leads to many mitotic aberrations. The abnormalities observed varied on the basis of the ratio of AFB1 to treatment time. The aberrations included micronuclei in interphase, stickiness; two groups ring star disturbed and oblique metaphase late separation diagonal bridge and laggard and disturbed. anaphase and telophase. This study showed that biomonitoring Vicia faba is a sustainable method for estimating the cytotoxicity and genotoxicity of applied AFB1. Additionally, AFB1 caused changes in the protein profile detected by SDS‒PAGE, with each treated sample displaying a unique electrophoretic pattern due to the formation and disappearance of certain bands. The ISSR and RAPD assays changes in band numbers in all samples compared with the untreated control, and a decrease in genetic template stability (GTS) ratios was observed with higher levels of AFB1. The image cytometric data revealed a correlation between the dosage of AFB1 and its impact on cell cycle components in the meristematic cells of Vicia faba roots. Furthermore, an increase in AFB1 concentrationled to a decrease in B-cell lymphoma 2 (Bcl2) levels, an increase in chromatin condensation levels, and an increase in poly ADP‒ribose polymorphism (PARP) levels.
The Dutch version of the Dignity Therapy Question Protocol for individual Dutch nursing home residents without cognitive impairments (during COVID-19): a pilot study
Authors: van Dammen Herman , Vissers Kris , van der Putten Gert-Jan , Engels Yvonne 
Published: January 2025

Abstract
Background
Dignity therapy is a brief, structured psychotherapeutic intervention originally designed to help last-stage cancer patients maintain their dignity. It consists of a semi-structured interview encouraging patients to talk about their lives. The recorded session are transcribed and edited, after which the patient has the opportunity to make further changes to the final document. It can be shared with whom the patient likes. We cross-culturally translated dignity therapy into Dutch and explored its feasibility of applying it to Dutch cognitively capable nursing home residents.

Method
Beaton’s Guidelines for Good Clinical Practice were used to cross-culturally translate dignity therapy. Next, a pilot study was conducted with 12 nursing home residents in which the original English-language questionnaire was transculturally translated according to the method of Beaton. After the interviews were completed, feasibility was examined by open-ended questions and a five-point Likert scale questionnaire.

Results
We translated the questionnaire. The translated questions were well understood and resulted in an appropriate Dutch version of the English-language dignity therapy questions. However, the words ‘dignity’ and ‘therapy’ caused confusion. The mean number of words in the legacy document was 1078 words, which appeared shorter than in a community-based hospice setting or patients with metastatic cancer or terminally ill people. The reading aloud was much appreciated and was an emotional experience for some.

Conclusion
We successfully translated the DTQP into the Dutch language and tested it in 12 nursing home residents. The questions posed by this therapy appeared suitable and acceptable. Furthermore, participants all accepted the therapy and gave no suggestions to adapt the procedure. Follow-up research in the form of an impact study is needed to show whether and how this therapy can strengthen the sense of dignity of Dutch nursing home residents.
Automatic image generation and stage prediction of breast cancer immunobiological through a proposed IHC-GAN model
Authors: Saad Afaf , Ghatwary Noha , Gasser Safa M. , ElMahallawy Mohamed S. 
Published: January 2025

AbstractInvasive breast cancer diagnosis and treatment planning require an accurate assessment of human epidermal growth factor receptor 2 (HER2) expression levels. While immunohistochemical techniques (IHC) are the gold standard for HER2 evaluation, their implementation can be resource-intensive and costly. To reduce these obstacles and expedite the procedure, we present an efficient deep-learning model that generates high-quality IHC-stained images directly from Hematoxylin and Eosin (H&E) stained images. We propose a new IHC-GAN that enhances the Pix2PixHD model into a dual generator module, improving its performance and simplifying its structure. Furthermore, to strengthen feature extraction for HE-stained image classification, we integrate MobileNetV3 as the backbone network. The extracted features are then merged with those generated by the generator to improve overall performance. Moreover, the decoder’s performance is enhanced by providing the related features from the classified labels by incorporating the adaptive instance normalization technique. The proposed IHC-GAN was trained and validated on a comprehensive dataset comprising 4,870 registered image pairs, encompassing a spectrum of HER2 expression levels. Our findings demonstrate promising results in translating H&E images to IHC-equivalent representations, offering a potential solution to reduce the costs associated with traditional HER2 assessment methods. We extensively validate our model and the current dataset. We compare it with state-of-the-art techniques, achieving high performance using different evaluation metrics, showing 0.0927 FID, 22.87 PSNR, and 0.3735 SSIM. The proposed approach exhibits significant enhancements over current GAN models, including an 88% reduction in Frechet Inception Distance (FID), a 4% enhancement in Learned Perceptual Image Patch Similarity (LPIPS), a 10% increase in Peak Signal-to-Noise Ratio (PSNR), and a 45% reduction in Mean Squared Error (MSE). This advancement holds significant potential for enhancing efficiency, reducing manpower requirements, and facilitating timely treatment decisions in breast cancer care.
Prognostic value of systemic immune-inflammation index in patients with small-cell lung cancer treated with immune checkpoint inhibitors
Authors: Hamakawa Yusuke , Hirahara Ayumi , Hayashi Akiko , Ito Kota , Shinohara Hiroyuki , Shiba Aya , Higashi Yuko , Aga Masaharu , Miyazaki Kazuhito , Taniguchi Yuri , Misumi Yuki , Agemi Yoko , Nakamura Yukiko , Shimokawa Tsuneo , Okamoto Hiroaki 
Published: January 2025

