bluuebunny/crossref_metadata_2025_split huggingface dataset:
P049 Sleep Regularity is Associated with Stability of Daily Light Exposure in Adolescents During School and Vacation
Authors: Hand A , Stone J , Shen L , Vetter C , Cain S , Bei B , Phillips A 
Published: October 2021

Abstract

Study Objectives
Light is the main time cue for the human circadian system. Irregular sleep/wake patterns are associated with poor health outcomes, which could be mediated by irregular patterns of light exposure. The relationship between sleep and light regularity has not been directly explored. We investigated the relationship between sleep and light regularity in adolescents, across school-term and vacation, using novel metrics for measuring light regularity.

Methods
Daily sleep and light patterns were measured via wrist actigraphy in 104 adolescents (54% male, age M±SD = 17.17±0.80 years) over two weeks of school-term and a subsequent two-week vacation. The Sleep Regularity Index (SRI) was computed for each two-week block. Stability of daily light exposure was assessed using variation of mean daily light timing (MLiT), variation in daily photoperiod, and the Light Regularity Index. Associations between SRI and each light regularity metric were examined, and within-individual changes in metrics were examined between school and vacation.

Results
More regular sleep was significantly associated with more regular scores for each light variability metric, during school and vacation. Between school and vacation sleep regularity decreased and nuanced changes in light patterns were observed. Variability measured by the MLiT variable increased, whereas variability measured by the LRI and photoperiod variable decreased.

Conclusions
Adolescents with irregular sleep also have irregular patterns of light exposure. These findings suggest sleep regularity may be a useful proxy for variability in the main circadian time cue, meaning that irregular light exposure may carry implications for the developing adolescent circadian system.
P095 Heart Rate Variability during Sleep in Paroxysmal Atrial Fibrillation patients with and without Obstructive Sleep Apnoea
Authors: Mohammadieh A , Dissanayake H , Sutherland K , Ucak S , de Chazal P , Cistulli P 
Published: October 2021

Abstract

Introduction
Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups.

Methods
Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA.

Results
Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively).

Conclusions
This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.
P101 Economic evaluation of diagnostic sleep studies for obstructive sleep apnoea in the adult population: a systematic review
Authors: Natsky A , Vakulin A , Chai Coetzer C , Kaambwa B 
Published: October 2021

Abstract

Background
Obstructive sleep apnoea (OSA) is a significant public health problem with large health and economic burden. Despite the existence of effective treatment, undiagnosed OSA remains a challenge. The gold standard diagnostic tool is polysomnography (PSG), yet this test is expensive, labour intensive, and time-consuming. Home-based, limited channel sleep study testing (Level 3 and 4) can advance and widen access to diagnostic services. This systematic review aims to summarise available evidence regarding the cost-effectiveness of limited channel tests compared to laboratory and home PSG in diagnosing OSA.

Method
Eligible studies were identified across the following databases: MEDLINE, Psychinfo, Proquest, Scopus, CINAHL, Cochrane, Emcare and Web of Science. Studies were screened, critically appraised and eligible data were extracted using a standardised template. Relevant findings were summarised using a qualitative approach adhering to economic reporting standards.

Results
915 non-duplicate abstracts were identified, 82 full-text articles were retrieved for review. 32 studies met the inclusion criteria and were included in the final analysis: 28 studies investigated Level 3 and four assessed Level 4 OSA diagnostic tests. Using a dominance ranking framework to compare cost and outcomes, both Level 3 and Level 4 OSA diagnostic tests were cost-effective compared to PSG.

Discussion
Although study designs and methodologies differ broadly, findings indicate that using limited channel diagnostic sleep tests for OSA is associated with lower cost and non-inferior health outcomes relative to PSG. Limited channel tests also resulted in shorter waiting times and improvements in access to diagnostic services for patients with OSA.
P102 Accessing healthcare for sleep problems during the COVID-19 pandemic
Authors: Ng Y , Nguyen E , Bei B , Hamilton G , Rajaratnam S , Ou C , Mansfield D 
Published: October 2021

Abstract

Introduction
As part of a study to assess the impact of the COVID-19 pandemic on the sleep of patients of a multidisciplinary sleep clinic, we surveyed how they accessed healthcare for sleep problems.

