bluuebunny/crossref_metadata_2025_split huggingface dataset:
P117 Changes in prescription of home non-invasive ventilation (NIV) in Southern Adelaide Local Health Network (SALHN) from 2016 – 2020
Authors: Raja Mohamed F , Krishnan S , Bassett K , Aiyappan V , Chai-Coetzer C 
Published: October 2021

Abstract

Background
Long term NIV is established therapy for patients with chronic type 2 respiratory failure (T2RF) due to neuromuscular disorders and obesity hypoventilation syndrome (OHS) without significant OSA. There is emerging evidence that COPD patients with T2RF also benefit from NIV. In our centre, there appears to be an increase in the prescription of long term NIV to patients over time, with 60% of all active long term NIV patients commencing therapy from 2017 onwards. In this study we will determine if (i) there has been increased provision of long term NIV to ward patients recovering from acute T2RF, (ii) there has been an increase in patients with COPD and T2RF commenced on long term NIV, (iii) there are patients with OHS and comorbid OSA who can be changed from NIV to CPAP and (iv) there is adequate follow up for patients who initiated NIV in the ward acutely.

Methods
Retrospective, observational study using a pre-existing database of all current and previous patients commenced on NIV from July 2016 to July 2020.
Progress to date
All active long term NIV patients have been identified and a database (n= 220) created containing all relevant information including date and place of NIV initiation and indication.
Intended outcome and impact
This audit will objectively assess the growth of our NIV service to facilitate better allocation of resources. It will also determine if our commencement and management of those on long term NIV is aligned with current evidence and best practice guidelines.
P123 Accuracy and Reliability of the Transcutaneous Carbon Dioxide (TcCO2) Signal in the Sleep Laboratory
Authors: Rossely A , Turton A , Roebuck T , Ho S , Naughton M , Mansfield D , Hamilton G 
Published: October 2021

Abstract
Carbon Dioxide (CO2) monitoring is an essential part of assessing and treating disorders of hypoventilation in the sleep laboratory. While reliablity issues have been previously reported with the Transcutaneous Carbon Dioxide (TcCO2) signal, there is limited data assessing the validity of this signal or its trend in the sleep laboratory context. Therefore, this study aimed to investigate the change in TcCO2 accuracy from the beginning to the end of the sleep study in real world conditions across two different Victorian public hospital sleep laboratories that used two different TcCO2 monitors. The sample included 13 consecutive patients from Monash Health and 44 consecutive patients from Alfred Health with an average age of 64 and 56 years respectively. Arterial Blood Gas (ABG) measurements were taken prior to and following each sleep study and compared concurrently with the TcCO2 value. Bland-Altman analysis revealed an average difference between TcCO2 and PaCO2 of 3.29mmHg with agreement between -11.44 and 16.64mmHg for the TCM4 device and 1.31mmHg with agreement between -7.64 and 9.05mmHg for the TCM5 device. When accuracy was compared across time points for each patient, 46% of patients had an overnight accuracy change of ≥ 8mmHg when using the TCM4 compared with 20% when using the TCM5. It was concluded that the TcCO2 signal was un-reliable across the different monitors and that the TcCO2 trend may be difficult to interpret with confidence without blood gas calibration at the commencement and conclusion of the sleep study.
P131 The impact of an online sleep education program on university students’ sleep knowledge, attitudes, and behaviours
Authors: Semsarian C , Rigney G , Cistulli P , Bin Y 
Published: October 2021

Abstract

Introduction
Sleep is essential for optimising health and academic performance, yet university students consistently report poor sleep quality. We conducted a before-and-after study to determine if an interactive, online sleep course improved sleep (1) knowledge, (2) attitudes, and (3) behaviours among university students.

Methods
Undergraduate students completed the course from August-November 2020. The course involved activities that encouraged students to reflect on their own sleep behaviours and goals. Baseline data was collected through course surveys and students were invited to complete a 6-month follow-up survey via email.

