bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probabilistic sleep staging in MSLTs across hypersomnia disorders
Authors: Hjuler Andersen Louise , Brink-Kjaer Andreas , Sum-Ping Oliver , Pizza Fabio , Biscarini Francesco , Haubjerg Østerby Niels Christian , Mignot Emmanuel , Plazzi Giuseppe , Jennum Poul J 
Published: October 2024

Abstract

Study Objectives
This study aimed to identify novel markers of narcolepsy type 1 (NT1) using between-nap opportunity periods (“lights on”) and in-nap opportunity periods (“lights off”) features of Multiple Sleep Latency Test (MSLT) recordings. We hypothesized that NT1 could be identified both from sleep–wake instability and patterns of sleepiness during wakefulness. Further, we explored if MSLTs from NT1 and narcolepsy type 2 (NT2) patients could be distinguished despite having the same diagnostic thresholds.

Methods
We analyzed “lights on” and “lights off” periods of the MSLT, extracting 163 features describing sleepiness, microsleep, and sleep stage mixing using data from 177 patients with NT1, NT2, idiopathic hypersomnia (IH), and subjective hypersomnia (sH) from three sleep centers. These features were based on automated probabilistic sleep staging, also denoted as hypnodensities, using U-Sleep. Hypersomnias were differentiated using either or both features from “lights on” and “lights off.”

Results
Patients with NT1 could be distinguished from NT2, IH, and sH using features solely from “lights on” periods with a sensitivity of 0.76 and specificity of 0.71. When using features from all periods of the MSLT, NT1 was distinguished from NT2 alone with a sensitivity of 0.77 and a specificity of 0.84.

Conclusions
The findings of this study demonstrate microsleeps and sleep stage mixing as potential markers of sleep attacks and unstable sleep–wake states common in NT1. Further, NT1 and NT2 could be frequently distinguished using “lights off” features.
Differential Transcriptome Reprogramming Induced by the Soybean Cyst Nematode Type 0 and Type 1.2.5.7 During Resistant and Susceptible Interactions
Authors: Sultana Mst Shamira , Niyikiza Daniel , Hawk Tracy E. , Coffey Nicole , Lopes-Caitar Valéria , Pfotenhauer Alexander C. , El-Messidi Hana , Wyman Chris , Pantalone Vince , Hewezi Tarek 
Published: October 2024

Soybean cyst nematode (SCN, Heterodera glycines [Hg]) is a serious root parasite of soybean ( Glycine max) that induces extensive gene expression changes associated with pleiotropic biological activities in infected cells. However, the impacts of various SCN Hg types on host transcriptome reprogramming remain largely unknown. Here, we developed and used two recombinant inbred lines (RIL; RIL-72 and RIL-137) to profile transcriptome reprogramming in the infection sites during the resistant and susceptible interactions with SCN Hg Type 1.2.5.7 and Type 0. SCN bioassays indicated that RIL-72 was susceptible to Type 1.2.5.7 but resistant to Type 0, whereas RIL-137 was resistant to both types. Comparative analysis of gene expression changes induced by Type 1.2.5.7 in the resistant and susceptible lines revealed distinct transcriptome regulation with a number of similarly and oppositely regulated genes. The expression levels of similarly regulated genes in the susceptible line appeared to be insufficient to mount an effective defense against SCN. The functional importance of oppositely regulated genes was confirmed using virus-induced gene silencing (VIGS) and overexpression approaches. Further transcriptome comparisons revealed shared as well as Hg type- and genotype-specific transcriptome reprogramming. Shared transcriptome responses were mediated through common SCN-responsive genes and conserved immune signaling, whereas genotype-specific responses were derived from genetic variability, metabolic and hormonal differences, and varied regulation of protein phosphorylation and ubiquitination. The conserved defense mechanisms together with genotype-specific responses would enable plants to trigger effective and tailored immune responses to various Hg types and adapt the defense response to their genetic backgrounds. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Incorporating Virtual Reality Agents During a Dichotic Speech Reception Task: Insights From the Heart
Authors: Plain Bethany , Pielage Hidde , Zekveld Adriana A. , Richter Michael , Bhuiyan Tanveer A. , van de Ven Sjors R. B. , Kramer Sophia E. 
Published: October 2024