Methods
Patients were invited to complete an online survey in October 2020.

Results
74 patients completed the survey (mean age 50.2 years, range 21–83 years, 56.8% female). 26/74 (35%) reported at least one delay in accessing healthcare for sleep problems. In particular, 7/49 (14.3%) had delays seeing a general practitioner whilst 16/43 (37.2%) experienced delays accessing a sleep physician. 7/26 (26.9%) reported delays booking a sleep study and 4/15 (26.7%) had delays hiring continuous positive airway pressure equipment. 11/31 (35.5%) experienced delays seeing a psychologist for sleep problems. 11/74 (14.9%) preferred to wait until they were able to attend the clinic in person. 21/74 (28.4%) had telehealth consultations with a sleep physician and/or psychologist. 19/21 (90.5%) described it easy to participate and 20/21 (95.2%) reported receiving satisfactory care through telehealth consultation. Only 5/21 (23.8%) preferred to attend in-person instead of participating in a telehealth consultation again. 11/74 (14.9%) had telephone consultations with a sleep physician and/or psychologist. 8/11 (72.7%) found it easy to participate and 8/11 (72.7%) reported receiving satisfactory care through telephone consultation. Only 3/11 (27.3%) preferred to attend in-person instead of participating in a telephone consultation again.

Discussion
During the COVID-19 pandemic, 35% of patients reported delays accessing healthcare for sleep problems. Most patients who participated in telehealth and telephone consultations described positive experiences.
P103 Impact of the COVID-19 pandemic on the sleep of patients of a multidisciplinary sleep clinic
Authors: Ng Y , Nguyen E , Bei B , Hamilton G , Rajaratnam S , Ou C , Mansfield D 
Published: October 2021

Abstract

Introduction
This study aimed to assess the impact of the COVID-19 pandemic on the sleep of adult patients of a multidisciplinary sleep clinic.

Methods
Patients were invited to complete online surveys: Survey 1 in October 2020 (increased COVID-19 restrictions) followed by Survey 2 in February 2021 (after easing of restrictions for a COVIDSafe summer).

Results
Of the 746 patients invited to participate, 73 completed and 8 partially returned Survey 1 (mean age 50.1 years, range 21–83 years, 58% female). Subsequently, 46 completed and 5 partially answered Survey 2. In Survey 1, 22/74 (29.7%) reported reduced sleep quantity and 31/75 (41.3%) indicated worse sleep quality compared with prior to the pandemic. In Survey 2, 33/46 (71.7%) described unchanged sleep quantity whilst 5/46 (10.9%) reported increased sleep quantity since easing COVID-19 restrictions. 36/46 (78.3%) indicated unchanged sleep quality whereas 5/46 (10.9%) described improved sleep quality since easing restrictions. However, 9/46 (19.6%) reported that their sleep remained worse compared with pre-pandemic. For patients who completed both surveys, there was no significant change in Insomnia Severity Index scores (Survey 1 mean 13.6, Survey 2 mean 12.9, mean difference -0.67 [95%CI -2.02, 0.68], p=0.32) or PROMIS Sleep-Related Impairment 8a T-scores (Survey 1 mean 59.0, Survey 2 mean 59.5, mean difference 0.44 [95%CI -1.55, 2.42], p=0.66).

Discussion
The COVID-19 pandemic has negatively affected the sleep of 44% of patients. Following easing of restrictions, symptoms of insomnia and sleep-related impairment did not change significantly, and 19.6% reported that their sleep was not back to their pre-pandemic baseline.
P130 An audit of urinary drug screening use in multiple sleep latency and maintenance of wakefulness testing in an Australian tertiary centre
Authors: Semasinghe Bandaralage S , Sriram B , Rafla M , Sharma N , McWhae S 
Published: October 2021

