bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Work Stressors on RN Exhaustion
Authors: Filipova Anna A. 
Published: February 2023

OBJECTIVEThis study examines the effect of work environment stressors on RNs' exhaustion through perceived organizational support (POS).BACKGROUNDDrawing on conservation of resources theory and POS theory, POS is theorized to act as a buffer or mediator between lack of COVID-related support and communication (LCSC), 3 role stressors (role overload, role ambiguity, nonparticipation), bullying, and exhaustion.METHODSA cross-sectional survey design was used. A total of 169 questionnaires (16.6% response rate) were analyzed, performing Pearson correlation, mediation, moderation, and hierarchical robust regression tests.RESULTSThe 3 role stressors were strongly related to bullying. Support was found for an interactive relationship between LCSC and POS at different levels of bullying. Role overload, role ambiguity, and bullying had positive direct effects on exhaustion, whereas POS had negative direct and indirect effects.CONCLUSIONSCognitive skills training at individual level coupled with organizational-based stress interventions and leadership development programs could reduce exhaustion.
CLINICAL PHENOTYPES OF SEPSIS-ASSOCIATED ENCEPHALOPATHY: A RETROSPECTIVE COHORT STUDY
Authors: Lu Xin , Qin Mubing , Walline Joseph Harold , Gao Yanxia , Yu Shiyuan , Ge Zengzheng , Gong Chao , Zhu Huadong , Annane Djillali , Li Yi 
Published: February 2023

ABSTRACT

Background: Sepsis-associated encephalopathy (SAE) is a dysfunction of the central nervous system experienced during sepsis with variable clinical and pathophysiologic features. We sought to identify distinct SAE phenotypes in relation to clinical outcomes. Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the eICU database were used to conduct a retrospective cohort study. Adult sepsis patients were included and SAE was defined as having a Glasgow Coma Scale (GCS) score ˂15 or delirium. The following our clinical phenotypes were defined as: ischemic-hypoxic, metabolic, mixed (ischemic-hypoxic and metabolic), and unclassified. The primary outcome was in-hospital mortality. Results: The study enrolled 4,120 sepsis patients, 2,239 from MIMIC-IV (including 1,489 patients with SAE, 67%), and 1,881 from eICU (1,291, 69%). For the SAE cohort, 2,780 patients in total were enrolled (median age, 67 years; interquartile range, 56–76.8; 1,589 (57%) were male; median GCS score was 12 [8–14]; median Sequential Organ Failure Assessment score was 6 [4–9]). The SAE phenotype distributions between the MIMIC-IV and eICU cohorts were as follows (39% vs. 35% ischemic-hypoxic, P = 0.043; 38% vs. 40% metabolic, P = 0.239; 15% vs. 15% mixed, P = 0.972; 38% vs. 40% unclassified, P = 0.471). For the overall cohort, the in-hospital mortality for patients with ischemic-hypoxic, metabolic, mixed, or unclassified phenotypes was 33.9% (95% confidence interval, 0.3–0.37), 28.4% (0.26–0.31), 41.5% (0.37–0.46), and 14.2% (0.12–0.16), respectively. In the multivariable logistic analysis, the mixed phenotype was associated with the highest risk of in-hospital mortality after adjusting for age, sex, GCS, and modified Sequential Organ Failure Assessment score (adjusted odds ratio, 2.11; 95% confidence interval, 1.67–2.67; P < 0.001). Conclusions: Four SAE phenotypes had different clinical outcomes. The mixed phenotype had the worst outcomes. Further understanding of these phenotypes in sepsis may improve trial design and targeted SAE management.
Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs
Authors: Aghazarian Gary S. , Lind Romulo , Motola David , Perry Melanie , Singletary Norman , Lastrapes Linda , Ghanem Muhammad , Jawad Muhammad A. , Teixeira Andre F. 
Published: February 2023

Purpose:
Postoperative nausea and vomiting (PONV) is one of the most common adverse effects of anesthesia and surgery, resulting in patient discomfort and dissatisfaction. Latest research has demonstrated the efficacy of NK-1 receptor antagonists in PONV management and its use in chemotherapy nausea prophylaxis. The authors of this article would like to provide evidence to support the use fosaprepitant, as monotherapy, in postoperative care, replacing a polypharmacological standard of care regimen.

Methods:
This was a retrospective chart review of 400 patients who received standard of care antiemetic regimen or received fosaprepitant (No-Fosaprepitant vs. Fosaprepitant groups, respectively). The primary outcome of this study is to evaluate the impact of fosaprepitant (administered intravenously) on perioperative antiemetic use, treatment cost, and patient satisfaction.