Abstract
Introduction
The systemic immune-inflammation index (SII) has emerged as a promising prognostic marker in various malignancies. However, its prognostic significance in patients with small-cell lung cancer (SCLC) treated with immune checkpoint inhibitors (ICIs) remains unclear. In this study, we evaluated the prognostic impact of the SII in patients with SCLC after ICI use.

Methods
Of 62 patients with SCLC who received chemoimmunotherapy at our institution between September 2019 and July 2024, we retrospectively analyzed 36 patients who subsequently received ICI maintenance therapy following the initial chemoimmunotherapy treatment. The SII was calculated at the start of the second cycle of the ICI maintenance therapy. Patients were stratified into high (≥ 570) and low (< 570) SII groups. Overall survival (OS) and progression-free survival (PFS) were compared between the groups using the Kaplan–Meier method and log-rank test. Multivariate analysis using the Cox proportional hazards model was performed to identify independent prognostic factors.

Results
The high SII group exhibited a significantly shorter OS (median 12.1 vs. 24.1 months, P = 0.010) and PFS (median 5.2 vs. 8.1 months, P = 0.026) than those in the low SII group. A multivariate analysis identified SII ≥ 570 as an independent negative prognostic factor for OS (hazard ratio 3.83, 95% confidence interval 1.38–10.6, P = 0.010).

Conclusions
Elevated SII in the initial phase of ICI maintenance therapy was associated a with poor prognosis in patients with SCLC, supporting its utility as a prognostic biomarker in this setting. Therefore, prospective validation is required to confirm these findings.
Effect of negotiation skills training program on head nurses’ knowledge and behavior
Authors: Moustafa Hanaa M. , Hassan Rabab M. , Badran Fawzia M. 
Published: January 2025

Abstract
Background
Negotiating is a common occurrence and a significant part of everyday tasks for head nurses. The ability of the head nurse to effectively negotiate is a crucial management tool for work management in healthcare facilities.

Aim
The present study aimed to assess the effect of negotiation skills training program on head nurses’ knowledge and behavior.

Methods
A pretest–posttest, one-group quasi-experimental design was conducted at Menoufia University Hospitals. It is located in Shebeen, Elkom City, Cairo, Egypt. All head nurses and their assistants and their number 64 head nurses.

Results
The results indicated that a minority of head nurses had satisfactory knowledge regarding negotiation in the pretest phase and obviously increased in the posttest to be more than three quarters and slightly decreased in the follow-up phase. Also, a minority had a high negotiation behavior level in the pretest phase and increased to be more than half in the posttest with a slight decrease in the follow-up stage. There was a highly statistically significant difference between pre-, post-, and follow-up results regarding negotiation knowledge and behavior.

Conclusion
The study revealed that the head nurse’s knowledge and behavior increased markedly after implementing the negotiation skills training program.

Recommendations
Conduct continuous education and training programs for stimulating and developing head nurses’ knowledge, behavior regarding negotiation, and hospital administration should support the importance of negotiation skills to both head nurses and organizations.

