bluuebunny/crossref_metadata_2025_split huggingface dataset:
P071 Simple Vestibular-Occular Motor Assessment as a Predictor of Driving Performance Vulnerability following extended Wakefulness
Authors: Dunbar C , Nguyen P , Guyett A , Nguyen K , Bickley K , Reynolds A , Hughes M , Scott H , Adams R , Lack L , Catcheside P , Cori J , Howard M , Anderson C , Lovato N , Vakulin A 
Published: October 2023

Abstract

Introduction
Driver fatigue is a significant contributor to road crashes, but identifying individuals at driving risk is challenging. We examined the potential of simple baseline vestibular ocular motor system (VOMS) assessment via virtual reality goggles to predict subsequent vulnerability to driving simulator impairment following extended wakefulness.

Methods
49 individuals (Mean±SD Age 32.6±12.9, 45% Males) underwent 9hr baseline sleep opportunity followed by approximately ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis classified drivers into vulnerable (n=17) or resistant (n=32) groups based on their worst steering deviation and number of crashes from driving tests. Baseline VOMS were performed ~10mins prior to the first three drives (1, 7 and 13hrs of wakefulness). XGBoost machine learning model was trained using baseline VOMs features to predict vulnerable vs resistant groups from driving tests 4 and 5 (19 and 25hrs of wakefulness) Model performance was evaluated using 5-fold cross-validation approach using ROC analysis.

Results
XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting vulnerable vs resistant groups. Top 10 VOMs metrics assessed during baseline non-sleep deprived tests demonstrated a strong ability to predict the driver's performance following extended wakefulness, differentiating between the vulnerable vs resistant groups (AUC 0.73 [95%CI 0.61-0.83, p&lt;0.001]).

Conclusion
VOMs tests conducted at baseline holds promise for predicting future driving impairment. This approach has the potential to be highly valuable in determining an individual's fitness to drive. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.
P082 Neural aperiodic activity as a novel biomarker of sleepiness in patients with obstructive sleep apnoea
Authors: Butler J , Yeo A , Lushington K , Chatburn A , Bay M , Sarkar P , Kang T 
Published: October 2023

Abstract

Background
Obstructive sleep apnoea (OSA) is characterised by repetitive collapse of the upper airway causing intermittent episodes of hypoxia and apnoeas during sleep. Excessive daytime sleepiness (EDS) is the cardinal symptom of OSA and presents in between 40.5 to 58% of patients. Currently, the diagnosis of OSA requires demonstration of an elevated apnoea hypopnea index (AHI) on a polysomnogram (PSG). Higher AHI scores denote increased OSA disease severity. The correlation between objective AHI scores and subjective sleepiness reporting tools such as the Epworth Sleepiness Scale (ESS) is less clear.
Electroencephalogram (EEG) readings form an important component of PSG testing. Traditionally, the periodic oscillatory waves captured on EEG are examined to accurately identify stages of sleep. EEG aperiodic activity is a measure of neural excitation/inhibition ratios and has emerged as a novel objective measure of sleepiness.

Methods
Intended data collection from 500 patients who have undergone ambulatory PSG testing at the Royal Adelaide Hospital between January 1st 2021 and December 31st 2022 as part of their routine care. Data collection will include patient demographics, cardiorespiratory comorbidities, medications, body mass index (BMI), Epworth Sleepiness Scale (ESS) and PSG EEG data including sleep parameters [Total sleep time (TST), stage of sleep, periodic limb movement limb index (PLMI), AHI scores].

Progress to date
Research proposal is currently under review by the CALHN HREC.

Intended outcome and impact
In this study we will assess the utility of aperiodic neural activity as a predictor of sleepiness in patients with elevated AHI and ESS scores.
P107 Optimizing Obstructive Sleep Apnea Therapy in Patients with Acute Coronary Syndrome: A Pilot Randomised Controlled Trial
Authors: Tong B , Dissanayake H , Patel S , Ucak S , McClintock S , Skilton M , Sutherland K , Yee B , Sarkissian N , Cistulli P 
Published: October 2023

