bluuebunny/crossref_metadata_2025_split huggingface dataset:
P121 Chronotype Differences in Sleep Quality: A Systematic Review of Early Birds and Night Owls
Authors: Sajadi Hezaveh Z , Halaki M , Fitzmaurice M , Marin Galindo A , Chow C 
Published: December 2024

Abstract

Introduction
A growing body of literature explores the health risks associated with chronotype, independent of various other factors. Amongst them, sleep quality stands out as significant yet relatively underexplored. This study aims to examine the association between chronotype and sleep quality.

Method
MEDLINE, Web of Science, Scopus, Embase and Cinahl were searched for studies published before May 2024. Search terms were grouped into sleep quality and its assessment tools, plus chronotype and its assessment tools. Studies reporting the distribution of sleep quality parameters in different chronotype categories among the adult disease-free population were considered eligible. This study is registered in PROSPERO (CRD42023448002).

Progress to Date
After removing duplicates, we retrieved 1,125 abstracts. Following title/abstract screening, 724 studies remained, and upon full-text screening, 197 studies met the inclusion criteria. We are currently in the data extraction stage, having extracted data from 56 studies. Preliminary findings indicate that as chronotype progresses from morning to intermediate and late, there is a notable decrease in sleep quality and quantity, an increase in excessive daytime sleepiness, and a higher rate of insomnia. However, results regarding sleep efficiency and sleep latency are inconsistent. Additionally, different patterns may emerge when results are grouped by weekdays versus weekends or chronotype assessment tools (e.g., Munich Chronotype Questionnaire, Morningness-Eveningness Questionnaire).

Intended Outcome and Impact
After extracting the data, we will evaluate the quality of the included studies and consider conducting a meta-analysis. Our ultimate goal is to use the research findings to inform practitioners and sleep clinicians about the significance of chronotype in managing sleep issues.
P123 Identifying differences in sleep spindle activity in children with excessive daytime sleepiness
Authors: Shetty M , Plunkett G , Davey M , Nixon G , Walter L , Horne R 
Published: December 2024

Abstract

Background
Sleep spindles have been hypothesised to protect the sleeping brain from external stimuli and thus promote sleep. We aimed to identify differences in sleep spindle activity between children with narcolepsy, idiopathic hypersomnolence (IH) and subjectively sleepy children (with a normal multiple sleep latency test), and if there was any association between spindle activity with quality of life or severity of daytime sleepiness.

Methods
Spindles were manually identified from both C4 and F4 EEG signals during N2 and N3 sleep in 25 children with narcolepsy, 6 with IH and 21 with subjective sleepiness. Spindles were classified as Fast or Slow. Spindle activity was characterised as number, average duration (s), density (spindles/min) and intensity (density x average duration). Parents completed OSA-18 and ESS-CHAD questionnaires.

Results
Both F4 and C4 Slow and Slow&Fast spindle durations were longer in children with narcolepsy (p&lt;0.001) and IH (p&lt;0.05) compared to subjectively sleepy children. In the subjective sleepy children, all activity measures for all C4 spindles were negatively correlated with emotional symptoms and C4 Slow spindle density and intensity were negatively correlated with sleep disturbance on the OSA-18. Duration of C4 Fast spindles was positively correlated (p&lt;0.05) with the ESS-CHAD score.

Conclusions
The increased duration of frontal and central spindles in children with narcolepsy and IH likely represents an attempt to stabilise sleep during NREM. Our preliminary finding of a relationship between reduced spindle activity and daytime symptoms requires further assessment with questionnaires tailored to children with excessive daytime sleepiness.
P124 Modifying overnight patient care to improve sleep: nurses’ perspectives on barriers and enablers to changing delivery of care
Authors: Tu L , Casey P , Considine J , Yang M , Balanathan S , McCarthy P , Trewella R , Young A 
Published: December 2024

Abstract

Background
Studies demonstrate sleep loss during hospitalisation is common, with patients averaging 5.7 hours of sleep per night. This is well short of the recommended 7 to 9 hours for optimal recovery. Preceding an intervention to improve sleep through modifying the physical environment and delivery of care, we first need to understand nurses’ perspectives on changing delivery of overnight care, to identify behaviour change techniques that will best support change in practice.

