bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alarm fatigue and sleep quality in healthcare workers
Authors: Rypicz L , Witczak I , Supinova M , Salehi H P , Jarabicova O 
Published: October 2024

Abstract

Background
Alarm fatigue, a prevalent issue in medical settings, arises when healthcare professionals are exposed to an overwhelming number of clinical alarms, leading to desensitization and decreased responsiveness. The constant alertness required due to medical device alarms in hospitals can severely disrupt the quality of sleep for medical personnel. This study aims to demonstrate whether there is a relationship between alarm fatigue and sleep quality in medical staff. For the research project, it was decided to carry out the study in three European neighbouring countries: Poland, Slovakia and the Czech Republic

Methods
The the survey was carried out in three European countries: Poland, Slovakia, and the Czechia from June to July 2023. The study was attended by a total of 756 participants. The study used: a socio-demographic metric; Alarm Fatigue Assessment Questionnaire and The Pittsburgh Sleep Quality Index to evaluates sleep quality.

Results
Among the 756 survey participants, 603 (79.76%) had poor sleep quality (6-21 PSQI points), 147 (19.44%) had good sleep quality (0-5 PSQI points), and 6 (0.79%) did not answer. The analysis of sleep quality scores for participating countries shows that sleep problems were significantly higher in Slovakia and Poland than in the Czech Republic. Alarm fatigue levels were determined for respondents in every country in this study. The statistical difference between countries is significant. In Slovakia and Poland, the levels of alarm fatigue caused by medical devices were significantly higher than in the Czech Republic. With regards to sleep quality, there is a positive correlation between alarm fatigue and sleep problems. A statistically significant positive correlation was obtained for all three countries.

Conclusions
The study found that workers in the health system are exposed to alarm fatigue, and that this in turn can reduce sleep quality. The consequences of this may be reflected in patient safety.

Key messages
• The results of the study clearly indicate that quality of work should be ensured by developing protocols for managing medical device alarms.
•  Combatting alarm fatigue among medical personnel is vital for public health as it reduces medical errors caused by sleep deprivation.
Sickness absence patterns during the COVID-19 pandemic among Finnish public sector employees
Authors: Haukka E , Joensuu M , Kausto J , Oksanen T , Vahtera J , Kivimäki M , Ervasti J 
Published: October 2024

Abstract

Background
The patterns of sickness absence (SA), that is, the clustering of differing lengths of episodes and total number of days absent, have not been examined. We examined these SA patterns and factors associated with the patterns during the COVID-19 pandemic.

Methods
We used survey data from employees of four large Finnish cities in 2020 linked with SA data in 2021 retrieved from employer registers (n = 39 791). SA patterns were defined through cluster analysis (K-means) including number of SA days, short (1-9 days), and long (10-365 days) SA episodes within one year. The associations of employee and work characteristics in 2020 with SA clusters in 2021 were analysed with multinomial regression.

Results
Four SA patterns (=clusters) were identified: 1) Optimal SA pattern (n = 31 320, 79%), 2) Recurring short SA episodes (n = 5149, 13%), 3) Recurring long SA episodes (n = 2964, 7%), and 4) Very high levels of SA with long episodes (n = 358, 1%). Compared to optimal SA pattern, female gender, higher body mass index, former smoking, abstinence from alcohol, not being in high occupational socioeconomic position, on-site work during COVID-19, and COVID-19 infection were associated with all suboptimal SA patterns. Recurring short SA episodes were more likely in younger employees (odds ratio=0.98, 95% confidence interval 0.97-0.98), those with a temporary job (1.10, 1.00-1.20), current smokers (1.34, 1.21-1.48), those using passive commute modes (1.03, 1.01-1.05 [car]; 1.02, 1.00-1.04 [public transport]), and those who had experienced a team reorganization due to COVID-19 (1.27, 1.10-1.46). The two most adverse SA patterns were more likely among older employees, and less likely among those cycling to work (0.91, 0.84-0.98; 0.97, 0.95-0.99).

Conclusions
We identified three differential suboptimal SA patterns. Compared to the optimal SA pattern, several individual-level risk factors, but also some COVID-19 related factors were found to associate with suboptimal SA patterns.