Abstract
Continuous positive airway pressure (CPAP) therapy and oral appliance therapy (OAT) are recommended therapies for obstructive sleep apnoea (OSA). Recent clinical trials, limited by suboptimal implementation of OSA therapy, have demonstrated neutral cardiovascular benefit. It remains unclear if optimised OSA therapy will improve cardiovascular health. Thus, we have designed a pilot interventional study to inform a future RCT with the aim to evaluate the effectiveness of optimised and personalised OSA therapy in patients with acute coronary syndrome(ACS).
Patients diagnosed with ACS and OSA (ODI4≥10 events/h) were randomised to personalised OSA treatment (CPAP and/or OAT) versus usual medical care (UC). Patients receiving OSA therapy were allowed to acclimatise to therapy for 1-2 months, with the aim of optimising therapy. Patients were followed up monthly for 6 months to assess treatment effectiveness. Polysomnography and cardiovascular measures were conducted at baseline and 6 months post-therapy or usual care.
To date, 9 patients (CPAP=4, OAT=1, UC=4) have completed the study. OSA severity reduced in both treatment groups (CPAP: 53±14 vs. 17±18events/h, OAT: 22.4 vs. 14.7events/h). CPAP compliance was 6.8±0.9hours/day, 90±6%days &gt;4h. OAT subjective compliance was 7 hours/day daily. At completion, 3 patients on CPAP therapy reported they were ‘extremely-comfortable’ using CPAP for OSA treatment. The patient on OAT reported OAT was ‘very effective in reducing OSA symptoms’ and will continue therapy.
This preliminary data suggests that it is feasible to personalise and optimise OSA therapy in patients with ACS. Whether this positively impacts on cardiovascular risk remains to be determined.
RSSC-Lineage Multiplex PCR Assay Detects and Differentiates Ralstonia solanacearum, R. pseudosolanacearum, R. syzygii, and the R3bv2 Subgroup
Authors: Paudel Sujan , Dobhal Shefali , Lowe-Power Tiffany , Schlub Robert L. , Hu John , Allen Caitilyn , Alvarez Anne M. , Arif Mohammad 
Published: October 2023

Bacterial wilt strains in the Ralstonia solanacearum species complex (RSSC) pose serious threats to economically important crops worldwide. In 2014, Safni et al. proposed the reclassification of the RSSC into three genomospecies: R. solanacearum (Rsol), R. pseudosolanacearum (Rpseu), and R. syzygii (Rsyz). The revision requires the proper identification of strains for diagnostic and epidemiological studies. In response, we developed the inexpensive and user-friendly RSSC-Lineage Multiplex PCR, which effectively detects plant-pathogenic Ralstonia strains in general and also distinguishes between Rpseu, Rsol, Rsyz, and the high-security Select Agent “race 3 biovar 2” subgroup of Rsol, also known as the phylotype IIB-1 potato brown rot pandemic lineage. Genomes were retrieved from the NCBI GenBank database and screened for unique gene regions using OrthoMCL and other comparative genomic approaches. Specific primers were designed for each genomospecies, Ralstonia in general, and “race 3 biovar 2.” AT-rich flaps were added at the 5ʹ position of each primer to optimize the reaction thermodynamics. The specificity was tested in silico using the NCBI GenBank genome database and an in-house database. The in vitro specificity and accuracy of the tool was validated with 113 representative Ralstonia strains and 24 strains from other genera. The assay is highly specific, generating neither false positives nor false negatives. Primer set detection limits ranged from 10 to 100 pg. The assay also detected and differentiated strains from naturally and artificially inoculated plant hosts. This tool is highly specific, reliable, and economical for culture characterization, diagnostics, surveys, quarantine decisions, and epidemiological studies. [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 .
Environmental Influences on the Evaporation Rate of Horticultural Disinfestants
Authors: Copes Warren E. , Smith Barbara J. 
Published: October 2023