Results:
Total PONV medication cost decreased with the replacement of standard of care regimen for fosaprepitant, from 46.47±20.54 United States Dollars in the no-Fosaprepitant group to 25.69±14.84 United States Dollars in the Fosaprepitant group. There was a significant reduction in antiemetic doses between groups; 0.37±0.745 versus 7.61±5.202 for ondansetron (P=0.001), 92±1.279 versus 2.21±2.399 for promethazine (P=0.001), 0.25±0.685 versus 1.41±0.577 for scopolamine patch (P=0.001), and 0.05±0.218 versus 1.14±0.398 for dexamethasone (P=0.001). Patient satisfaction, measured by a questionnaire, was a 11.6% higher in the Fosaprepitant group.

Conclusion:
Fosaprepitant is a relevant alternative in preventing and treating PONV in patients who underwent bariatric/metabolic surgical procedures.
Busulfan or Treosulfan Conditioning Platform for Allogeneic Stem Cell Transplantation in Patients Aged >60 Y With Acute Myeloid Leukemia/Myelodysplastic Syndrome: A Subanalysis of the GITMO AlloEld Study
Authors: Malagola Michele , Polverelli Nicola , Martino Massimo , Patriarca Francesca , Bruno Benedetto , Giaccone Luisa , Grillo Giovanni , Bramanti Stefania , Bernasconi Paolo , De Gobbi Marco , Natale Annalisa , Terruzzi Elisabetta , Olivieri Attilio , Chiusolo Patrizia , Carella Angelo Michele , Casini Marco , Maffini Enrico , Nozzoli Chiara , Mazza Patrizio , Bassi Simona , Onida Francesco , Vacca Adriana , Falcioni Sadia , Luppi Mario , Iori Anna Paola , Pavone Vincenzo , Skert Cristina , Carluccio Paola , Borghero Carlo , Proia Anna , Selleri Carmine , Rubini Vicky , Sacchi Nicoletta , Oldani Elena , Bonifazi Francesca , Ciceri Fabio , Russo Domenico 
Published: February 2023

Background.
The conditioning regimens with different alkylators at different doses can influence the outcome of allogeneic stem cell transplantation (SCT), but conclusive data are missing.

Methods.
With the aim to analyze real-life allogeneic SCTs performed in Italy between 2006 and 2017 in elderly patients (aged >60 y) with acute myeloid leukemia or myelodysplastic syndrome, we collected 780 first transplants data. For analysis purposes, patients were grouped according to the type of alkylator included in the conditioning (busulfan [BU]-based; n = 618; 79%; treosulfan [TREO]-based; n=162; 21%).

Results.
No significant differences were observed in nonrelapse mortality, cumulative incidence of relapse, and overall survival, although in the TREO-based group, we observed a greater proportion of elderly patients (P < 0.001); more active diseases at the time of SCT (P < 0.001); a higher prevalence of patients with either hematopoietic cell transplantation-comorbidity index ≥3 (P < 0.001) or a good Karnofsky performance status (P = 0.025); increased use of peripheral blood stem cells as graft sources (P < 0.001); and greater use of reduced intensity conditioning regimens (P = 0.013) and of haploidentical donors (P < 0.001). Moreover, the 2-y cumulative incidence of relapse with myeloablative doses of BU was significantly lower than that registered with reduced intensity conditioning (21% versus 31%; P = 0.0003). This was not observed in the TREO-based group.

Conclusions.
Despite a higher number of risk factors in the TREO group, no significant differences were observed in nonrelapse mortality, cumulative incidence of relapse, and overall survival according to the type of alkylator, suggesting that TREO has no advantage over BU in terms of efficacy and toxicity in acute myeloid leukemia and myelodysplastic syndrome.
Carotid Intima-Media Thickness (cIMT) and Cognitive Performance
Authors: Vibha Deepti , Prasad Kameshwar , Dwivedi Sada Nand , Kant Shashi , Pandit Awadh Kishor , Tiemeier Henning , Srivastava Achal Kumar , Karthikeyan Ganesan , Garg Ajay , Verma Vivek , Kumar Amit , Nehra Ashima , Ikram Arfan 
Published: February 2023

Introduction:
Atherosclerosis has been shown to impact cognitive impairment, with most of the evidence originating from European, African, or East Asian populations that have employed carotid intima-media thickness (cIMT) as a biomarker for atherosclerosis. Vascular disease is related to dementia/cognitive decline. There is no community-based study from India that has looked at the association of cIMT with cognitive performance.

