bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Alarm Fatigue and Stress Among Acute Care Nurses: A Cross-Sectional Study
Authors: Bani Hani Salam , Abu Aqoulah Emran A. 
Published: October 2024

Introduction Given the vital nature of their profession, ICU nurses endure significant psychological and physical stress. Burnout, low job satisfaction, and deteriorated patient care might result from the high-stress atmosphere. Objectives This study aims to assess the level of alarm fatigue and stress among nurses who work in acute care units. Methods A descriptive design was used to recruit nurses in acute care units. A self-administered questionnaire was used to collect the required data composed of three parts, namely demographical data; the alarm fatigue part, which was created by Torabizadeh et al. and composed of 13 items, and the perceived stress scale (PSS) which is a psychological diagnostic instrument created to assess how much people find their daily lives to be stressful. It was created by Cohen et al. and composed of 10 items. Results An average age of (35.3 ± 6.24) years, and an average number of years of experience of (7.63 ± 5.56), were found among the 128 nurses that were recruited. Acute care nurses had a significant degree of alarm fatigue, as indicated by the overall alarm fatigue score of ( M = 30.1 ±  SD = 7.47). A moderate degree of stress was also indicated by the overall perceived stress score, which was ( M = 21.5 ± 5.02). Among nurses, alarm fatigue and felt stress are not correlated with any demographic feature, including sex, educational attainment, marital status, and working location. Conclusion Stress and alarm fatigue are serious problems for acute care units that can jeopardize nurse and patient safety. The implementation of methods that mitigate alarm fatigue and stress, such as alarm customization, adequate staffing, and support systems, can enhance the work environment in acute care units. Healthcare companies can raise the grade of care provided to patients and enhance the general well-being and job satisfaction of their nursing staff by addressing these challenges.
Conserved helical motifs in the IKZF1 disordered region mediate NuRD interaction and transcriptional repression
Authors: Zhang Tianyi , Wang Yi-Fang , Montoya Alex , Patrascan Ilinca , Nebioglu Nehir , Pallikonda Husayn A. , Georgieva Radina , King James W. D. , Kramer Holger B. , Shliaha Pavel V. , Rueda David S. , Merkenschlager Matthias 
Published: October 2024

Abstract
The transcription factor (TF) Ikaros zinc finger 1 (IKZF1) is essential for B-cell development, and recurrently mutated in human B-cell acute lymphoblastic leukemia (B-ALL). IKZF1 has been ascribed both activating and repressive functions via interactions with coactivator and corepressor complexes, but the relative abundance of IKZF1-associated coregulators and their contribution to IKZF1-mediated gene regulation are not well understood. To address this, we performed an unbiased identification of IKZF1-interacting proteins in pre-B cells and found that IKZF1 interacts overwhelmingly with corepressors and heterochromatin-associated proteins. Time-resolved analysis of transcription and chromatin state identified transcriptional repression as the immediate response to IKZF1 induction. Transcriptional repression preceded transcriptional activation by several hours, manifesting as a decrease in the fraction of transcriptional bursts at the single-molecule level. Repression was accompanied by a rapid loss of chromatin accessibility and reduced levels of histone H3 lysine 27 acetylation (H3K27ac), particularly at enhancers. We identified highly conserved helical motifs within the intrinsically disordered region of IKZF1 that mediate its association with the nucleosome remodeling and deacetylase (NuRD) corepressor complex through critical “KRK” residues that bind the NuRD subunit retinoblastoma binding protein 4 (RBBP4), a mechanism shared with the TFs FOG1, BCL11A, and SALL4. Functional characterization reveals that this region is necessary for the efficient silencing of target genes and antiproliferative functions of IKZF1 in B-ALL.
Siltuximab for chimeric antigen receptor T-cell therapy–related CRS and ICANS: a multicenter retrospective analysis
Authors: Bajwa Amneet , Zhao Qiuhong , Geer Marcus , Lin Chenyu , Westholder James , Maakaron Joseph , Ghosh Monalisa , Frame David , Galal Ahmed , Tossey Justin , Ahmed Nausheen , Bezerra Evandro , Denlinger Nathan , de Lima Marcos , Epperla Narendranath , Caimi Paolo , Voorhees Timothy 
Published: October 2024