Key messages
• We identified three suboptimal sickness absence patterns during COVID-19 pandemic.
• Individual characteristics, but also COVID-19 related factors were associated with the observed sickness absence patterns.
The health of older caregivers in Spain: a matter of age or a matter of care?
Authors: Bernal-Alonso A , Rodríguez-Blázquez C , Ayala A , Mateo-Abad M , Calderón-Larrañaga A , Forjaz M J 
Published: October 2024

Abstract

Introduction
Informal care is crucial in Spain’s care system, with a rising number of caregivers aged 75 or older, yet studies on its health effects are lacking. This study aims to determine the differential impact of age and care-related variables on the health of older caregivers.

Materials and methods
This is a cross-sectional, national study with a sample of 3,870 informal caregivers from the Spanish 2020 Disability, Personal Autonomy and Dependency Survey. We performed a logistic regression where self-reported deterioration in caregiver health due to caregiving was the dependent variable and age (&lt;75 vs. ≥ 75) was the independent variable. Caregivers’ sex, educational level (primary and lower or secondary and higher), income (&lt;1,150 euros per month vs. ≥ 1,150), severe functional limitation of caregivers and care-receptors (yes or no), duration of care (&lt; 8 years vs. ≥ 8 years), and daily hours of care were used as covariates.

Results
One in 6 caregivers was 75 or older (16,1%). Caregivers’ mean age was 58.4, and care-receptors’ 66.6 years. Women represented 63.0% of caregivers, and 42.8% of care-receptors. Up to 4.6% of caregivers had a severe limitation, and 43.7% of caregivers reported deterioration of their health due to caregiving. A greater perception of deterioration in caregiver health due to caregiving was associated with being 75 years or older (β = 0.34, p = 0.009). Covariates associated with caregivers’ health deterioration were being a woman (β = 0.77, p &lt; 0.001), presence of severe limitation of care receptors (β = 0.58, p &lt; 0.001), and increased daily hours of care (β = 0.01, p = 0.013). Caregivers’ severe limitation, level of education, income and years of care did not show a significant association with perception of health deterioration.

Discussion
Caregivers older than 75 years in Spain experience a key deterioration in their health associated with caregiving. This vulnerable population must be prioritized in health and social policies.

Key messages
• One out of 6 caregivers in Spain is aged 75 years or older. Caregiving impacts greatly in their health status.
• Older caregivers is a vulnerable population that must be a priority for health and social services.
The effects of hypothetical psychological interventions on alcohol use in European young adults
Authors: Do S , Börnhorst C , Didelez V , Ahrens W , Hebestreit A ,   I IDEFICS/I.Family consortia
Published: October 2024

Abstract

Background
Low psychosocial well-being (PWB) and high emotion-driven impulsiveness (EDI) are associated with alcohol. Yet, it is unclear whether a hypothetical intervention targeting one or the other in adolescence might be more effective in reducing alcohol consumption (AC) in young adulthood. Therefore, we aimed to compare the separate causal effects of PWB and EDI in adolescence on AC in young adulthood.

Methods
We included 505 European young adults from the IDEFICS/I.Family cohort (mean age: 20.2 years; age range: 18.2-23.5 years) who did not drink alcohol at study entry. AC was operationalized as the amount of weekly consumed alcoholic beverages (mean: 4.2 drinks per week; range: 0.3-70 drinks per week). EDI was assessed using the negative urgency subscale from the UPPS-P Impulsive Behaviour Scale. PWB was assessed using the KINDLR Health-Related Quality of Life Questionnaire. Following the principles of target trial emulation, we estimated, separately, the average causal effects of PWB and EDI on AC accounting for relevant confounders and applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). We stratified the results by sex and parental education.

Results
If all adolescents, hypothetically, had high levels of PWB, compared to low levels, we estimated a decrease in the average amount of alcoholic beverages in young adulthood by 0.1 drinks per week [95%-confidence interval: -2.3; 2.1]. Furthermore, if all adolescents had low levels of EDI, compared to high levels, we estimated an increase in alcoholic beverages in young adulthood by 1.5 drinks per week [0.1; 2.9]. Different effects for sex and parental education groups were found.

Conclusions
Hypothetical interventions targeting PWB in adolescents were not found to have effects on reducing AC in young adulthood. Interventions targeting EDI, however, would lead to an increase in AC. This may be due to unmeasured confounding and the missing distinction between drinking motives.