The evaporation rate of disinfestants when sprayed on production surfaces is expected to vary under different weather conditions, but it is unknown how that affects efficacy. This study was an initial investigation into how the evaporation rates of water and six commercial disinfestants vary under eight weather condition categories. Additionally, an empirical model was developed on the evaporation rate of water in response to air temperature, relative humidity, solar radiation, vapor pressure deficit, and wind speed under the same eight weather condition categories. Isopropyl alcohol lost more weight due to evaporation over 4 h ( P < 0.0001) than all other disinfestant solutions, and no differences ( P = 0.05) existed between the other five disinfestant solutions and water. Isopropyl alcohol had a mean percentage weight loss of 71% under hot and sunny conditions, 43% under cool and cloudy conditions, and 6% under indoor laboratory conditions. Water, hypochlorite, quaternary ammonium, and peroxy disinfestant solutions evaporated at a similar rate over 4 h, with an approximate mean percentage weight loss of 17% under hot and sunny conditions, 6% under cool and cloudy conditions, and 1% under indoor laboratory conditions. The regression model that best explained the influence of weather on evaporation included the variables solar radiation, temperature, and wind speed ( P < 0.0001, R2 = 0.5603). This information will be used further to model the evaporative rate of disinfestants under the same range of weather conditions when applied to multiple types of substrate materials that represent common horticultural plant production surfaces. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Fear of Movement in People with CRPS
Authors: Farzad Maryam , MacDermid Joy , Packham Tara 
Published: October 2023

Background:
People with complex regional pain syndrome (CRPS) commonly report a fear of movement that can worsen symptoms and increase disability. The Tampa Scale of Kinesiophobia (TSK) is used to evaluate fear of movement and (re)injury, but findings have been inconsistent in different populations.

Objective:
To evaluate the psychometric properties of the Persian version of TSK-11 in individuals with upper limb CRPS. Specifically, to determine if the factor structure aligns with the original two-factor model, consisting of “activity avoidance” and “somatic focus.”

Methods:
People with CRPS (n=142, mean age=42, 54% female) completed the TSK. The psychometric testing included internal consistency and test-retest reliability (intra-class correlation coefficient), and convergent construct validity. Confirmatory and Exploratory factor analyses (CFA, EFA) were performed to evaluate the structural validity.

Results:
The TSK-11 showed acceptable internal consistency (Cronbach alpha 0.93) and excellent test-retest reliability (ICC=0.93, 95% CI: 0.92 to 0.94). The Standard Error of Measurement and Minimal Detectable Change were 4.3 and 11.7, respectively. The results also demonstrated excellent criterion validity (r=0.81). CFA demonstrated that the original two-factor model did not fit. EFA derived a two-factor solution with different items. The factor structure accounted for 64.91% of the variance, and the internal consistency of the factors was acceptable (>0.90). Expert consensus suggested naming these two factors as Fear-avoidance, Magnification & Helplessness.

Discussion:
The TSK-11 demonstrates excellent retest reliability in people with CRPS. The original two-factor structure was not confirmed, and a new 2-factor structure of the TSK-11 proposed consisting of subscales for Fear Avoidance beliefs and Magnification/Helplessness. Given the overlap between these constructs and the construct of pain catastrophizing, further study is needed to clarify both measures’ content validity and relative uniqueness.
Socioeconomic, Racial, and Insurance Disparities in Clinical Outcomes After Surgery Among Patients With Idiopathic Scoliosis
Authors: Thornley Patrick , Garner Sarah , Rogers Kenneth J. , Yorgova Petya , Gabos Peter G. , Shah Suken A. 
Published: October 2023

Background:
Socioeconomic status (SES), race, and insurance type correlate with initial curve severity for patients with idiopathic scoliosis, but less is known regarding how these variables impact surgical outcomes. The objectives of this study were to determine the influence of SES, race, and insurance on preoperative appointment attendance, likelihood of obtaining a preoperative second opinion, brace prescription, missed 6 or 12-month postsurgical appointments, incidence of emergency department visits 0 to 90 days after surgery, and major complications within a year of surgery.

Methods:
A review of 421 patients diagnosed with idiopathic scoliosis who underwent surgery at a single high-volume pediatric spinal deformity institution between May 2015 and October 2021 was conducted. Area Deprivation Index, a quantitative measure of SES, was collected. Scores were stratified by quartile; higher scores indicated a lower SES. χ2 tests for correlation were performed to determine whether clinical outcomes were dependent upon Area Deprivation Index, race, or insurance type; P ≤0.05 was significant.