Abstract
Multiple sleep latency test (MSLT) and maintenance of wakefulness test (MWT) are objective measures of excessive daytime sleepiness, used in diagnosing and monitoring patients with sleep disorders. MSLT and MWT can be affected by substances such as psychotropics, stimulants, opioids and sedatives. Recent studies demonstrate high prevalence of positive urine drug screening (UDS) results in patients undergoing MSLT and MWT.
We retrospectively audited patients who underwent UDS with MSLT/MWT at a tertiary centre from 1st January 2019 to 1st January 2020. The following data was collected: MSLT/MWT/UDS results, sleep disorder diagnosis/es, return to driving/work after testing and pre-existing and subsequent prescription of stimulants/wakefulness-promoting agents/psychotropics/sodium oxybate.
Our cohort featured 32 patients (23 female). 29 MSLTs and 3 MWTs were performed. Median age was 31 years old. 13 patients were on wakefulness-promoting agents/psychotropics when tested, where 8 were on serotonin–norepinephrine reuptake inhibitors/selective serotonin reuptake inhibitors.
13 patients (~45%) had a reduced mean sleep latency (MSL), where 10 minutes was used as the cut-off. All 3 MWTs were within normal limits. 5 patients (~16%) had a positive UDS. 1 patient had a low MSL and tested positive for cannabinoids and opioids. The other 4 patients with normal MSL tested positive for benzodiazepines (2), cannabinoids (1) and opioids (1). All patients were cleared for work and 85% of patients who had a low MSL returned to work during follow-up.
The rate of positive UDS in patients undergoing MSLT/MWT was comparable to existing publications and re-emphasizes the relevance of mandating UDS prior to MSLT/MWT.
P141 High prevalence of obstructive sleep apnoea in patients with mild cognitive impairment or mild dementia
Authors: Szollosi I , Georgeson T , Curtin D , Natarajan K , Eeles E , Coulson E 
Published: October 2021

Abstract

Aims
Obstructive sleep apnoea (OSA) occurs with greater frequency in advancing age. The resulting sleep fragmentation and oxygen desaturations may induce or contribute to neurodegeneration. As such, OSA may be an important modifiable risk factor for the development of dementia. However, the prevalence of OSA within the population with cognitive impairment remains uncharacterised. This study aims to assess the prevalence of OSA in patients attending a specialist memory clinic with either mild cognitive impairment (MCI) or mild stages of dementia (Mini-Mental State Examination (MMSE) &gt; 20).

Methods
Eligible and consenting participants were asked to wear an ApneaLink™ (ResMed) device overnight that measured nasal airflow and oximetry to generate a Respiratory Disturbance Index (RDI). The Epworth Sleepiness Scale (ESS) was used to evaluate subjective symptoms.

Results
64 participants completed the study. Mean(±SD) age=76.1±9.2 years, MMSE=25.6±2.8, RDI=15.5±12.0. The distribution of normal, mild, moderate and severe OSA was 16%, 44%, 26% and 14% respectively. 84% of participants had an abnormal RDI (&gt;5), with 40% being moderate to severe (RDI &gt;15) where CPAP may be the recommended treatment. Mean ESS was 7.08±4.45 and not correlated with OSA severity.

Conclusion
The prevalence of OSA in MCI or early stages of dementia is high and represents a potential target for therapeutic intervention. Further research studies are required to determine whether treatment of OSA alters dementia progression.
P154 Upper Airway Sensation in Obstructive Sleep Apnea - A Systematic Review and Meta-Analysis to Inform Pathogenesis, Treatment and Future Research
Authors: Wallace E , Toson B , Carberry J , Eckert D 
Published: October 2021

Abstract

Introduction
Upper airway sensory impairment may contribute to obstructive sleep apnea (OSA) for certain patients. However, the type of sensory impairment and its role in OSA pathogenesis remain unclear. This study aimed to: (1) evaluate methods of upper airway sensory testing in the OSA literature, (2) compare upper airway sensation in people with and without OSA and (3) investigate the relationship between OSA severity and upper airway sensory impairment.

Methods
Electronic databases were searched up to February 2020 for studies reporting methods of upper airway sensory testing in people with OSA (n=3,819). From the selected studies (n=38), information on the type of sensation, testing methods, validity and reliability were extracted. Meta-analyses were performed on case-controlled studies and studies reporting correlations between upper airway sensation and OSA severity.