Key messages
• We demonstrate that causal inference methods, compared to traditional ones, improve the robustness of estimated effect measures and address important sources of bias in European cohort data.
• To inform public health interventions on reducing alcohol consumption, future research should investigate different drinking motives, e.g. alleviating negative emotions or enhancing positive emotions.
A comparative study of how teachers communicate in deaf education classrooms
Authors: Holcomb Leala , Dostal Hannah , Wolbers Kimberly 
Published: October 2024

Abstract
This study investigates the communication practices of four teachers in 3rd to 6th grade classrooms with 9 deaf students with limited language proficiency and in stages of emergent writing development. Analyzing language modalities, utterance types, and class interactivity, we found that teachers using American sign language used student-centered approaches, generating a greater number of directives and responsive utterances. They persevered in increasing students’ engagement and were successful in clarifying misunderstandings. Teachers using spoken English used teacher-centered approaches, making general comments directed at the whole class, which consequently reduced student participation and responsiveness. They also largely avoided repairing communication breakdowns with emergent writers, focusing instead on those with greater auditory and speaking abilities. These patterns reveal disparities in classroom communication that can affect student learning. Our findings highlight the need for teacher preparation programs to equip teachers with skill sets to employ accessible and effective communication during instruction, especially with deaf students who are still developing foundational language and writing skills.
Kendra’s journey: an intrinsic case study of a deaf autistic child
Authors: Gosselin Hills Jennifer , Bowen Sandy K 
Published: October 2024

Abstract
This study used an intrinsic case study to investigate how interventions from applied behavior analysis impacted language development, academic progress, and the reduction of severe challenging behaviors for an 8-year-old child who is Deaf and autistic. 3 main themes were identified: language acquisition, behavioral change strategies, and academic performance. Additionally, 2 common threads wove in and out of each and connected all 3 themes: language access and qualified providers, including Deaf professionals. This study expands the literature about using behavioral strategies with children who are Deaf and autistic and discusses implications for clinical and educational practice.
Plant cell wall structure and dynamics in plant–pathogen interactions and pathogen defence
Authors: Munzert Kristina S , Engelsdorf Timo 
Published: October 2024

Abstract
Plant cell walls delimit cells from their environment and provide mechanical stability to withstand internal turgor pressure as well as external influences. Environmental factors can be beneficial or harmful for plants and vary substantially depending on prevailing combinations of climate conditions and stress exposure. Consequently, the physicochemical properties of plant cell walls need to be adaptive, and their functional integrity needs to be monitored by the plant. One major threat to plants is posed by phytopathogens, which employ a diversity of infection strategies and lifestyles to colonize host tissues. During these interactions, the plant cell wall represents a barrier that impedes the colonization of host tissues and pathogen spread. In a competition for maintenance and breakdown, plant cell walls can be rapidly and efficiently remodelled by enzymatic activities of plant and pathogen origin, heavily influencing the outcome of plant–pathogen interactions. We review the role of locally and systemically induced cell wall remodelling and the importance of tissue-dependent cell wall properties for the interaction with pathogens. Furthermore, we discuss the importance of cell wall-dependent signalling for defence response induction and the influence of abiotic factors on cell wall integrity and cell wall-associated pathogen resistance mechanisms.
RNA-directed peptide synthesis across a nicked loop
Authors: Su Meng , Roberts Samuel J , Sutherland John D 
Published: October 2024

Abstract
Ribosomal translation at the origin of life requires controlled aminoacylation to produce mono-aminoacyl esters of tRNAs. Herein, we show that transient annealing of short RNA oligo:amino acid mixed anhydrides to an acceptor strand enables the sequential transfer of aminoacyl residues to the diol of an overhang, first forming aminoacyl esters then peptidyl esters. Using N-protected aminoacyl esters prevents unwanted peptidyl ester formation in this manner. However, N-acyl-aminoacyl transfer is not stereoselective.
Jesse Jackson
Authors: Stanford Karin L. , Jackson Ashley L. 
Published: October 2024