Results
N=212 students completed the baseline questionnaires and n=75 (35%) completed the follow-up survey. Students retained at follow-up possessed higher baseline sleep knowledge and received higher grades. At 6-months follow-up, sleep knowledge increased from baseline (mean quiz score: 60 vs 84%, p&lt;0.001). 85% of students aimed to increase their sleep knowledge at baseline and 91% reported that they were more knowledgeable at follow-up. 83% of students aimed to improve their sleep at baseline and 37% reported improvement at follow-up. 53% of students’ attitudes towards their sleep behaviours had changed from baseline. There was reduction in sleep latency (mean 33.3 vs 25.6min, p=0.015), but no change in total Pittsburgh Sleep Quality Index score at follow-up.

Discussion
Completion of an interactive sleep education course led to increased sleep knowledge and changes in sleep attitudes, with no meaningful change in sleep behaviours. Future interventions require careful design and evaluation, and should consider components of behavioural change (e.g. motivation, triggers) that go beyond the knowledge-attitudes-behaviour continuum.
P143 Sleep-dependent declarative memory consolidation and NREM sleep EEG oscillations in older adults with obstructive sleep apnea
Authors: Teh J , Grummit L , Haroutonian C , Cross N , Bartlett D , Yee B , Grunstein R , Naismith S , D’Rozario A 
Published: October 2021

Abstract

Objectives
To compare overnight declarative memory consolidation and NREM sleep EEG oscillations in older adults with OSA to an age-matched control group, and to assess the quantitative sleep EEG features as correlates of memory consolidation.

Methods
46 participants (24 without OSA and 22 patients with OSA) were recruited. Participants completed a word-paired associates declarative memory task before and after an 8-hour sleep opportunity with full polysomnography. Power spectral analysis was performed on all-night EEG recorded at frontal and central electrode sites. We calculated slow wave activity (slow oscillations absolute power 0.25–1 Hz; and delta EEG power (0.5–4.5 Hz) in NREM sleep. Slow spindle density (11–13 Hz, events p/min) and fast spindle density (13–16 Hz, events p/min) in stage N2 was derived using an automated spindle detection algorithm.

Results
Patients with OSA showed no significant differences in overnight memory recall and recognition compared to individuals without OSA. The OSA group showed reduced slow spindle density at the central region and fast spindle density at the frontal region relative to controls. No differences were observed in SWA. Within group correlations showed slow and fast spindle density were correlated to percent recognition in the control group.

Conclusion
Older adults with OSA had deficits in slow and fast sleep spindles compared to controls. OSA patients showed preserved sleep-dependent declarative memory consolidation despite sleep fragmentation and intermittent hypoxemia. Sleep spindles were positively correlated with overnight memory consolidation in controls but not OSA patients. Targeted interventions to boost spindles may enhance memory consolidation in older adults.
P145 Assessing the Performance of Automatic Analysis During Routine Intralab Conordance Activities
Authors: Teuwen P , Eriksson N , Mateus E , Dalman M , Yau Y , Scott A 
Published: October 2021

Abstract

Introduction
This study aims to retrospectively assess the performance of somnolyzer against trained scientist performance of PSG analysis, under routine interlab concordance conditions in an Australian laboratory.

Methods
Retrospective study (2016 – 2018). Study data included 200 epoc fragments with SWS, REM and NREM. PSG data sets (n = 36) consisted of type 1 (n = 31) and type 2 (n = 5) studies. Individual scorers were compared to a master scoreset set by consensus from two experienced sleep scientists. The automatic analysis system used was Somnolyzer 24x7. Data analysis involved; Group 1: intraclass correlations and Bland-Altman plots, Group 2: Paired T-tests.

Results
Human analysis was shown to outperform automatic analysis in each major metric assessed, except sleep latency. Automatic analysis performed to a similar level in 6 out of 9 of the major metrics assessed (r &gt; 0.9), however the 95% limit of agreement range was found to larger. Automatically analysed RDI’s were more likely to be lower than the master score sets, as were arousal indices.