Methods
This exploratory, cross-sectional study will survey respiratory ward nurses (n=42) in a tertiary hospital. Nurses will be invited to complete a voluntary electronic survey, comprising participant characteristics (e.g., sex, age, years of experience) and 35 5-point Likert scale items informed by the Theoretical Domains Framework (TDF). Results, reported as descriptive statistics, will be mapped to domains of the TDF and the Behaviour Change Wheel to determine the behaviour change techniques that will enable implementation of the practice change.

Progress to date
The draft “Sleep in Hospital: A Survey of Nurses’ Perspectives” has been completed, incorporating nursing co-design and will undergo pilot-testing and finalisation during June. Following ethical approval, surveys will be distributed, data collected, and analysed prior to SDU 2024.

Intended outcome and impact
To our knowledge, this is the first Australian study to investigate enablers and barriers to implementing changes in nursing care to sleep in hospital. The results will inform our understanding of how to enable change in care delivery to improve patients’ sleep, with the potential to enhance patient experience and healthcare outcomes.
P125 Identification of potential fatigue risks associated with Marine Pilot Transfer operations
Authors: van den Berg M , Zaslona J , Wu L , Signal L 
Published: December 2024

Abstract

Introduction
Helicopter-based Marine Pilot Transfer operations involve transporting marine pilots to offshore vessels. These operations occur around the clock from remote locations. Helicopter crew work a ‘fly-in-fly-out’ schedule from their homebase usually located in a different time zone. This study monitored helicopter crew across ~21-day tours to identify potential fatigue risks.

Methods
Sleep was monitored with actigraphy and diaries. At the end of each shift, crew completed ratings of fatigue, sleepiness, and workload and a 5-minute PVT. Shifts were grouped by end times in 4x6-hourly bins. Linear mixed models investigated sleep and operational factors associated with fatigue, sleepiness, and performance at end of shifts.

Results
Data was collected from 15 helicopter crew across 21-day tours. Shifts ranged from 1.6-11 hours (n=220) with 1-14 sectors flown per shift. At the end of a shift, higher fatigue and sleepiness ratings were associated with less prior sleep (p&lt;.05), longer shifts (p &lt;.05), higher workload (p &lt;.05), and end shift timing (p&lt;.05). Fatigue and sleepiness were greater when shifts ended between 0001-0600, and for sleepiness also between 0601-1200. Higher workload was associated with slower response speed and slowest 10% of responses (p&lt;.05). End of shift PVT performance was slower in the first week of the tour compared to later weeks.

Discussion
The key fatigue risks in this operation are associated with high workload and/or long periods of work at a less than ideal circadian phase. A multi-faceted approach, including on-going education, management of possible jetlag at the beginning of their tour, and monitoring of high-risk shifts is recommended.
P127 OSA-specific hypoxic burden predicts dampened autonomic function in children with Down syndrome
Authors: Walter L , Bhatnagar D , Ong M , Davey M , Nixon G , Horne R , Edwards B 
Published: December 2024

Abstract

Background
Hypoxic burden (HB) has been associated with cardiovascular disease in adults with obstructive sleep apnoea (OSA) but has not been assessed in typically developing (TD) children with sleep disordered breathing (SDB), nor children with Down syndrome (DS) who have a higher incidence of SDB with more severe hypoxia. We assessed whether HB in TD children and children with DS was related to heart rate variability (HRV) as an indicator of poor cardiovascular outcomes.

Methods
Children (3-19 y, n=44) with DS and TD children matched for SDB severity, age and sex underwent overnight polysomnography and were grouped into primary snoring (PS), Mild or Moderate/Severe (MS) OSA. HRV was analysed using power spectral analysis of the electrocardiograph.

Results
Children with MS OSA in both groups had higher HB compared with children with PS (p&lt;0.001 for both) and Mild OSA (p&lt;0.01 for both). Children with DS and PS or Mild OSA had higher HB compared with TD children (PS p&lt;0.01; Mild OSA p&lt;0.05). There was no difference between the groups for children with MS OSA. HB significantly predicted dampened sympathetic and parasympathetic activity (low frequency power) only in children with DS; R² 0.12, β -11.31, SE 2.75, p=0.02.