The Reverend Jesse Louis Jackson Sr. (b. 8 October 8 1941) is an influential American civil rights leader, Baptist minister, and politician. He was born to Helen Burns and Noah Robinson in Greenville, South Carolina. His mother eventually married Charles Jackson, who later adopted and gave him a new last name. Jackson made historic strides as an African American candidate in his notable bids for the US presidency in 1984 and 1988. These presidential campaigns elevated the role of Blacks in politics—evidenced by Jackson’s status as the first African American to participate in a presidential debate and by successful voter registration campaigns. Jackson’s earliest civil rights action occurred in 1960 when he and seven other students led a sit-in at the segregated Greenville Public Library. Jackson attended the University of Illinois and later transferred to North Carolina A&T, where he became student body and chapter president of Omega Psi Phi fraternity. He also became active in conventional politics, joined the Young Democrats of North Carolina, and worked for North Carolina Governor Terry Sanford. Intent on becoming a minister, Jackson enrolled in Chicago Theological Seminary. During this period, his life changed drastically after meeting Reverend Dr. Martin Luther King Jr. in 1965 while participating in the Selma to Montgomery marches for voting rights. Dr. King appointed Jackson as the national director of Operation Breadbasket, a component of the Southern Christian Leadership Conference’s economic opportunities program. After Dr. King’s assassination, Jackson left the SCLC and established Operation PUSH, People United to Save Humanity, in 1971. In 1984, he created a “Rainbow Coalition” of marginalized groups to fight for human rights and gain a voice in politics. Jackson is renowned for his oratory and expert negotiating skills, marked by his many successful hostage negotiations, including the release of Navy Lieutenant Robert Goodman from Syria during the 1984 presidential election campaign. He is most well known for one of his most recited phrases, “I Am Somebody.” Later in his career, Jackson launched an annual Wall Street conference in partnership with the New York Stock Exchange, brokered deals with corporations to invest in Black communities, authored several books, and hosted a CNN weekly TV show titled “Both Sides with Jesse Jackson.” President Bill Clinton awarded Jackson the Presidential Medal of Freedom in 2000. Diagnosed with Parkinson’s disease in November 2017, he remains one of the most noted leaders of civil rights and global affairs.
Compound heterozygous RYR1‐RM mouse model reveals disease pathomechanisms and muscle adaptations to promote postnatal survival
Authors: Liang Chen , Malik Sundeep , He Miao , Groom Linda , Ture Sara K. , O'Connor Thomas N. , Morrell Craig N. , Dirksen Robert T. 
Published: October 2024

AbstractPathogenic variants in the type I ryanodine receptor (RYR1) result in a wide range of muscle disorders referred to as RYR1‐related myopathies (RYR1‐RM). We developed the first RYR1‐RM mouse model resulting from co‐inheritance of two different RYR1 missense alleles (Ryr1TM/SC‐ΔL mice). Ryr1TM/SC‐ΔL mice exhibit a severe, early onset myopathy characterized by decreased body/muscle mass, muscle weakness, hypotrophy, reduced RYR1 expression, and unexpectedly, incomplete postnatal lethality with a plateau survival of ~50% at 12 weeks of age. Ryr1TM/SC‐ΔL mice display reduced respiratory function, locomotor activity, and in vivo muscle strength. Extensor digitorum longus muscles from Ryr1TM/SC‐ΔL mice exhibit decreased cross‐sectional area of type IIb and type IIx fibers, as well as a reduction in number of type IIb fibers. Ex vivo functional analyses revealed reduced Ca2+ release and specific force production during electrically‐evoked twitch stimulation. In spite of a ~threefold reduction in RYR1 expression in single muscle fibers from Ryr1TM/SC‐ΔL mice at 4 weeks and 12 weeks of age, RYR1 Ca2+ leak was not different from that of fibers from control mice at either age. Proteomic analyses revealed alterations in protein synthesis, folding, and degradation pathways in the muscle of 4‐ and 12‐week‐old Ryr1TM/SC‐ΔL mice, while proteins involved in the extracellular matrix, dystrophin‐associated glycoprotein complex, and fatty acid metabolism were upregulated in Ryr1TM/SC‐ΔL mice that survive to 12 weeks of age. These findings suggest that adaptations that optimize RYR1 expression/Ca2+ leak balance, sarcolemmal stability, and fatty acid biosynthesis provide Ryr1TM/SC‐ΔL mice with an increased survival advantage during postnatal development.
Therapeutic effects of FGF21 mimetic bFKB1 on MASH and atherosclerosis in Ldlr−/−.Leiden mice
Authors: Inia José A. , Attema Joline , de Ruiter Christa , Menke Aswin L. , Caspers Martien P. M. , Verschuren Lars , Wilson Maria , Arlantico Alexander , Brightbill Hans D. , Jukema J. Wouter , van den Hoek Anita M. , Princen Hans M. G. , Chen Mark Z. , Morrison Martine C. 
Published: October 2024