Results:
The sample was 313 Caucasian (74%), 69 (16%) black, and 39 (9.3%) other patients. More patients had private versus public insurance (80% vs 20%) and were of higher SES. The likelihood of missing preoperative appointments was higher for black patients (P = 0.037). Those with lower SES missed more postoperative appointments and received less bracing and second opinions (P = 0.038, P = 0.017, P = 0.008, respectively). Being black and publicly insured correlated with fewer brace prescriptions (P < 0.001, P = 0.050) and decreased rates of obtaining second opinions (P = 0.004, P = 0.001).

Conclusion:
Patients with idiopathic scoliosis surgery who were Caucasian, privately insured, and of higher SES were more likely to seek preoperative second opinions, be prescribed a brace, and attend postoperative appointments. Recognition of the inherent health care disparities prevalent within each pediatric spine surgery referral region is imperative to better inform local and national institutional level programs to educate and assist patients and families most at risk for disparate access to scoliosis care.

Level of Evidence:
Level III; retrospective case-control study.
A Web-based Prediction Model for Early Death in Patients With Metastatic Triple-negative Breast Cancer
Authors: Pan Wen-kai , Ren Si-yan , Zhu Liao-xiang , Lin Bao-chai 
Published: October 2023

Background:
Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by the absence of expression of estrogen receptor, progesterone receptor, or human epidermal growth factor receptor 2. This subtype of breast cancer is known for its high aggressiveness, high metastatic potential, tendency for recurrence, and poor prognosis. Patients with metastatic TNBC (mTNBC) have a poorer prognosis and a higher likelihood of early death (survival time ≤3 months). Therefore, the development of effective individualized survival prediction tools, such as prediction nomograms and web-based survival calculators, is of great importance for predicting the probability of early death in patients with metastatic TNBC.

Methods:
Patients diagnosed with mTNBC in the Surveillance, Epidemiology, and End Results database between 2010 and 2015 were included in the model construction. Univariate and multivariate logistic regression analysis was performed to identify risk factors associated with early death in patients with mTNBC and predictive prognostic nomograms were constructed. The accuracy of the nomograms was verified using receiver operating characteristic curves, and GiViTi Calibration belt plots were used to evaluate the model consistency. The clinical applicability of the nomograms was evaluated using decision curve analysis. On the basis of the predictive prognostic nomograms, a network survival rate calculator was developed for individualized survival prediction in patients with mTNBC.

Results:
A total of 2230 patients diagnosed with mTNBC were included in the Surveillance, Epidemiology, and End Results database for this study. After strict exclusion criteria, 1428 patients were found to be eligible for the study. All the patients were randomly divided into a training cohort and a validation cohort in a ratio of 7:3. Independent risk factors for mTNBC, including age, tumor size, brain metastasis, liver metastasis, surgery, and chemotherapy, were identified and integrated to construct the prediction nomogram and survival calculator. Results of receiver operating characteristic curves, calibration curves, and decision curve analysis curves from the training and validation cohort confirmed that the developed nomogram and web-based survival calculator in this study could accurately predict the probability of early death in patients with mTNBC.

Conclusions:
In this study, we developed a reliable prediction nomogram and web-based survival calculator for predicting the probability of early death in patients with mTNBC. These tools can assist clinical physicians in identifying high-risk patients and developing personalized treatment plans as early as possible.
Secondary Syphilis With Pulmonary Involvement
Authors: Öz Miraç , Absieha Nasser E. , Dilegelen Umut , Zengin Burak Alper , Gündüz Kaan , Evren Ebru , Saryal Sevgi 
Published: October 2023

Abstract
Syphilis is a multisystem infection caused by the spirochete Treponema pallidum. A 63-year-old man admitted to the hospital with chest pain and rashes on the chest wall and hands for 14 days. Thorax computed tomography revealed multiple nodular shadows in the bilateral lower lobes of the lung. Skin lesions were considered compatible with secondary syphilis.
The antibody test for syphilis was positive. Screening for other associated sexually transmitted diseases (serology for HIV, hepatitis C, and hepatitis B) was negative. A specific therapy with crystallized penicillin G 2.4 MIU was applied. The key features for secondary syphilis diagnosis were positive serologic tests for syphilis and complete recovery on thorax computed tomography after antisyphilitic treatment. Pulmonary involvement in secondary syphilis is considered a rare occurrence.
Misuse of Antibiotics in Dengue Fever—A Contributor to Antimicrobial Resistance?
Authors: Alosious Aaja , Luvis Mariya , Shaji Roshitha Ann , Tom Antriya Annie 
Published: October 2023

Abstract

Background
Dengue, a vector-borne viral infection, is a concern in the tropical and subtropical regions across the world. The rampant use of antibiotics in dengue patients in India reinforces the anticipated threat of emergence of antimicrobial resistance.