Conclusion
HB increased with increasing OSA severity, was higher in children with DS and PS or Mild OSA, and significantly predicted dampened autonomic function in children with DS. The potential contribution of the adverse effects of HB on autonomic function adds weight to the importance of identifying and treating SDB in children with DS.
P128 Don’t drop the F-bomb: Paramedic perceptions, attitudes, and behaviours surrounding fatigue
Authors: Wanstall S , Naweed A , Brown B , Crowther M , Rayner T , Adams R , Reynolds A 
Published: December 2024

Abstract

Introduction
Fatigue is prevalent among paramedics internationally, with negative effects on occupational performance and safety, individual well-being, and organisational service delivery. Thus, effective fatigue management is critical. This study aimed to understand paramedic perceptions, attitudes, and behaviours surrounding fatigue.

Methods
A qualitative methodology involving a semi-structured interview and scenario invention task was utilised to understand paramedic (n = 30) experiences of fatigue and explore related perceptions, attitudes, and behaviours. Data were inductively analysed utilising reflexive thematic analysis with a constructivist grounded theory approach.

Results
Eight organising themes were constructed under three global themes: (1) ‘Fatigue is a complex experience’, reflecting perceived complexity and multidimensionality of fatigue as a construct and experience; (2) ‘We have to look after ourselves’, reflecting attitudes about paramedic identities and relationships with organisations, and how these influence attitudes toward fatigue and fatigue management; and (3) ‘Working in the trenches’, reflecting how attitudes impact paramedics acting on fatigue, and coping strategies employed when working fatigued. Together, findings highlighted complex relationships between paramedics and their identities, job roles, and organisations, which influence effective and safe fatigue management.

Discussion
Paramedic perceptions, attitudes, and behaviours surrounding fatigue pose barriers to effective individual and organisational fatigue management. Understanding how paramedics perceive and interact with fatigue is a key factor in designing, implementing, and evaluating fatigue risk management strategies, including fatigue and relevant sleep health education and interventions. Addressing organisational culture, fatigue education, and fatigue risk management design could be considered for improving positive worker engagement with individual and organisational management strategies.
P133 Exploring the treatment journey of Obstructive Sleep Apnoea: A scoping review on the perspectives of Chinese Patients
Authors: Zhu X , Bin Y , Smith L , Cistulli P , Cheung J 
Published: December 2024

Abstract

Background
Globally, obstructive sleep apnoea (OSA) is a common sleep-related breathing disorder, thought to affect up to 23.6% of patients of Chinese ethnicity. However, little is known about the perspectives of the Chinese patient population and the key factors underpinning their health behaviours and treatment engagement. This scoping review aims to systematically synthesise the literature to understand Chinese patient perspectives towards OSA and its management.

Methods
A systematic search was conducted on 28 Jul 2023 across CINAHL, Embase, Medline, PsycINFO, and Scopus in Chinese and English for studies including the concepts: obstructive sleep apnoea, Chinese adult patients, treatments (CPAP, surgery, mandibular devices, pharmacotherapy, positional therapy, complementary therapies, lifestyle changes), and psycho-social-behavioural factors. Search results were screened and data extracted by 2 independent reviewers.

Results
From 679 results, 43 studies conducted in China, Hong Kong, Taiwan and Singapore were included in this review, comprising 15,358 adults (mean age: 48 years, 78% male). Evaluated outcomes included beliefs about OSA, treatment preferences, acceptance, satisfaction, and adherence. Considerable heterogeneity was observed in the measurement of treatment acceptance and satisfaction, coupled with insufficient reporting of factors influencing treatment preference. Notable limitations included the under-representation of older women and migrant Chinese populations and the limited coverage of health beliefs and health behavioural change.