Abstract
Chimeric antigen receptor T-cell (CAR-T) therapies are effective in many hematologic malignancies; however, adverse events including cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) can affect a significant number of patients. Those who develop refractory CRS or ICANS have few treatment options. Siltuximab, a monoclonal antibody binding circulating interleukin-6, has been proposed to have clinical activity in both CRS and ICANS. We conducted a multicenter retrospective analysis of siltuximab treatment for CRS and ICANS after CAR-T therapy in a real-world cohort from 6 academic centers. Fifty-four patients were evaluated. Sixteen patients had CRS previously treated with tocilizumab and 17 patients had ICANS previously treated with steroids. Of the patients with CRS at the time of siltuximab, 75% had improvement in CRS grade. Of the patients with ICANS at the time of siltuximab, 60% had improvement in ICANS grade. To our knowledge, this is the largest cohort of patients treated with siltuximab for CRS and/or ICANS after CAR-T therapies. Siltuximab appeared to be effective for both CRS and ICANS, including previously treated toxicities. These data support the use of siltuximab in CRS and ICANS as well as provide rationale for future prospective studies.
Impact of arm position compared to tourniquet and general anesthesia on peripheral vein width in supine adult patients: a prospective, monocentric, cross-sectional study
Authors: Berger Christian , Brandhorst Philipp , Asen Elena , Grallert Sven , Treskatsch Sascha , Weigeldt Moritz 
Published: October 2024

Abstract
Background
IV access is a commonly performed procedure that is often taught based on tradition rather than evidence. The effect of arm retroflexion on vein width, either alone or in combination with a tourniquet or general anesthesia (GA), remains unclear. In this case, the sonographically measured vein width is a surrogate parameter for the success of the puncture.

Methods
Prospective, cross-sectional study involving 57 patients scheduled for surgery in general anesthesia. We analyzed the impact of arm retroflexion, tourniquet, general anesthesia, and their combinations on the antebrachial veins in supine patients by ultrasound. Measurements were taken awake and during general anesthesia, each with and without the application of a tourniquet, and in three different arm positions (0°, 30°, and max° retroflexion) each. Data are presented as median and interquartile range [IQR].

Results
Tourniquet application (AT) had the greatest single effect on Cubital vein outer diameter compared to the baseline value of all measures (3.9 mm [3.4–5.1]; 4.8 mm [4.1–5.7], P = 0.001, r = 0.515). This effect was surpassed by the combination of AT and GA (5.1 mm [4.6–6.6], P = 0.001, r = 0.889). In contrast, retroflexion alone did not result in an increase at either 30° (4.2 mm [3.7–5.1], p = 1.0, r = 0.12) or max° (4.2 mm [3.6–4.9], p = 0.72, r = 0.23). With GA and AT, no further enlargement was measurable by 30° (5.4 mm [4.6–6.6], p = 1.0, r = 0.15) or max° (5.4 mm [4.6–6.6], p = 1.0, r = 0.07) retroflexion compared to GA-AT-0° (5.1 mm [4.6–6.6], p = 1.0, r = 0.15).

Conclusions
This study provides evidence that retroflexion of the arm in supine patients, whether alone or in addition to a tourniquet or general anesthesia, does not have any additional effect on vein width as a surrogate parameter for successful IV success. It shows for the first time that general anesthesia effectively increases vein diameter.

Trial registration
DRKS00029603 (date of registration 07.07.2022).
Kidney function, uric acid, and risk of atrial fibrillation: experience from the AMORIS cohort
Authors: Ding Mozhu , Schmidt-Mende Katharina , Carrero Juan-Jesus , Engström Gunnar , Hammar Niklas , Modig Karin 
Published: October 2024

Abstract
Background
Uric acid closely relates to both kidney disease and atrial fibrillation (AF), yet the extent to which it influences the kidney-AF association remains uncertain. We examined the relationship between kidney function and risk of AF, accounting for uric acid levels.

Methods
A total of 308,509 individuals in the Swedish Apolipoprotein-Related Mortality Risk (AMORIS) cohort were included and their serum creatinine and uric acid were measured during 1985–1996. Ten-year incident AF was identified via linkage with the national registers. Glomerular filtration rate (eGFR) (ml/min/1.73 m2) was calculated with the 2009 Chronic Kidney Disease Epidemiology Collaboration equation. Hyperuricemia was defined as > 420 µmol/L for men and > 360 µmol/L for women.

Results
Over a mean follow-up of 9.4 years, 10,007 (3.2%) incident AF cases occurred. After adjusting for age, sex, cardiovascular diseases, total cholesterol, triglycerides, and glucose, individuals with low eGFR (< 30 and 30–59 ml/min/1.73 m2 ) had a higher risk of AF compared to those with normal eGFR (60–89) (hazard ratio (HR) = 1.72, 95% confidence interval (CI):1.29–2.30; HR = 1.10, 95% CI: 1.03–1.18, respectively). After further adjusting for uric acid levels, the association disappeared (HR = 0.97, 95% CI: 0.72–1.30; HR = 0.93, 95% CI: 0.86-1.00, respectively). When stratifying by hyperuricemia yes/no, eGFR < 30 ml/min/1.73 m2 was associated with higher AF risk in a small group of individuals without hyperuricemia (HR = 2.58, 95% CI: 1.64–4.07).