Methods:
In this cross-sectional study between December 2014 and 2019, we recruited 7505 persons [(mean age 64.6 (9.2) y) and 50.9% women] from a community-dwelling population in New Delhi. These persons underwent carotid ultrasound to quantify cIMT and a cognitive test battery that tapped into memory, processing speed, and executive function. We also computed the general cognitive factor (g-factor), which was identified as the first unrotated component of the principal component analysis and explained 37.4% of all variances in the cognitive tests. We constructed multivariate linear regression models adjusted for age, sex, education, and cardiovascular risk factors. Additional adjustment was made for depression, anxiety, and psychosocial support in the final model.

Results:
We found a significant association of higher cIMT with worse performance in general cognition (β=−0. 01(95% CI: −0.01; −0.01); P<0.001), processing speed (β=−0.20; 95% CI: −0.34; −0.07); P=0.003), memory (β=−0.29; 95% CI: −0.53; −0.05); P=0.016), and executive function (β=−0.54; 95% CI: −0.75; −0.33); P=<0.001). There was no statistically significant association of cIMT with Mini-Mental Status Examination score (β=0.02; 95% CI: −0.34; 0.40; 0.89).

Conclusion:
The cross-sectional study found significant associations of increased cIMT with worse performance in global cognition, information processing, memory, and executive function.
Nasu-Hakola Disease With Stroke-like Attack
Authors: Rashid Nezhad Azra , Olfati Nahid , Shoeibi Ali , Rezaei Talab Fariborz , Soltani Sabi Mohsen 
Published: February 2023

Homozygous mutations in the triggering receptor expressed on myeloid cells 2 (TREM2) gene are known to cause Nasu-Hakola disease, which is a rare cause of progressive presenile dementia.
A 36-year-old woman presented with repetitive seizures, a 5-year history of progressive behavioral and cognitive changes, and an affected sibling. Magnetic resonance imaging of the brain revealed an ischemic lesion in the left medial temporal lobe. Extensive evaluation of juvenile stroke revealed that viral and autoimmune encephalitides, serum lactate and pyruvate levels, and cerebrospinal fluid composition were all normal. Brain magnetic resonance imaging was notable of thinning of the corpus callosum and caudate and frontotemporal cortical atrophy, in addition to the ischemic lesion. Whole exome sequencing revealed a homozygous mutation (c.A257T; p.D86V) in TREM2.
The present case expands the clinical phenotype of Nasu-Hakola disease and further suggests that TREM2 pathway might have role in vessel wall health.
Quantifying the Prognostic Value of Preoperative Surgeon Intuition: Comparing Surgeon Intuition and Clinical Risk Prediction as Derived from the American College of Surgeons NSQIP Risk Calculator
Authors: Marwaha Jayson S , Beaulieu-Jones Brendin R , Berrigan Margaret , Yuan William , Odom Stephen R , Cook Charles H , Scott Benjamin B , Gupta Alok , Parsons Charles S , Seshadri Anupamaa J , Brat Gabriel A 
Published: February 2023

Background:
Surgical risk prediction models traditionally use patient attributes and measures of physiology to generate predictions about postoperative outcomes. However, the surgeon’s assessment of the patient may be a valuable predictor, given the surgeon’s ability to detect and incorporate factors that existing models cannot capture. We compare the predictive utility of surgeon intuition and a risk calculator derived from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP).

Study Design:
From 10/1/2021 to 9/1/2022, surgeons were surveyed immediately before performing surgery to assess their perception of a patient’s risk of developing any postoperative complication. Clinical data were abstracted from ACS NSQIP. Both sources of data were independently used to build models to predict the likelihood of a patient experiencing any 30-day postoperative complication as defined by ACS NSQIP.

Results:
Preoperative surgeon assessment was obtained for 216 patients. NSQIP data were available for 9182 patients who underwent general surgery (1/1/17 to 9/1/22). A binomial regression model trained on clinical data alone had an AUC of 0.83 (95% CI: 0.80-0.85) in predicting any complication. A model trained on only preoperative surgeon intuition had an AUC of 0.70 (95% CI: 0.63-0.78). A model trained on surgeon intuition and a subset of clinical predictors had an AUC of 0.83 (95% CI: 0.77-0.89).