Conclusions
These findings support using caution with automatic analysis, particularly with medical interpretation and practice. Automatic analysis performance can vary dramatically between PSG data sets. This output can vary from one that is comparable to a human analysis through to a level that is well below that of human scorers, under concordance conditions. Consideration should be given to the accuracy of automatic analysis when making scientific conclusions with borderline cases.
P147 Solriamfetol Titration & AdministRaTion (START): Characteristics of patients with obstructive sleep apnoea (OSA) and prescriber rationale for starting treatment with solriamfetol
Authors: Singh H , Hyman D , Parks G , Chen A , Foley C , Ito D , Thorpy M 
Published: October 2021

Abstract

Introduction
Solriamfetol (Sunosi) is a dopamine/norepinephrine reuptake inhibitor approved (EU/US) to treat excessive daytime sleepiness (EDS) in adults with OSA (37.5–150 mg/day) or narcolepsy (75–150 mg/day). This study examined characteristics of patients with OSA initiating solriamfetol and prescribers’ rationales.

Methods
This descriptive study included a retrospective patient chart review among US-based physicians prescribing solriamfetol for patients with OSA/narcolepsy. Solriamfetol initiation strategies were classified as de novo (no prior EDS medication), transition (switched/switching from existing EDS medications), or add-on (adding to current EDS medication).

Results
Physicians (n=24) entered data from 50 patients with OSA (mean+/-SD age, 52+/-9.1 years; 62% male). EDS was primarily moderate (56%) or severe (36%). Mean+/-SD Apnea-Hypopnoea Index at OSA diagnosis was 33.1+/-19.7 (n=37). The most common nonpharmacologic treatment was positive airway pressure (n=39, 78%); 36/39 (92%) were considered adherent. Common comorbidities included obesity (BMI&gt;/=30) (n=25, 50%), cardiovascular disorders (n=16, 32%), and type 2 diabetes (n=14, 28%). Twenty-two (44%) patients were de novo, 26 (52%) transitioned (primarily from wake-promoting agents [18/26, 69%]), and 2 (4%) added solriamfetol (to stimulants). The efficacy of solriamfetol prompted most discussions to prescribe de novo (18/22, 82%); a desire for improved efficacy and/or augmentation of other medications prompted most transitioning (15/26, 58%) and add-on (2/2, 100%) therapy. At data collection, 48 (96%) patients were stable on solriamfetol; one each discontinued due to lack of efficacy and side effects.

Discussion
Efficacy was a key consideration for physicians prescribing solriamfetol for EDS in a real-world sample of patients with OSA.

Support
Jazz Pharmaceuticals
P164 Back to school - Supporting invasively ventilated children to return to the classroom
Authors: Wood C , Waters K , Gray K 
Published: October 2021

Abstract

Introduction
Integration of children with high health needs into the education system, such as those who are invasively ventilated, requires careful planning.

Methods
We retrospectively reviewed data bases and medical records from January 2004 until December 2020 to profile school age children who, following insertion of a tracheostomy to facilitate invasive ventilation, required assistance in entering or returning to the education system.

Results
44 children received invasive respiratory support. Five (11%) remain under the legal school age of 6 years. Fourteen (32%) children entered main stream education – Private or state schools. Three (7%) children attended main stream schools with extra assistance in a support unit. Eighteen (41%) children attended Special Schools that met their individual underlying health care needs. Four (9%) children received either home schooling or attended hospital school. All children received appropriate education according to cognitive ability and none were placed in an inappropriate school setting due to their need for extra support with respiratory health.

Discussion
High use of health technologies can be perceived as a barrier to the normal classroom so negotiation with education authorities should be part of the patient journey. Support for (re-)integration to the school system includes recruitment and training of support staff and appropriate assessments of ability to provide a safe environment whilst maintaining appropriate level of supervision. Collaboration between the hospital and the education facility is key to the successful integration of children into the education system.
P166 Measures of overnight sleep stability in patients with hypersomnolence
Authors: Woods S , Frenkel S , Lopez C , Murnane C , Southcott A 
Published: October 2021

Abstract

Introduction
Hypersomnolence causes significant impairment of daytime functioning. The multiple sleep latency test (MSLT) measures objective hypersomnolence (OH). Patients with hypersomnolence with a normal MSLT are said to have subjective hypersomnolence (SH). The mechanisms of hypersomnolence in such patients is uncertain. This study describes differences in measures of sleep stability derived from the overnight polysomnography (PSG) in patients with OH and SH.