Discussion
Factors influencing patient engagement with OSA treatments are multifactorial. Patients’ health beliefs and sociocultural factors play important role in treatment acceptance and adherence. Future research should focus on patient-centered approaches to identify strategies to promote behavioral change and provide culturally sensitive care.
CryptKeeper: a negative design tool for reducing unintentional gene expression in bacteria
Authors: Roots Cameron T , Barrick Jeffrey E 
Published: December 2024

Abstract
Foundational techniques in molecular biology—such as cloning genes, tagging biomolecules for purification or identification, and overexpressing recombinant proteins—rely on introducing non-native or synthetic DNA sequences into organisms. These sequences may be recognized by the transcription and translation machinery in their new context in unintended ways. The cryptic gene expression that sometimes results has been shown to produce genetic instability and mask experimental signals. Computational tools have been developed to predict individual types of gene expression elements, but it can be difficult for researchers to contextualize their collective output. Here, we introduce CryptKeeper, a software pipeline that visualizes predictions of Escherichia coli gene expression signals and estimates the translational burden possible from a DNA sequence. We investigate several published examples where cryptic gene expression in E. coli interfered with experiments. CryptKeeper accurately postdicts unwanted gene expression from both eukaryotic virus infectious clones and individual proteins that led to genetic instability. It also identifies off-target gene expression elements that resulted in truncations that confounded protein purification. Incorporating negative design using CryptKeeper into reverse genetics and synthetic biology workflows can help to mitigate cloning challenges and avoid unexplained failures and complications that arise from unintentional gene expression.
Discretionary powers and ostensible discretionary trusts
Authors: Lupoi Maurizio 
Published: December 2024

Abstract
A relationship of confidence was at the heart of trusts embodying discretionary powers until the end of the XIX century. Modern discretionary trusts are centred on powers of appointment in respect of beneficiaries who are only discretionary objects. Modern discretionary trusts are dubbed “ostensible” discretionary trusts when the discretion held by the trustee is severely curtailed by settlors, who often double as trustees. The pre-eminence of settlors of ostensible discretionary trusts is such that there is no relationship of confidence between them and their trustees. Ostensible discretionary trusts are invalid because all the basic characters of trusts fail.
Efficacy of avilamycin on the incidence and severity of diarrhea associated with pathogenic Escherichia coli and the subsequent growth performance of nursery pigs
Authors: Weiland Sarah A , Chang Petra L , Puls Chris L , Evelsizer Robert W , Carr Scott N , Frederick Brent , Ebarb Sara , Ritter Matt J 
Published: December 2024

Abstract
A total of 3,329 commercial crossbred barrows and gilts were used to compare the efficacy of avilamycin on incidence and severity of diarrhea and growth performance of pigs naturally infected with Escherichia coli. An incomplete block design was used with a 2 × 4 factorial arrangement of treatments: 1) Stocking density (Single: 0.67 sq. m/pig vs. Double: 0.33 sq. m/pig) and 2) Nursery medication program [Nonmedicated control fed for 56 d (CON) vs. 80.5 mg/kg avilamycin fed for 21 d (AVI21) vs. 80.5 mg/kg avilamycin fed for 42 d (AVI42) vs. 55.1 mg/kg carbadox fed for 21 d (CAR21)]. Subjective diarrhea scores were collected weekly on each pen according to a 3-point scale. Pigs were weighed on days 0, 21, 42, and 56 of the study. Pigs had ad libitum access to feed and water throughout the study. Diets were formulated to meet or exceed NRC (2012) recommendations. Fecal swabs from pigs were collected and confirmed the presence of hemolytic E. coli within the first two weeks of study. During the first 21 d, feeding AVI21 and AVI42 lowered (P &lt; 0.05) diarrhea severity compared to controls, with CAR21 being intermediate. In the second 21 d, feeding AVI42 lowered (P &lt; 0.05) diarrhea incidence and severity compared to the other treatments. In general, feeding medication resulted in lower maximum diarrhea scores compared to nonmedicated controls. For the overall study period (day 0 to 56), there were no (P &gt; 0.05) stocking density × nursery medication program interactions for growth performance measures. A significant interaction (P &lt; 0.05) was observed for day 0 to 42; feed conversion did not differ between double and single stocking density treatments for AVI42, whereas for CON, AVI21, and CAR21, feed conversion was lower in the single stocking density treatment. For the overall study period, there was no effect (P &gt; 0.05) of nursery medication program on final BW, ADG, ADFI, or incidence of morbidity and mortality. Overall G:F was improved (P &lt; 0.05) for pigs fed avilamycin compared to carbadox, with controls being intermediate. Double stocking resulted in lower overall ADFI (P &lt; 0.05) and improved G:F (P &lt; 0.05) compared to single stocking, but increased overall morbidity and mortality and diarrhea severity, incidence, and overall scores (P &lt; 0.05). The results of this study demonstrate relatively similar performance with improved feed conversion and improvements in diarrhea incidence and severity for pigs fed avilamycin compared to carbadox.
Enhancing adapted physical activity training for community organizations: co-construction and evaluation of training modules
Authors: Saadawi Nour , Best Krista L , Pastore Olivia L , Périnet-Lacroix Roxanne , Tomasone Jennifer R , Légaré Mario , de Serres-Lafontaine Annabelle , Sweet Shane N 
Published: December 2024