Results
Seven types of upper airway sensation were reported: olfactory, gustatory, chemical, tactile, vibratory, thermal and neuro-sensation. Methods of upper airway sensory testing varied. No tests were validated or assessed for reliability in OSA populations. People with OSA had impaired sensation on airflow (p&lt;0.001), chemical (p&lt;0.001), gustatory (p=0.01), olfactory (p=0.04) and tactile (p&lt;0.001) tests. Upper airway sensory impairment correlated with OSA severity (p&lt;0.001).

Conclusions
People with OSA demonstrated impaired upper airway sensation, which related to increasing OSA severity. The extent to which upper airway sensation was impaired varied across testing methods. The findings suggest that development of valid and reliable upper airway sensory tests, that relate to upper airway function in people with OSA, are necessary for future clinical and research practices.
P161 Regularity of sleep-wake patterns in the UK Biobank (N = 86 624) and an open-source tool to calculate the Sleep Regularity Index
Authors: Windred D , Russell A , Burns A , Cain S , Phillips A 
Published: October 2021

Abstract

Introduction
Regular sleep-wake patterns aid in the maintenance of optimal physical and mental health, by helping to align environmental, behavioural, and physiological rhythms. The distribution of sleep regularity across the population has not been well documented. Furthermore, researchers currently lack tools to easily quantify sleep regularity.

Method
We have described sleep regularity in 86 624 UK Biobank participants (age (M±SD) = 62.45±7.84; 56.2% female) using data from wrist-worn accelerometers. Regularity was measured using the Sleep Regularity Index (SRI), which quantifies day-to-day similarity in sleep-wake patterns, and which is linked to cardio-metabolic and mental health outcomes. We developed an R package to calculate SRI from accelerometer data, which works in conjunction with GGIR (a validated accelerometer processing tool) to identify sleep-wake state, including naps and broken sleep.

Results
The SRI distribution had M±SD = 78.02±11.53, and median = 80.49. The least regular quintile (SRI&lt;70.2) had standard deviation of sleep onset = 2.23h, offset = 2.14h, and duration = 1.95h, compared with onset = 0.78h, offset = 0.85h, and duration = 0.95h in the most regular quintile (SRI&gt;87.3). Approximately 14% of participants exhibited large day-to-day shifts in sleep timing (&gt;3h) at least once per week.

Discussion
This is the largest description of sleep regularity to-date. The norms established here provide a reference for researchers and clinicians intending to quantify sleep regularity with the SRI. We have combined methods described here into an open-source R package to calculate SRI from accelerometer or sleep diary data, available for download via GitHub.
Progress towards control and elimination of neglected tropical diseases targeted by preventive chemotherapy in São Tomé e Príncipe
Authors: Byrne Aisling , Rosário Alzira , da Conceição Ferreira Maria , de Jesus Trovoada dos Santos Maria , Rollinson David , Vaz Nery Susana 
Published: October 2021

Abstract
The São Tomé e Príncipe government is committed to achieving neglected tropical disease (NTD) control and elimination as a public health problem by 2025. In 2014, the Ministry of Health led a national survey to determine the prevalence of soil-transmitted helminths (STHs) and schistosomiasis across the country. Following this survey, a preventive chemotherapy (PC) campaign with mebendazole and praziquantel reached 31 501 school-age children in 2015. A follow-up 2017 survey to determine the impact of the intervention showed success in controlling schistosomiasis, as no infections were found, but limited impact on STHs, with prevalence similar to pretreatment levels. The survey also investigated the prevalence of a third NTD, lymphatic filariasis (LF), which was found to be endemic in the country. Since then the Ministry of Health has developed the Strategic Plan for the Fight Against Neglected Tropical Diseases 2019–2025 and identified gaps to be addressed. This narrative review systematises the existing literature reporting on the epidemiology of NTDs for which there are PC programs in São Tomé e Príncipe. PubMed was searched for relevant papers that measured the prevalence of LF, schistosomiasis and STHs. Additionally, data provided by the Ministry of Health surveys were analysed. Finally, we discuss current NTD control, including the impact of the coronavirus disease 2019 pandemic and identify priorities for program strengthening and operational research.
Telemedicine for preanesthesia evaluation: review of current literature and recommendations for future implementation
Authors: Azizad Omaira , Joshi Girish P. 
Published: October 2021

Purpose of review
The in-person preanesthesia visit serves multiple purposes including identification and optimization of comorbid conditions as well as patient education. However, it imposes a significant burden on patients and healthcare providers. In this review, we define the scope of telemedicine and present the most up-to-date literature supporting its role for the preanesthesia evaluation. The opportunities and challenges are discussed and approaches to implementation of telemedicine in preanesthesia care are offered. Finally, the future of telemedicine as it pertains to preanesthesia care is examined.