Aim
We aimed to retrospectively investigate the prescribing pattern of antibiotics and compare the clinical status of dengue patients treated with and without antibiotics.

Methods
Between January 2016 and December 2020 period, data of patients who tested positive for at least 1 of the 3 screening tests (nonstructural protein 1, immunoglobulin M, or immunoglobulin G) were collected from patient medical chart, and we assessed the clinical outcome of dengue patients treated with and without antibiotics.

Results
Of 370 patients, 196 (52.97%) were managed with antibiotics and 174 (47.02%) were managed without antibiotics along with other supportive measures. A peak in the percentage of prescriptions with antibiotics was seen in 2019, 168 (85.71%) were prescribed with a single antibiotic with a majority of them, and 56.6% received third generation cephalosporins. Only 46 (23.46%) had bacterial co-infection while 150 (76.53%) had no co-infection. Thirty-five patients (70%) with dengue hemorrhagic fever were clinically managed with antibiotics compared with 50% patients in the “dengue fever” category. Only 8% of patients with mild dengue were given 2 antibiotics, whereas 13% with moderate dengue and 16% with severe dengue were prescribed with 2 antibiotics.

Conclusions
The increased number of prescriptions with antibiotics for a viral infection when not recommended by the guideline may lead to emergence of antibiotic resistance in hospitals as well as community.
Burnout and Disengagement at Work Among Health Professionals—Interrelations and Associations With Stress Indicators and Job Resources
Authors: Hämmig Oliver 
Published: October 2023

Objective
The aim of the study is to explore common risk and protective factors of burnout and disengagement at work among healthcare workers.

Methods
Cross-sectional survey data of 1232 health professionals and employees of five public hospitals and rehabilitation clinics collected in 2015/16 in German-speaking Switzerland were used and analyzed. Different stress measures and job resources were studied as predictors of burnout and work engagement.

Results
Burnout was found to be largely explained by work stress (β = 0.22) and particularly by general stress (β = 0.54) whereas work engagement was only marginally determined by these stress indicators. Job autonomy or supervisor support on the other hand had no protective effect on burnout at all but a fairly strong predictive effect on work engagement (β = 0.27/0.23).

Conclusion
Burnout turned out to be mainly stress-induced whereas work engagement emerged largely as a result of job autonomy and supervisor support.
Orthosis vs. exercise for the treatment of adult idiopathic trigger fingers: A randomized clinical trial
Authors: Nadar Mohammed Sh. 
Published: October 2023

Objective:
Trigger finger is a common clinical disorder that often results in pain and functional limitations. This study aimed to determine whether joint-blocking orthosis was effective in treating adult idiopathic trigger fingers.

Methods:
Fifty-five participants were randomly assigned to either a hand therapy group or an orthosis group that immobilized the proximal interphalangeal joint for 6 weeks. The Green classification of triggering; short-form version of the Disabilities of the Arm, Shoulder, and Hand; and numeric pain rating scale were used to assess participants’ data.

Results:
The orthosis was “successful” in completely resolving the symptoms of trigger finger in 53.6% of the participants at 6 weeks postintervention, whereas the hand therapy control group did not result in any “successful” outcomes. The Green classification score for the orthosis group decreased from 2.68 (standard deviation = 0.47) at baseline to 0.93 (standard deviation = 1.12) at 6 weeks. The short-form version of the Disabilities of the Arm, Shoulder, and Hand disability score was significantly reduced after wearing the orthosis, F (2, 52) = 74.16 p < 0.001, and improved from baseline (M = 37.6) to 6 weeks (M = 20.26). The pain intensity score was also significantly decreased after wearing the orthosis, F (2, 52) = 52.17 p < 0.001, partial η2 = 0.67.

Conclusion:
Using orthosis to immobilize the proximal interphalangeal joint, day and night, for 6 weeks, is an effective and reasonable option for treating idiopathic trigger fingers with Green grade 2 or 3. Hand therapy without orthosis did not result in significant improvements.