Conclusions:
Preoperative surgeon intuition alone is an independent predictor of patient outcomes; however, a risk calculator derived from ACS NSQIP is a more robust predictor of post-operative complication. Combining intuition and clinical data did not strengthen prediction.
Has the COVID-19 pandemic ended or not? opinions from the public in the U.S
Authors: Yang Yong 
Published: February 2023

AbstractRecently President Joe Biden announced the end to the COVID-19 pandemic in the US but some scientists expressed different opinions. This study aimed to examine the view of the end of the COVID-19 pandemic among the public. Data were collected in September 2022 from an online crowdsourcing platform, and respondents answered if they believed that the pandemic has ended in the United States or not. Logistic regressions were used to estimate the likelihood of agreeing on the end of the pandemic, adjusted by demographics and several related variables. Among 2983 respondents, 78.1% believed that the COVID-19 pandemic had ended, and the percentage decreased to 66.5% after adding weights. Males, younger adults, Hispanics, those with higher levels of educational attainment, those with middle levels of household income, those living in suburban or rural areas, and those living in states that voted for the Republican party in the 2020 Presidential Election were more likely to believe that the pandemic had ended, compared with their counterparts. With about one-third of Americans did not agree that the pandemic had ended and marked demographical and geographical differences, the timing and the way of the pandemic end announcement should be deliberately cautious.
Risk of Second Primary Cancers After a Diagnosis of First Primary Cancer: A Pan-Cancer Analysis and Mendelian Randomization Study
Authors: Ruan Xiaohao , Huang Da , Zhan Yongle , Huang Jingyi , Huang Jinlun , NG Ada Tsui-Lin , TSU James Hok-Leung , Na Rong 
Published: February 2023

AbstractBackgroundThe risk of second primary cancers (SPC) is increasing after the first primary cancers (FPC) are diagnosed and treated. The underlying causal relationship remains unclear.MethodsWe conducted a pan-cancer association (26 cancers) study in the Surveillance, Epidemiology, and End Results (SEER) database. The standardized incidence ratio (SIR) was estimated as the risk of SPCs in cancer survivors based on the incidence in the general population. Furthermore, the causal effect was evaluated by two-sample Mendelian Randomization (MR, 13 FPCs) in the UK Biobank (UKB, n=459,136) and robust analysis (radial MR and Causal Analysis Using Summary Effect estimates, CAUSE).ResultsWe found 11 significant cross-correlations among different cancers after harmonizing SIR and MR results. Whereas only 4 of them were confirmed by MR to have a robust causal relationship. In particular, patients initially diagnosed with oral pharyngeal cancer would have an increased risk of non-Hodgkin lymphoma (SIRSEER=1.18, 95%Confidence Interval [CI]:1.05-1.31, ORradial-MR=1.21, 95%CI:1.13-1.30,P=6.00×10−3; ORcause=1.17, 95%CI:1.05-1.31,P=8.90×10−3). Meanwhile, ovary cancer was identified to be a risk factor for soft tissue cancer (SIRSEER=1.72, 95%Confidence Interval [CI]:1.08-2.60, ORradial-MR=1.39, 95%CI:1.22-1.58,P=1.07×10−3; ORcause=1.36, 95%CI:1.16-1.58,P=0.01). And kidney cancer was likely to cause the development of lung cancer (SIRSEER=1.28, 95%Confidence Interval [CI]:1.22-1.35, ORradial-MR=1.17, 95%CI:1.08-1.27,P=6.60×10−3; ORcause=1.16, 95%CI:1.02-1.31,P=0.05) and myeloma (SIRSEER=1.54, 95%Confidence Interval [CI]:1.33-1.78, ORradial-MR=1.24, 95%CI:1.21-2.45,P=0.02; ORcause=1.49, 95%CI:1.04-2.34,P=0.02).ConclusionsA certain type of primary cancer may cause another second primary cancer, and the profound mechanisms need to be studied in the future.FundingThis work was in supported by grants from National Natural Science Foundation of China (Grant No. 81972645), Innovative research team of high-level local universities in Shanghai, Shanghai Youth Talent Support Program, intramural grant of The University of Hong Kong to Dr. Rong Na, and Shanghai Sailing Program (22YF1440500) to Dr. Da Huang.
Atherogenic index of plasma is associated with the risk of myocardial infarction: a prospective cohort study
Authors: Zhang Yijun , Wu Shouling , Tian Xue , Xu Qin , Xia Xue , Zhang Xiaoli , Li Jing , Chen Shuohua , Wang Anxin , Liu Fen 
Published: February 2023