Trial Registration Number [TRN]
The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Ain Shams University (code number: NUR 23.10.131).
War-related continuous traumatic stress as a potential mediator of associations between moral distress and professional quality of life in nurses: a cross-sectional study in Ukraine
Authors: Zasiekina Larysa , Martyniuk Anastasiia 
Published: January 2025

Abstract
Background
At the beginning of 2022, Central Europe entered a state of emergency due to the Russian invasion of Ukraine. Nurses were particularly vulnerable to a decline in their professional quality of life, facing repeated exposure to military trauma, ethical dilemmas, prolonged working hours, and increased stress and fatigue. This study aimed to contribute to our understanding of the potential mediating effect of war-related continuous traumatic stress on the association between moral distress and professional quality of life, including compassion satisfaction and compassion fatigue, represented by burnout and secondary traumatic stress.

Methods
This study used the Professional Quality of Life (ProQOL) Scale to assess compassion fatigue, including burnout, secondary traumatic stress, and compassion satisfaction; the Moral Distress Questionnaire for Nurses to examine everyday moral distress in healthcare facilities and everyday ethical dilemmas of nurses; and the Continuous Traumatic Stress Response (CTSR) Scale to assess ongoing threats, resulting in exhaustion/rage, and fear/betrayal. The sample consisted of 130 female nurses (mean age 40.20 ± 12.15 years) from general surgery, neurosurgery, trauma and orthopaedic surgery, and urgent care who had been undergoing advanced training to work with injured military personnel at the Volyn Medical Institute (Ukraine) from March to May 2023. All nurses had experienced direct and indirect exposure to military trauma, and 105 participants were working with injured military personnel.

Results
The results of the mediation analysis indicated that war-related continuous traumatic stress fully mediated the relationship between moral distress and different components of professional quality of life, namely, compassion fatigue, including burnout and secondary traumatic stress, and compassion satisfaction.

Conclusion
Research has shown that continuous traumatic stress has a significant effect on the relationship between moral distress and various aspects of professional quality of life, underscoring the need for targeted interventions for nurses facing war-related trauma.
Multimorbidity latent classes in relation to 11-year mortality, risk factors and health-related quality of life in Malaysia: a prospective health and demographic surveillance system study
Authors: Tan Michelle M. C. , Hanlon Charlotte , Muniz-Terrera Graciela , Benaglia Tatiana , Ismail Roshidi , Mohan Devi , Konkoth Ann Breeze Joseph , Reidpath Daniel , Pinho Pedro José M. Rebello , Allotey Pascale , Kassim Zaid , Prina Matthew , Su Tin Tin 
Published: January 2025

Abstract
Background
We aimed to identify specific multimorbidity latent classes among multi-ethnic community-dwelling adults aged ≥ 18 years in Malaysia. We further explored the risk factors associated with these patterns and examined the relationships between the multimorbidity patterns and 11-year all-cause mortality risk, as well as health-related quality of life (HRQoL).

Methods
Using data from 18,101 individuals (aged 18–97 years) from the baseline Census 2012, Health Round 2013, and Verbal Autopsies 2012–2023 of the South East Asia Community Observatory (SEACO) health and demographic surveillance system, latent class analysis was performed on 13 chronic health conditions to identify statistically and clinically meaningful groups. Multinomial logistic regression and Cox proportional hazards regression models were conducted to investigate the adjusted association of multimorbidity patterns with the risk factors and mortality, respectively. HRQoL was analyzed by linear contrasts in conjunction with ANCOVA adjusted for baseline confounders.

Results
Four distinct multimorbidity latent classes were identified: (1) relatively healthy (n = 10,640); (2) cardiometabolic diseases (n = 2428); (3) musculoskeletal, mobility and sensory disorders (n = 2391); and (4) complex multimorbidity (a group with more severe multimorbidity with combined profiles of classes 2 and 3) (n = 699). Significant variations in associations between socio-demographic characteristics and multimorbidity patterns were discovered, including age, sex, ethnicity, education level, marital status, household monthly income and employment status. The complex multimorbidity group had the lowest HRQoL across all domains compared to other groups (p < 0.001), including physical health, psychological, social relationships and environment. This group also exhibited the highest mortality risk over 11 years even after adjustment of confounders (age, sex, ethnicity, education and employment status), with a hazard of death of 1.83 (95% CI 1.44–2.33), followed by the cardiometabolic group (HR 1.42, 95% CI 1.18–1.70) and the musculoskeletal, mobility and sensory disorders group (HR 1.29, 95% CI 1.04–1.59).

Conclusions
Our study advances the understanding of the complexity of multimorbidity and its implications for health outcomes and healthcare delivery. The findings suggest the need for integrated healthcare approaches that account for the clusters of multiple conditions and prioritize the complex multimorbidity cohort. Further longitudinal studies are warranted to explore the underlying mechanisms and evolution of multimorbidity patterns.