Recent findings
Although telemedicine for preanesthesia practice was proposed almost two decades ago, the COVID-19 pandemic has accelerated its implementation. The potential benefits of telemedicine include improved patient satisfaction as well as the ability to provide cost-effective specialty services while reducing the burden on healthcare providers. Limitations to telemedicine include lack of technology, training, regulatory barriers, and an inability to perform a physical exam.

Summary
Telemedicine will continue to expand and its application to the preanesthesia evaluation is a clear example of how technology will revolutionize anesthesia practice. In order for telemedicine to continue to expand in the postpandemic period, steps must be taken to ensure that healthcare facilities and providers keep up with the times.
Use of a Multifunctional Cocktail for Postoperative Bleeding and Pain Control in Spinal Fusion: A Randomized, Double-blind, Controlled Trial
Authors: Jiang Wei , Fu Mengyu , Dong Wei , Zhou Nian , Shen Jieliang , Zhang Xiaojun , Hao Jie 
Published: October 2021

Study Design.
A prospective, randomized, double-blind controlled trial.

Objective.
To explore the effect of multifunctional cocktail for bleeding and pain control after spinal fusion.

Summary of Background Data.
Managing postoperative bleeding and pain after spinal fusion remains a challenge. Topical application of tranexamic acid or anesthetic agents for bleeding or pain management just started recently, and the multifunctional cocktail for bleeding and pain control simultaneously after spinal fusion have never been published.

Methods.
Ninety patients who underwent posterior spinal fusion were enrolled in this study. The multifunctional cocktail was injected into the incision before wound closure in the cocktail group. In the control group, an equal volume of normal saline was injected and a patient-controlled analgesic pump was used. Visual analogue scale score; opioid consumption; intraoperative, postoperative, hidden and total blood loss; volume of drainage, hematocrit levels of drainage; hemoglobin levels; and complications were compared between the two groups.

Results.
There were no differences in the visual analogue scale within 48 hours after surgery between the two groups. However, the opioid dosages in the control group were higher than those in the cocktail group. The postoperative blood loss, total blood loss, and hidden blood loss were lower in the cocktail group than in the control group. The drainage volume showed no differences between the two groups; however, the hematocrit level of drainage at 24 hours after surgery was lower in the cocktail group than in the control group. The hemoglobin level was higher in the cocktail group than in the control group at postoperative day 3. Thirteen patients with unbearable nausea and vomiting in the control group, whereas no complications in the cocktail group.

Conclusion.
Topical application of a multifunctional cocktail that we designed provides an effective and safe method for reducing pain and bleeding after spinal fusion.
Molecular mechanism and therapeutic targeting of necrosis, apoptosis, pyroptosis, and autophagy in cardiovascular disease
Authors: Li Pan , Dong Xiao-Rong , Zhang Bei , Zhang Xin-Tong , Liu Jing-Zhuo , Ma De-Sheng , Ma Li 
Published: October 2021

Abstract
Cell death occurs in various tissues and organs in the body. It is a physiological or pathological process that has different effects. It is of great significance in maintaining the morphological function of cells and clearing abnormal cells. Pyroptosis, apoptosis, and necrosis are all modes of cell death that have been studied extensively by many experts and scholars, including studies on their effects on the liver, kidney, the heart, other organs, and even the whole body. The heart, as the most important organ of the body, should be a particular focus. This review summarizes the mechanisms underlying the various cell death modes and the relationship between the various mechanisms and heart diseases. The current research status for heart therapy is discussed from the perspective of pathogenesis.