Objectives:
Listening effort is moderated by not only task difficulty, but also success importance. In real communication scenarios, success importance varies based upon the social context. However, in the laboratory, it can be challenging to manipulate social context without compromising experimental control. Outside of hearing sciences, studies have applied virtual reality (VR) to incorporate social context in a controlled and repeatable manner. Several of these studies have demonstrated that social manipulations in VR can reliably elicit changes in cardiovascular measures. Here, we investigated the effect of adding VR agents to a speech reception task, while measuring from the cardiovascular system.

Design:
Twenty-eight, normally hearing participants undertook a dichotic speech reception task. Sentences in stationary noise were presented dichotically, that is, different sentences presented simultaneously to each ear. Participants were tasked to either repeat one of the sentences (single-sentence condition) or both of the sentences (dual-sentence condition). The task was conducted under two VR conditions: (1) in the presence of agents, who provided sporadic performance feedback and (2) in the presence of nonagent controls, without any feedback given. Alongside task performance, we quantified changes in cardiovascular measures, relative to pretask baselines: heart rate variability, pre-ejection period, heart rate, and blood pressure. After each condition, participants rated their subjective effort, difficulty, performance, and engagement.

Results:
Performance and the subjective perception of performance were lower, while subjective effort and difficulty were higher, in the dual-sentence condition, compared with the single-sentence condition. Heart rate was the only cardiovascular measure that was sensitive to the experimental manipulations. Contrary to our expectations, heart rate increased in the nonagent control conditions, compared with the agent conditions. An exploratory analysis revealed heart rate fluctuations within a trial: heart rate was higher during the first 6 sec of the trial (reflecting the presentence masking noise and the sentence presentation) in the dual-sentence condition, compared with the single-sentence condition.

Conclusions:
This study was the first to incorporate VR agents who provided performance feedback during a dichotic speech reception task. Our results suggest that the VR agents did not increase success importance, which could be attributed to a lack of realism of the agents. We also demonstrated that the cardiovascular response to experimental manipulations may differ depending on the data window selected for analysis.
Clinical Outcomes after Cleft Palate Repair at a Major Referral Hospital in Addis Ababa, Ethiopia
Authors: Gebremariyam Zenebe Teklu , Eshete Mekonen , Baraki Atakiltie 
Published: October 2024

Background:
The two most common complications after primary palatoplasty are oronasal fistula and velopharyngeal insufficiency (VPI). To the best of our knowledge, there have been no studies examining postpalatoplasty speech outcomes in Ethiopia.

Methods:
A hospital-based retrospective cross sectional study design was used. A total of 149 patient records were reviewed, and 103 patients fulfilled all the inclusion criteria. These 103 cleft lip and palate patients who had undergone cleft palate repair at Yekatit 12 Hospital Medical College and who had undergone long-term speech assessment with the speech therapy department from January 2019 to December 2021 were included in this study. The bivariate/multivariate logistic regression was used to compare between different groups of patients, with the level of significance set at a P value of less than 0.05.

Results:
Moderate and severe hypernasality was seen in 45.7% of patients. Age at time of palatal surgery has significant association with incidence of hypernasality (P = 0.01). The type of cleft, sex of the patient, and type of surgery had no significant association with incidence of hypernasality. Oronasal fistula was seen in 25% of patients, with Pittsburgh type VI being the most common (40%).

Conclusions:
There is a high rate of VPI and oronasal fistula in this cohort of patients who underwent palatoplasty at Yekatit 12 Hospital. One of the factors for higher complication rate was older age at time of surgery. Therefore, patient education and strengthening the cleft care with training are paramount to ensure better results.
The “Mosque Tower Pattern” for the Preoperative Marking of Reduction Mammaplasty
Authors: Elia Rossella , Maruccia Michele , Tedeschi Pasquale , Nacchiero Eleonora , Giudice Giuseppe 
Published: October 2024

Background:
Breast reduction, the seventh most performed plastic surgery globally, has witnessed a significant increase in procedures over recent years. Various techniques exist, each with its advantages and complications, emphasizing the critical role of preoperative marking. Although existing literature focuses on different reduction mammaplasty techniques, limited attention is given to surgical preoperative marking. This study introduces a “mosque tower” pattern combined with a superomedial pedicle, aiming to minimize complications and standardize the design based on individualized factors such as patient characteristics and predicted breast reduction weight.