Abstract
Community-based physical activity programmes benefit persons with disabilities. However, there is a lack of evidence-based tools to support kinesiologists’ training in such programmes. This study aimed to co-create and evaluate physical activity training modules for community-based adapted physical activity (APA) programmes. In Phase 1, a working group (n = 8) consisting of staff, kinesiologists from two community-based APA programmes, and researchers met over four online meetings to discuss needs, co-create training modules, and assess usability. In Phase 2, a pre–post quasi-experimental design evaluated changes in capability, opportunity, and motivation of kinesiologists (n = 14) after completing the training modules, which included standardized mock client assessments and participant ratings of module feasibility. Means and standard deviations were computed for feasibility, followed by paired-samples t-tests, along with Hedge’s correction effect size. Mock client sessions underwent coding and reliability assessment. The working group meetings generated two main themes: training in (i) motivational interviewing and behaviour change techniques and (ii) optimizing APA prescription. Nine online training modules were created. In Phase 2, medium to large effects of training modules were observed in capability (Hedge’s g = 0.67–1.19) for 8/9 modules, opportunity (Hedge’s g = 0.77–1.38) for 9/9 modules, and motivation (Hedge’s g = 0.58–1.03) for 6/9 modules. In mock client assessments, over 78% of participants appropriately used five behaviour change techniques and, on average, participants demonstrated good use of motivational interviewing strategies.
The findings indicate that training kinesiologists was feasible and has the potential to enhance community-based physical activity programmes for persons with disabilities.
Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as mortality predictors in acute Aluminum phosphide (grain pills) poisoning: clinical insights and risk assessment
Authors: Sharif Asmaa F , Mabrouk Heba A , Abdo Sanaa A , Elwy Abdelhamid Mohamed , Fayed Manar M 
Published: December 2024

Abstract

Background
Aluminum phosphides (AlP) is a solid fumigant pesticide known for its high toxicity and mortality. Diagnosis of AlP is based on the history and clinical examination. The literature on the early prediction of adverse outcomes following AlP exposure is limited. Therefore, the current study aimed to investigate the role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte Ratio (PLR) as early accessible predictors of mortality in AlP-exposed patients.

Method
We conducted a retrospective cross-sectional study on 420 adult patients with acute AlP poisoning.

Results
This study reported mean NLR and PLR of 4.07 ± 3.82 and 182.97 ± 147.29, respectively. Patients with high NLR and PLR showed more severe presentation, indicated by the significantly lower Glasgow scales and higher poison severity score grades. Besides, the need for mechanical ventilation, vasopressor therapy, and ICU admission was significantly higher among patients with high NLR and PLR (P = 0.000). We observed a significantly higher proportion of mortality among patients with high NLR (69.5%) and PLR (87.4%) (P = 0.000). The NLR &gt; 3.42, PLR &gt; 172.5, and their combinations were significant predictors of mortality, showing area under curves above 0.94. Utilizing a combination of NLR and PLR yielded a modestly improved performance as a mortality predictor with a slight increase in the Youden index (0.81). The high NLR and high PLR groups had mean survival times of 28.851 and 16.256 h respectively.

Conclusion
These findings suggest that high NLR and PLR are associated with a worse prognosis and a higher mortality risk among patients with acute AlP poisoning.