Conclusion
Uric acid largely accounted for the relationship between eGFR and AF in this study. However, in individuals without hyperuricemia, eGFR in the lowest range (< 30 ml/min/1.73 m2) was still associated with increased risk of AF.
Interpersonal symptoms in adolescence depression across Asian and European regions: a network approach
Authors: Cheung H. N. , Asgarabad M. Habibi , Ho W. S. , Zibetti M. R. , Li S. T. K. , Stella W. Y. Chan , Williams J. M. 
Published: October 2024

Abstract
Background
Major Depressive Disorder (MDD) poses a significant global health challenge, with symptom presentation potentially varying between adolescents and adults. Adolescence is a critical period marked by heightened vulnerability to interpersonal stresses, yet the impact of these stresses on the structure of depressive symptoms is not well understood. Recognizing the cultural nuances in how depression manifests among adolescents is crucial. To this end, this paper employs a network analysis approach, utilizing a comprehensive symptom checklist from the Multidimensional Depression Assessment Scale (MDAS). Our study investigates the role of interpersonal symptoms within the broader cluster of emotional, cognitive, and somatic symptoms and explores variations in adolescent groups in four Asian and European regions.

Methods
We recruited a diverse sample of 6,348 adolescents aged 12 to 18 from Hong Kong, Taiwan, the UK, China, and the Netherlands using the Qualtrics platform. Employing the Gaussian Graphical Model, we established a network model of depressive symptoms as measured by the MDAS, segregating the sample into Asian and European regions to examine the interconnections between them. The study focused on identifying central symptom nodes and comparing the network structures between the two groups.

Results
The analysis identified feeling worthless, low energy, being a burden to others, and low mood as central symptoms of depression. Notably, there were significant differences in the connections between depressive symptoms among Asian (Hong Kong, China and Taiwan) and European (UK and the Netherlands) adolescents, highlighting cultural variations in how interpersonal symptoms interact with emotional, cognitive, and somatic symptoms.

Conclusion
This study is pioneering in applying network analysis to include interpersonal symptoms in examining depression among a diverse adolescent population. It demonstrates that interpersonal symptoms are integral to the central features of depressive symptoms. Furthermore, our findings suggest that, compared to their UK and Dutch peers, interpersonal symptoms in Asian adolescents are uniquely connected to other symptom clusters, reflecting distinct cultural patterns. Limitations: The study engaged a broad community sample; however, future research could benefit from including a larger sample size to allow for a more detailed analysis of a greater number of symptom nodes.
Attitudes and perceptions of Thai medical students regarding artificial intelligence in radiology and medicine
Authors: Angkurawaranon Salita , Inmutto Nakarin , Bannangkoon Kittipitch , Wonghan Surapat , Kham-ai Thanawat , Khumma Porched , Daengpisut Kanvijit , Thabarsa Phattanun , Angkurawaranon Chaisiri 
Published: October 2024

Abstract
Introduction
Artificial Intelligence (AI) has made a profound impact on the medical sector, particularly in radiology. The integration of AI knowledge into medical education is essential to equip future healthcare professionals with the skills needed to effectively leverage these advancements in their practices. Despite its significance, many medical schools have yet to incorporate AI into their curricula. This study aims to assess the attitudes of medical students in Thailand toward AI and its application in radiology, with the objective of better planning for its inclusion.

Methods
Between February and June 2022, we conducted a survey in two Thai medical schools: Chiang Mai University in Northern Thailand and Prince of Songkla University in Southern Thailand. We employed 5-point Likert scale questions (ranging from strongly agree to strongly disagree) to evaluate students’ opinions on three main aspects: (1) their understanding of AI, (2) the inclusion of AI in their medical education, and (3) the potential impact of AI on medicine and radiology.

Results
Our findings revealed that merely 31% of medical students perceived to have a basic understanding of AI. Nevertheless, nearly all students (93.6%) recognized the value of AI training for their careers and strongly advocated for its inclusion in the medical school curriculum. Furthermore, those students who had a better understanding of AI were more likely to believe that AI would revolutionize the field of radiology (p = 0.02), making it more captivating and impactful (p = 0.04).

Conclusion
Our study highlights a noticeable gap in the understanding of AI among medical students in Thailand and its practical applications in healthcare. However, the overwhelming consensus among these students is their readiness to embrace the incorporation of AI training into their medical education. This enthusiasm holds the promise of enhancing AI adoption, ultimately leading to an improvement in the standard of healthcare services in Thailand, aligning with the country’s healthcare vision.
Diet quality in young adulthood and sleep at midlife: a prospective analysis in the Bogalusa Heart Study
Authors: Potts Kaitlin S. , Gustat Jeanette , Wallace Maeve E. , Ley Sylvia H. , Qi Lu , Bazzano Lydia A. 
Published: October 2024

Abstract
Background
Diet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though longitudinal evidence for how diet associates with sleep is scarce. This study aimed to determine the prospective association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS).