Methods:
The retrospective case series includes 103 women who underwent reduction mammaplasty between 2017 and 2020. Surgical marking is described, and complications are recorded. The study categorizes breasts into three groups based on key-hole dimensions, correlating them with predicted resection weight. Statistical analysis establishes a rationale formula for selecting key-hole size.

Results:
A total of 175 breasts were reduced in 103 women with an average follow-up of 29.8 months. The mean resection weight was 883 g per breast (range: 490–2531). A complication rate of 8% was observed, with only 2.8% experiencing wound breakdown, notably lower than reported rates in other studies. Key-hole dimension as a predicting variable was correlated significantly with resection weight.

Conclusions:
The mosque tower pattern proves to be an effective, safe, and reproducible method for preoperative marking in reduction mammaplasty. The study emphasizes the importance of individualized planning to achieve satisfactory results, particularly for surgeons in their early practice.
Impact of Neurostimulation, Immunomodulation, Topical Medication Application, and Surgical Reconstruction on Corneal Nerve Function and Regeneration
Authors: Drake Taylor N. , Sheppard John D. 
Published: October 2024

Abstract:
The corneal epithelium, supplied by thousands of nerve endings, plays a substantial role in absorbing and distributing nutrients along the ocular surface. Many studies have explored the influence of various modalities in regulating tear production to manage corneal disorders and dry eye disease. These findings have highlighted the advantages of enhancing corneal nerve function and regeneration through neurostimulation, neural signaling, immunomodulation, topical medication application, and surgical reconstruction. The purpose of this narrative review article was to provide an overview of the current state of knowledge on this topic based on a PubMed database literature search for relevant animal and human studies investigating the modification of the trigeminal pathway to restore corneal nerve function and improve overall ocular health. Further investigation into this area of research is important to help guide new therapeutic targets for the prevention and development of treatments of corneal degeneration.
Haves and have-nots: socioeconomic position improves accuracy of machine learning algorithms for predicting high-impact chronic pain
Authors: Morris Matthew C. , Moradi Hamidreza , Aslani Maryam , Sun Sicong , Karlson Cynthia , Bartley Emily J. , Bruehl Stephen , Archer Kristin R. , Bergin Patrick F. , Kinney Kerry , Watts Ashley L. , Huber Felicitas A. , Funches Gaarmel , Nag Subodh , Goodin Burel R. 
Published: October 2024

Abstract
Lower socioeconomic position (SEP) is associated with increased risk of developing chronic pain, experiencing more severe pain, and suffering greater pain-related disability. However, SEP is a multidimensional construct; there is a dearth of research on which SEP features are most strongly associated with high-impact chronic pain, the relative importance of SEP predictive features compared to established chronic pain correlates, and whether the relative importance of SEP predictive features differs by race and sex. This study used 3 machine learning algorithms to address these questions among adults in the 2019 National Health Interview Survey. Gradient boosting decision trees achieved the highest accuracy and discriminatory power for high-impact chronic pain. Results suggest that distinct SEP dimensions, including material resources (eg, ratio of family income to poverty threshold) and employment (ie, working in the past week, number of working adults in the family), are highly relevant predictors of high-impact chronic pain. Subgroup analyses compared the relative importance of predictive features of high-impact chronic pain in non-Hispanic Black vs White adults and men vs women. Whereas the relative importance of body mass index and owning/renting a residence was higher for non-Hispanic Black adults, the relative importance of working adults in the family and housing stability was higher for non-Hispanic White adults. Anxiety symptom severity, body mass index, and cigarette smoking had higher relevance for women, while housing stability and frequency of anxiety and depression had higher relevance for men. Results highlight the potential for machine learning algorithms to advance health equity research.
The Effect of Peer-Mentor Support for Older Vulnerable Patients With Ischemic Heart Disease—A 24-Week Randomized Controlled Trial
Authors: Pedersen Maria , Overgaard Dorthe , Boateng Takyiwa , Bennich Birgitte , Beck Anne Marie , Andersen Ingelise , Sibilitz Kirstine Lærum , Mairey Isabelle Pascale , Thygesen Lau Caspar , Petersen Rikke Agnete 
Published: October 2024