Methods
A retrospective analysis of 100 patients undergoing PSG/MSLT for investigation of hypersomnolence was performed. Patients were classified as OH (MSLT≤8 min) or SH (MSLT&gt;8min). Sleep stage distribution and PSG-derived markers of sleep stability including cardiopulmonary coupling (CPC), cyclic alternating pattern (CAP) and sleep stage shifts were compared between the two groups.

Results
When compared to OH patients (N=50), SH patients (N=50) had significantly more sleep stage shifts, more shifts to stage N1 and longer PSG sleep latency. Small but significantly lower sleep efficiency, higher stage N1 and N3 proportions were also observed in SH patients. OH patients had a small but significantly higher CAP rate and CAP index compared to SH patients. There were no significant differences in CPC metrics between the two groups.

Conclusion
Several PSG-derived markers of sleep stability indicated that patients with SH experienced more unstable sleep than OH patients. This may provide insight into the underlying pathophysiological mechanisms which differentiate these patient groups and may serve as a future therapeutic target.
The roles of photochemical and non-photochemical quenching in regulating photosynthesis depend on the phases of fluctuating light conditions
Authors: Han Jimei , Gu Lianhong , Warren Jeffrey M , Guha Anirban , Mclennan David A , Zhang Wangfeng , Zhang Yali 
Published: October 2021

Abstract
The induction and relaxation of photochemistry and non-photochemical quenching (NPQ) are not instantaneous and require time to respond to fluctuating environments. There is a lack of integrated understanding on how photochemistry and NPQ influence photosynthesis in fluctuating environments. We measured the induction and relaxation of chlorophyll a fluorescence and gas exchange in poplar and cotton at varying temperatures under saturating and fluctuating lights. When the light shifted from dark to high, the fraction of open reaction centers in photosystem II (qL) gradually increased while NPQ increased suddenly and then remained stable. Temperature significantly changed the response of qL but not that of NPQ during the dark to high light transition. Increased qL led to higher photosynthesis but their precise relationship was affected by NPQ and temperature. qL was significantly related to biochemical capacity. Thus, qL appears to be a strong indicator of the activation of carboxylase, leading to the similar dynamics between qL and photosynthesis. When the light shifted from high to low intensity, NPQ is still engaged at a high level, causing a stronger decline in photosynthesis. Our finding suggests that the dynamic effects of photochemistry and NPQ on photosynthesis depend on the phases of environmental fluctuations and interactive effects of light and temperature. Across the full spectra of light fluctuation, the slow induction of qL is a more important limiting factor than the slow relaxation of NPQ for photosynthesis in typical ranges of temperature for photosynthesis. The findings provided a new perspective to improve photosynthetic productivity with molecular biology under natural fluctuating environments.
Age-Diverse Workplace Friendship: A Systematic Literature Review and Recommendations for Future Research
Authors: Dietz Laura , Fasbender Ulrike 
Published: October 2021

AbstractFriendship may help to bridge differences between people, such as between age-diverse employees. Oftentimes, age diversity in employee interactions cultivates interpersonal tensions. Age-diverse workplace friendship—a relationship between coworkers of different ages, who like each other and who are engaged in a balanced social exchange—may help to overcome these interpersonal tensions because having something in common can de-escalate age-related difficulties and reduce negative feelings between diverse individuals. Despite the relevance of the topic, literature focusing on age-diverse workplace friendship is rare. To address this gap and direct future research, we aim to integrate research on related topics such as workplace friendship and (age) diversity at work into a systematic literature review. Concentrating primarily on the formation and maintenance of age-diverse workplace friendship, we identified similarity-attraction theory, social identity theory, and socioemotional selectivity theory as the three dominant theories referenced in the literature and utilize them to embed and connect our findings into existing theory. More specifically, we review and summarize the findings of our systematic literature review into an integrated framework depicting the antecedents, formation and maintenance processes, and outcomes of age-diverse workplace friendship. We discuss the theoretical and practical implications of our findings and point out directions for future research.
Long bone shape variation in the forelimb of Rhinocerotoidea: relation with size, body mass and body proportions
Authors: Mallet Christophe , Houssaye Alexandra , Cornette Raphaël , Billet Guillaume 
Published: October 2021