Methods
This prospective study included 593 BHS subjects with dietary assessment at the 2001–2002 visit and sleep questionnaire responses from the 2013–2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested.

Results
Higher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower probability of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower probability of insomnia symptoms at follow-up (RR [95% confidence interval CI]: 0.85 [0.77, 0.93]), those in Q5 of AHEI had 0.54 times the probability as those in Q1 (95% CI: 0.39, 0.75), and there was a significant trend across quintiles (trend p = 0.001). There were no significant associations between young adult diet quality and having a high sleep apnea risk or a healthy sleep pattern at follow-up.

Conclusions
A healthy diet was associated with a lower probability of future insomnia symptoms. If replicated, these findings could have implications for chronic disease prevention strategies incorporating the lifestyle behaviors of sleep and diet.
World Health Organization repository of systematic reviews on interventions in environment, climate change and health: a new resource for decision makers, intervention implementers, and researchers
Authors: Shrikhande Shreya , Wolf Jennyfer , Vert Cristina , Egorova Alexandra , Neira Maria , Prüss Annette 
Published: October 2024

AbstractTo facilitate the use of the mounting evidence on how human health is inextricably linked to the health of the planet and the urgent need for measures against the escalating triple planetary crisis, the WHO has developed a repository of systematic reviews on interventions in the area of environment, climate change and health (ECH). This commentary introduces the repository, describes its rationale and development, and points to potential future evolutions. The repository aims to provide a user-friendly tool for quickly finding systematic reviews and meta-analyses on specific ECH topics. The spreadsheet includes details on each systematic review, such as population, intervention type, control group, outcomes, and location, among other information. This supports effective assessment of the available evidence, potentially informing policy decisions across various sectors. The repository is a resource for anyone interested in the interlinkages between health and environment and is also targeted at decision makers, intervention implementers and researchers in order to identify priority issues and support evidence-based action. Furthermore, it can be used to identify areas in need of greater research. Additionally, systematic reviews of intervention effectiveness are often used for setting general guidelines and standards, for choosing the most promising intervention in a certain situation and for calculating the disease burden attributable to a specific environmental risk.
Significant individual variation in cardiac-cycle-linked cerebrospinal fluid production following subarachnoid hemorrhage
Authors: Eide Per Kristian , Undseth Ragnhild Marie , Gjertsen Øyvind , Valnes Lars Magnus , Ringstad Geir , Lindstrøm Erika Kristina 
Published: October 2024

Abstract
Background
Spontaneous subarachnoid hemorrhage (SAH) often results in altered cerebrospinal fluid (CSF) flow and secondary hydrocephalus, yet the mechanisms behind these phenomena remain poorly understood. This study aimed to elucidate the impact of SAH on individual CSF flow patterns and their association with secondary hydrocephalus.

Methods
In patients who had experienced SAH, changes in CSF flow were assessed using cardiac-gated phase-contrast magnetic resonance imaging (PC-MRI) at the Sylvian aqueduct and cranio-cervical junction (CCJ). Within these regions of interest, volumetric CSF flow was determined for every pixel and net CSF flow volume and direction calculated. The presence of acute or chronic hydrocephalus was deemed from ventriculomegaly and need of CSF diversion. For comparison, we included healthy subjects and patients examined for different CSF diseases.

Results
Twenty-four SAH patients were enrolled, revealing a heterogeneous array of CSF flow alterations at the Sylvian aqueduct. The cardiac-cycle-linked CSF net flow in Sylvian aqueduct differed from the traditional figures of ventricular CSF production about 0.30–0.40 mL/min. In 15 out of 24 patients (62.5%), net CSF flow was retrograde from the fourth to the third and lateral ventricles, while it was upward at the cranio-cervical junction in 2 out of 2 patients (100%). The diverse CSF flow metrics did not distinguish between individuals with acute or chronic secondary hydrocephalus. In comparison, 4/4 healthy subjects showed antegrade net CSF flow in the Sylvian aqueduct and net upward CSF flow in CCJ. These net CSF flow measures also showed interindividual variability among other patients with CSF diseases.

Conclusions
There is considerable inter-individual variation in net CSF flow rates following SAH. Net CSF flow in the Sylvian aqueduct differs markedly from the traditional ventricular CSF production rates of 0.30–0.40 mL/min in SAH patients, but less so in healthy subjects. Furthermore, the cardiac-cycle-linked net CSF flow rates in Sylvian aqueduct and CCJ suggest an important role of extra-ventricular CSF production.