AbstractBackground and aimsThe atherogenic index of plasma (AIP) has been confirmed as a contributor of cardiovascular disease. But few evidence on the longitudinal pattern of AIP during follow-up. This study aimed to explore the associations between baseline and long-term AIP with the risk of myocardial infarction (MI).MethodsA total of 98 861 participants without MI at baseline were included from the Kailuan study. The baseline AIP was calculated as log (triglyceride/high-density lipoprotein cholesterol). The long-term AIP was calculated as the updated mean AIP and the number of visits with high AIP. The updated mean AIP was calculated as the mean of AIP from baseline to the first occurrence of MI or to the end of follow-up. The number of visits with high AIP was defined as higher than the cutoff value at the first three visits. Univariable and multivariable Cox proportional hazard models were used to determine the association between AIP and the risk of MI.ResultsDuring a median follow-up of 12.80 years, 1804 participants developed MI. The multivariable models revealed that elevated levels of baseline and updated mean AIP increased the risk of MI, compared with quartile 1 the HR in quartile 4 was 1.63 (95% CI, 1.41-1.88) and 1.59 (95% CI, 1.37-1.83), respectively. Compared to those without high AIP, the risk of individuals with three times was 1.94 (95% CI,1.55-2.45).ConclusionsElevated levels of both baseline and long-term AIP displayed a higher risk of MI.
Surface sampling for SARS-CoV-2 in workplace outbreak settings in the UK, 2021-22
Authors: Nicholls Ian , Spencer Antony , Chen Yiqun , Bennett Allan , Atkinson Barry 
Published: February 2023

ABSTRACTAimsTo utilise environmental surface sampling to evaluate areas of SARS-CoV-2 contamination within workplaces to identify trends and improve local COVID-control measures.Methods and ResultsSurface sampling was undertaken at 12 workplaces that experienced a cluster of COVID-19 cases in the workforce between March 2021 and March 2022. 7.4% (61/829) of samples collected were positive for SARS-CoV-2 RNA by qPCR with only 1.8% (15/829) of samples identified with crossing threshold (Ct) values below 35.0. No sample returned whole genome sequence inferring RNA detected was degraded.ConclusionsFew workplace surface samples were positive for SARS-CoV-2 RNA and positive samples typically contained low levels of nucleic acid. Although these data may infer a low probability of fomite transmission or other forms of transmission within the workplace, Ct values may have been lower at the time of contamination. Workplace environmental sampling identified lapses in COVID-control measures within individual sites and showed trends through the pandemic.Significance and Impact of the StudyPrior to this study, few published reports investigated SARS-CoV-2 RNA contamination within workplaces experiencing cases of COVID-19. This report provides extensive data on environmental sampling identifying trends across workplaces and through the pandemic.
Acute infarct segmentation on diffusion-weighted image using deep learning algorithm and RAPID DWI: a comprehensive stroke center clinical validation study
Authors: Ryu Wi-Sun , Kang You-Ri , Noh Yoon-Gon , Park Jong-Hyeok , Kim Dongmin , Kim Byeong C. , Park Man-Seok , Kim Beom Joon , Kim Joon-Tae 
Published: February 2023

AbstractBackgroundAccurate infarct volume measurement requires manual segmentation in diffusion weighted image (DWI) which is time-consuming and prone to variability. We compared two DWI infarct segmentation programs based on deep learning and the apparent diffusion coefficient threshold (JBS-01K and RAPID DWI, respectively) in a comprehensive stroke center.MethodWe included 414 patients whose DWI were evaluated using RAPID DWI and JBS-01K. We used the Bland-Altman plot to compare estimated and manually segmented infarct volumes. We compared R-squared, root mean squared error, Akaike information criterion, and log likelihood after linear regression of manually segmented infarct volumes.ResultsThe mean age of included patients was 70,0±12.4 years, and 60.9% were male. The median time between the last known well and a DWI was 12.4 hours. JBS-01K segmented infarct volumes were more comparable to manually segmented volumes compared to RAPID DWI. JBS-01K had a lower root mean squared error (6.9 vs. 10.8) and log likelihood (p<0.001) compared to RAPID DWI. In addition, compared to RAPID DWI, JBS-01K more correctly classified patients according to the infarct volume threshold used in endovascular treatment trials (overall accuracy 98.1% vs. 94.0%; p = 0.002). In 35 patients who received DWI prior to endovascular treatment, JBS-01K infarct volume segmentation was more closely related to manual infarct volume segmentation.ConclusionWe demonstrated that a deep learning method segmented infarct on DWI more accurately than one based on the apparent diffusion coefficient threshold.