Abstract
In quadrupeds, limb bones are strongly affected by functional constraints linked to weight support, but few studies have addressed the complementary effects of mass, size and body proportions on limb bone shape. During their history, Rhinocerotoidea have displayed a great diversity of body masses and relative size and proportions of limb bones, from small tapir-like forms to giant species. Here, we explore the evolutionary variation of shapes in forelimb bones and its relationship with body mass in Rhinocerotoidea. Our results indicate a general increase in robustness and greater development of muscular insertions in heavier species, counteracting the higher weight loadings induced by an increased body mass. The shape of the humerus changes allometrically and exhibits a strong phylogenetic signal. Shapes of the radius and ulna display a stronger link with body mass repartition than with the absolute mass itself. Congruent shape variation between the humerus and the proximal part of the ulna suggests that the elbow joint is comprised of two strongly covariant structures. In addition, our work confirms the uniqueness of giant Paraceratheriidae among Rhinocerotoidea, whose shape variation is related to both a high body mass and a cursorial forelimb construction.
First Job Workplace Stressors for New Nurse Graduates in Their Own Words: A Secondary Analysis
Authors: Feeg Veronica D. , Mancino Diane J. , Kret Diane D. 
Published: October 2021

Abstract

AIM
The purpose of this study was to have a better understanding of the experiences of new nurse graduates in their work environment and the perceived stressors during their transition into the role of registered nurse.

BACKGROUND
The National Student Nurses’ Association conducts an annual survey of all its members who are new graduates in the months following graduation.

METHOD
The study used a qualitative design on a sample of 1,456 responses. Participants provided typed-in responses. Responses were sorted and coded using constant comparison method. Three independent judges aggregated interpretations through consensus.

RESULTS
The themes that emerged were related to respondents’ attempts to find balance and reflected the stress of the environment, expectations on self, and interactions with others that affected them.

CONCLUSION
New graduates describe their transitions to the role of new nurse in words that suggest that their workplace environments are extremely stressful.
The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review
Authors: Uzelli Yilmaz Derya , Azim Arden , Sibbald Matthew 
Published: October 2021

Purpose
Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. The use of standardized (or simulated) patient programs (SPPs) to support EDI in health sciences training is not well described. Here the authors present a theoretical model based on a synthesis of the literature for using SPPs in EDI training, along with a narrative review of the available literature.

Method
The authors searched PubMed, Scopus, Science Direct, and Google Scholar databases for studies published between January 2000 and October 2019 describing the use of SPPs to support EDI in health sciences education. Studies were included if they described standardized patient (SP) education involving EDI and reported empiric data about its design, delivery, or effectiveness. The authors conducted a narrative review and provided a synthesis of the available literature, identifying key themes.

Results
Out of 117 studies identified, 17 met the inclusion criteria. Most studies (53%; n = 9) focused on cultural competence; many focused on communication with diverse patients (29%; n = 5) or health inequity (18%; n = 3). Studies employed portrayal of diversity (71%; n = 12) or learning objectives supported by diversity (29%; n = 5) as approaches to EDI relevant to SP training. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities.

Conclusions
This review outlines approaches to EDI-based SPPs, with the perspectives and priorities of institutional approaches in mind. SP education around specific EDI issues is reported; however, programmatic approaches to EDI by SPPs are lacking. More research is needed to provide further evidence for the challenges, effectiveness, and outcomes of developing and implementing EDI-based SPPs in health sciences education.