AbstractFibroblast growth factor 21 (FGF21) is a promising target for treatment of obesity‐associated diseases including metabolic dysfunction‐associated steatohepatitis (MASH) and atherosclerosis. We evaluated the effects of the bispecific anti‐FGF21‐β klotho (KLB) agonist antibody bFKB1 in a preclinical model of MASH and atherosclerosis. Low‐density lipoprotein receptor knockout (Ldlr−/−).Leiden mice received a high‐fat diet for 20 weeks, followed by treatment with an isotype control antibody or bFKB1 for 12 weeks. Effects on plasma risk markers and (histo)pathology of liver, adipose tissue, and heart were evaluated alongside hepatic transcriptomics analysis. bFKB1 lowered body weight (−21%) and adipose tissue mass (−22%) without reducing food intake. The treatment also improved plasma insulin (−80%), cholesterol (−48%), triglycerides (−76%), alanine transaminase (ALT: −79%), and liver weight (−43%). Hepatic steatosis and inflammation were strongly reduced (macrovesicular steatosis −34%; microvesicular steatosis −100%; inflammation −74%) and while the total amount of fibrosis was not affected, bFKB1 did decrease new collagen formation (−49%). Correspondingly, hepatic transcriptomics and pathway analysis revealed the mechanistic background underlying these histological improvements, demonstrating broad inactivation of inflammatory and profibrotic transcriptional programs by bFKB1. In epididymal white adipose tissue, bFKB1 reduced adipocyte size (−16%) and inflammation (−52%) and induced browning, signified by increased uncoupling protein‐1 (UCP1) protein expression (8.5‐fold increase). In the vasculature, bFKB1 had anti‐atherogenic effects, lowering total atherosclerotic lesion area (−38%). bFKB1 has strong beneficial metabolic effects associated with a reduction in hepatic steatosis, inflammation, and atherosclerosis. Analysis of new collagen formation and profibrotic transcriptional programs indicate that bFKB1 treatment may have antifibrotic potential in a longer treatment duration as well.
Radiographic Indicators of Craniocervical Instability
Authors: Gordillo Alan J. , Magro Matt , Obiri-Yeboah Derrick , Patel Arpan A. , Sarel Vorster , Spiessberger Alexander 
Published: October 2024

Study Design:
Single-institution retrospective review.

Objective:
To establish baseline ranges and variability of 7 radiographic measurements of the cervical spine in a healthy patient population as potential diagnostic tools for craniocervical instability.

Summary of Background Data:
Craniocervical instability, common in patients with connective tissue disease such as Ehlers-Danlos Syndrome, often presents with a wide range of symptoms, including neck pain. Current diagnostic methods employ a range of clinical and radiographic features, but diagnostic challenges remain due to missed indications on static imaging and a lack of standardized measurement values and normalized variance.

Methods:
Seventy-two healthy patients with cervical imaging were analyzed. Surgimap software was used to annotate supine computed tomography images, flexion, extension, and neutral x-ray images for measurement. These measurements included the atlanto-dental interval, clival-axial angle, basion-dens interval, basion-axis interval, perpendicular basion to the inferior aspect of C2, also known as Grabb Oakes measurement, and the hard palate to C1 and hard palate to C2. Statistical analysis assessed differences among imaging modalities, and coefficients of variation were calculated for each measurement.

Results:
Our cohort consisted of a total of 72 patients with a mean age of 64 (SD: 13.54). All measurements except for the basion-axial interval and atlanto-dental interval demonstrated a significant difference between extension and flexion x-ray measurements. clivo-axial angle, hard palate to C1, and hard palate to C2 demonstrated the lowest coefficients of variance across imaging modalities.

Conclusion:
Understanding normal variance in cervical measurements is invaluable for accurate CCI diagnosis. Using a cohort of healthy patients, this study delineates the distribution and spread of 7 cervical measurements, delineating reference values and variability in these key measurements and highlighting their potential for use as imaging markers for CCI.

Level of Evidence:
Level III.