Background
The positive effects of cardiac rehabilitation (CR) are well established; however, among older and vulnerable patients, nonattendance and dropout are prevalent problems.

Aim
The objective of this study is to explore if a 24-week peer-mentor intervention increases initial and long-term CR attendance. Secondary aims are whether peer-mentor intervention improves lifestyle (diet and physical activity) and psychological outcomes (self-efficacy, anxiety, depression, and quality of life) among older vulnerable patients with ischemic heart disease.

Methods
The study was designed as a 2-arm, single-center, parallel, 24-week, randomized controlled trial (RCT) with follow-up at 12 and 24 weeks. Patients were randomized at a ratio of 1:1 to receive either the peer-mentor intervention (in addition to standard CR) or standard CR along (control arm).

Results
Between August 2021 and March 2023, 117 older, vulnerable patients were enrolled and randomized (59 randomized to peer-mentor intervention and 58 to usual care). The peer-mentor intervention significantly increased CR attendance. This applies to both initial participation in 1 CR session of physical training or dietary advice (78.0% vs 58.6%; P = .03), and long-term attendance in ≥50% dietary advice sessions (50.8% vs 27.6%; P = .01) and completed ≥50% (64.4% vs 41.4% P = .01) or ≥75% of the physical training sessions (59.3% vs 37.9%; P = .02). The study found no statistically significant effect on secondary outcomes.

Conclusions
Low CR attendance is a well-known problem, especially among older, vulnerable patients; however, we tested a low-cost, peer-mentor intervention that significantly increased both initial CR participation and long-term attendance in CR sessions in this group of patients.
A Curricular Review of Radiology Education in a Master of Physician Assistant Studies Program
Authors: Herzog Rachel , Li Terry , Hryniuk Alexa 
Published: October 2024

Introduction
Physician assistants/associates (PAs) are expected to be competent in ordering and interpreting diagnostic imaging. However, there are no further details outlining the educational expectations of PAs as it relates to radiology upon graduation. This can result in significant variability in the radiology curricula that PA students are taught and, consequently, hinder PAs' ability to work within their full scope of practice. Therefore, the purpose of this study was to map the radiology curriculum in a Master of Physician Assistant Studies (MPAS) program to elucidate radiological educational training before graduation.

Methods
Quantitative curricular mapping was used to assess the 2021 to 2022 MPAS program for radiological involvement. Relevant course and session objectives related to radiology education were identified. In addition, educational learning material was reviewed for diagnostic imaging content.

Results
Formal radiological training was observed in 8 of 27 courses in the preclinical curriculum, with 4.35% of the total session objectives directed to radiological education. This formal exposure comprises 18.9 hours (1.71%) of curricular time. Informal diagnostic imaging exposure increased radiology education to approximately 29.5 hours (2.67%) of curricular time. One course (Diagnostic Imaging) focuses exclusively on radiology teaching and accounts for approximately 50% of the total radiologic teaching. X-ray ordering and interpretation received the greatest emphasis throughout the curriculum, while ultrasound received the least attention.

Discussion
Further integration of formal radiological education into PA programs should be considered with specific attention directed toward point-of-care ultrasound exposure and ordering/interpretation skills.
“I never thought of it as payment”: Qualitative evaluation of workshops with advanced practice registered nurses on pharmaceutical industry payment reporting
Authors: Grundy Quinn , Rudner Nancy , Klein Tracy , Ladd Elissa , Hart Dana , MacIsaac Meghan , Bero Lisa 
Published: October 2024

Background:
With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website.

Purpose:
To gauge APRNs' familiarity with, and perceptions of the Open Payments database and discuss whether and how APRNs should respond.

Methodology:
Virtual workshops consisting of a didactic presentation and interactive exercises with APRNs recruited through professional networks, associations, and conferences. Transcripts were analyzed using a qualitative interpretive approach, grounded in an everyday ethics theoretical framework.

Results:
Thirty-six APRN clinicians, students, and faculty participated in nine workshops. Seeing sponsored meals reported in Open Payments as “payments” prompted participants to see familiar interactions in a new way. Participants valued the enhanced transparency as a way to identify risks of bias but were concerned that reporting might undermine public trust in APRNs. Emphasizing awareness as a precursor to action, participants desired greater preparation for ensuring independence in practice.

Conclusions:
The importance of tackling the ethical issues associated with industry interactions is heightened within the context of an existing climate of distrust within health care. However, many participants were concerned about the effects of transparency on public trust rather than how APRNs individually or collectively can be more trustworthy.

Implications:
Open Payments can serve as a useful tool to catalyze broader conversations about ethics, integrity in decision making, and health policy advocacy.
Advances in colon-targeted drug technologies
Authors: Yeung Charlotte , McCoubrey Laura E. , Basit Abdul W. 
Published: October 2024

Purpose of review
Herein, we present an overview of innovative oral technologies utilized in colonic drug delivery systems that have made significant translational and clinical advancements to treat inflammatory bowel disease (IBD) in recent years.

Recent findings
The colon is home to distinct physiological conditions, such as pH and microbiota, that have been exploited in the development of colonic drug delivery systems for the treatment of local and systemic diseases. However, given the intra and interindividual variability in the gastrointestinal tract of both healthy and diseased states, various systems have shown inconsistencies in targeted drug release to the colon. Recent breakthroughs have led to systems that incorporate multiple independent trigger mechanisms, ensuring drug release even if one mechanism fails due to physiological variability. Such advanced platforms have bolstered the development of oral biologics delivery, an especially promising direction given the lack of commercially available oral antibody medications for IBD. These concepts can be further enhanced by employing 3D printing which enables the personalisation of medicines.

Summary
Leveraging these novel technologies can accurately deliver therapeutics to the colon, allowing for treatments beyond gastrointestinal tract diseases. To realize the full potential of colonic drug delivery, it is paramount that research focuses on the clinical translatability and scalability of novel concepts.
Development and Validation of a Laparoscopic Sacrocolpopexy Training Model
Authors: Winn Heather M. , Tunitsky-Bitton Elena , O'Meara Amanda , Myers Erinn M. , Anderson-Montoya Brittany L. , Tarr Megan E. 
Published: October 2024

Importance
Proper training is necessary to develop the highly specialized skills required to safely perform laparoscopic sacrocolpopexy. Currently, there is no validated training model for laparoscopic sacrocolpopexy that includes dissection of the presacral space, both vaginal and presacral mesh attachments, and peritoneal closure.

Objectives
This study aimed to create a procedure specific hierarchical task analysis for laparoscopic sacrocolpopexy and then develop and validate a corresponding laparoscopic sacrocolpopexy pelvic training model for the simulation environment.

Study Design
This was an observational simulation study that was divided into 5 phases: (1) development of hierarchical task analysis, (2) model construction, (3) participant recruitment and simulation testing, (4) reliability and validity testing, and (5) creation of a standard passing performance measure.

Results
Construct, face, and content validity were established for this model. According to the participating experts, the model was able to replicate the steps of presacral dissection, anterior vaginal and sacral mesh attachment, and peritoneal closure. Thirteen trainees and 5 experts completed the simulation, and all “agreed” or “strongly agreed” that the model seemed useful for improving suturing technique and learning the procedure. Additionally, a passing performance measure was determined through contrasting groups methodology.

Conclusions
We developed a novel, reusable, and validated training model that can be utilized as a training resource for the many critical skills necessary to safely and efficiently perform laparoscopic sacrocolpopexy.